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Many problems that fall in medical domains of inquiry have behavioral components that can be optimized to increase benefits for patients. For example, although surgical intervention is effective in reducing the pain resulting from osteoarthritis of the knee, patients often struggle to regain complete functional use of the joint. In this translational study, we point to some ways in which behavioral contingencies of reinforcement are compromised, making the recovery process more difficult. We also report on the use of surface electromyography (sEMG) with healthy participants to create supplementary contingencies of reinforcement to support the development and maintenance of clinically relevant exercises. The procedures reported provide a proof-ofconcept and can contribute to an increase in the systematic use of games and feedback in physical rehabilitation in recovery from knee surgery. The results of this translational study suggest an expanded role for applied behavior analysis in the domains of health and medicine.

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The number of total knee arthroplasties (TKA) performed yearly is rapidly increasing. Additionally, upwards of 50% of patients who receive TKA never achieve a full functional recovery. This suggests considerable room for improvement. This need for improvement expands beyond TKA as similar effects are noted across knee injuries. Electromyography-based biofeedback (EMGBF) involves the delivery of feedback based on the activity of targeted muscle. By providing feedback contingent on changes in muscle amplitude, EMGBF may be an effective tool for strengthening quadricep muscles. This review aims to evaluate the utility of sEMGBF during physical therapy for various knee injuries. All studies were evaluated for the effectiveness of sEMGBF at improving muscle strength, range of motion, and reducing pain.Most studies reviewed found that including sEMGBF in physical therapy produced greater clinical benefits for patients than exercise alone. Further research is necessary to determine the best practice for including EMGBF in physical therapy.