Less is More: Reducing Biofeedback Frequency to Facilitate Acquisition and Retention of the Mendelsohn Maneuver in Healthy Adults

Abstract

Introduction: Past studies have shown that biofeedback can facilitate dysphagic patients in acquiring swallowing maneuvers. However, it is unclear how frequent we should provide such biofeedback. Motor learning studies have shown that consistent feedback may facilitate the acquisition of a new motor task but hinder the longterm retention of the acquired motor skills. The current study aimed to compare the effect of bandwidth feedback (individualized reduced feedback frequency schedule) and consistent feedback on acquisition and retention of Mendelsohn maneuver. Material & Methods: Thirty healthy adults were assigned to a bandwidth feedback group (n=15) or a consistent feedback group (n=15). In the first session, participants were first instructed to perform the Mendelsohn maneuvers without any feedback (baseline assessment), followed by an acquisition phase with 3 training blocks and finally, an immediate retention phase where feedback was removed. All participants returned for a delayed retention phase a week later. During the acquisition phase, the consistent feedback group received game-based sEMG signal as feedback in all trials but the bandwidth feedback group only received feedback when the performance deviated from an acceptable bandwidth of error. Results: The performance accuracy of each group in each phase was calculated and compared. Both groups had significant improvement after training (p<0.05). The bandwidth feedback group had significantly better performance than the consistent feedback group in the delayed retention phase with strong effect size (r=.56). Conclusions: The current study supports the use of an individualized feedback frequency schedule to facilitate the acquisition and retention of Mendelsohn maneuver.