Dataset Information

A Survey on the Use and Barriers of Surface Electromyography in Neurorehabilitation.

ABSTRACT: Historical, educational, and technical barriers have been reported to limit the use of surface electromyography (sEMG) in clinical neurorehabilitation settings. In an attempt to identify, review, rank, and interpret potential factors that may play a role in this scenario, we gathered information on (1) current use of sEMG and its clinical potential; (2) professional figures primarily dealing with sEMG; (3) educational aspects, and (4) possible barriers and reasons for its apparently limited use in neurorehabilitation. To this aim, an online 30-question survey was sent to 52 experts on sEMG from diverse standpoints, backgrounds, and countries. Participants were asked to respond to each question on a 5-point Likert scale or by ranking items. A cut-off of 75% agreement was chosen as the consensus threshold. Thirty-five invitees (67%) completed the electronic survey. Consensus was reached for 77% of the proposed questions encompassing current trends in sEMG use in neurorehabilitation, educational, technical, and methodological features as well as its translational utility for clinicians and patients. Data evidenced the clinical utility of sEMG for patient assessment, to define the intervention plan, and to complement/optimize other methods used to quantify muscle and physical function. The aggregate opinion of the interviewed experts confirmed that sEMG is more frequently employed in technical/methodological than clinical research. Moreover, the slow dissemination of research findings and the lack of education on sEMG seem to prevent prompt transfer into practice. The findings of the present survey may contribute to the ongoing debate on the appropriateness and value of sEMG for neurorehabilitation professionals and its potential translation into clinical settings.

SUBMITTER: Manca A

PROVIDER: S-EPMC7566898 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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A Survey on the Use and Barriers of Surface Electromyography in Neurorehabilitation.

Manca Andrea A Cereatti Andrea A Bar-On Lynn L Botter Alberto A Della Croce Ugo U Knaflitz Marco M Maffiuletti Nicola A NA Mazzoli Davide D Merlo Andrea A Roatta Silvestro S Turolla Andrea A Deriu Franca F

Frontiers in neurology 20201002

Historical, educational, and technical barriers have been reported to limit the use of surface electromyography (sEMG) in clinical neurorehabilitation settings. In an attempt to identify, review, rank, and interpret potential factors that may play a role in this scenario, we gathered information on (1) current use of sEMG and its clinical potential; (2) professional figures primarily dealing with sEMG; (3) educational aspects, and (4) possible barriers and reasons for its apparently limited use ...[more]

PMID: 33123079

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Project description:This article addresses the potential clinical value of techniques based on surface electromyography (sEMG) in rehabilitation medicine with specific focus on neurorehabilitation. Applications in exercise and sport pathophysiology, in movement analysis, in ergonomics and occupational medicine, and in a number of related fields are also considered. The contrast between the extensive scientific literature in these fields and the limited clinical applications is discussed. The "barriers" between research findings and their application are very broad, and are longstanding, cultural, educational, and technical. Cultural barriers relate to the general acceptance and use of the concept of objective measurement in a clinical setting and its role in promoting Evidence Based Medicine. Wide differences between countries exist in appropriate training in the use of such quantitative measurements in general, and in electrical measurements in particular. These differences are manifest in training programs, in degrees granted, and in academic/research career opportunities. Educational barriers are related to the background in mathematics and physics for rehabilitation clinicians, leading to insufficient basic concepts of signal interpretation, as well as to the lack of a common language with rehabilitation engineers. Technical barriers are being overcome progressively, but progress is still impacted by the lack of user-friendly equipment, insufficient market demand, gadget-like devices, relatively high equipment price and a pervasive lack of interest by manufacturers. Despite the recommendations provided by the 20-year old EU project on "Surface EMG for Non-Invasive Assessment of Muscles (SENIAM)," real international standards are still missing and there is minimal international pressure for developing and applying such standards. The need for change in training and teaching is increasingly felt in the academic world, but is much less perceived in the health delivery system and clinical environments. The rapid technological progress in the fields of sensor and measurement technology (including sEMG), assistive devices, and robotic rehabilitation, has not been driven by clinical demands. Our assertion is that the most important and urgent interventions concern enhanced education, more effective technology transfer, and increased academic opportunities for physiotherapists, occupational therapists, and kinesiologists.

Project description:The variability of electromyographic (EMG) recordings between and within participants is a complex problem, rarely studied in swimming. The importance of signal normalization has long been recognized, but the method used might influence variability. The aims of this study were to: (i) assess the intra-individual variability of the EMG signal in highly skilled front crawl swimmers, (ii) determine the influence of two methods of both amplitude and time normalization of the EMG signal on intra-individual variability and of time normalization on muscle activity level and (iii) describe the muscle activity, normalized using MVIC, in relation to upper limb crawl stroke movements. Muscle activity of rectus abdominis and deltoideus medialis was recorded using wireless surface EMG in 15 adult male competitive swimmers during three trials of 12.5 m front crawl at maximal speed without breathing. Two full upper limb cycles were analyzed from each of the swimming trials, resulting in six full cycles used for the intra-individual variability assessment, quantified with the coefficient of variation (CV), coefficient of quartile variation (CQV) and the variance ratio (VR). The results of this study support previous findings on EMG patterns of deltoideus medialis and rectus abdominis as prime mover during the recovery (45% activity relative to MVIC), and stabilizer of the trunk during the pull (14.5% activity) respectively. The intra-individual variability was lower (VR of 0.34-0.47) when compared to other cyclic movements. No meaningful differences were found between variability measures CV or VR when applying either of the amplitude or the time normalization methods. In addition to reporting the mean amplitude and standard deviation, future EMG studies in swimming should also report the intra-individual variability, preferably using VR as it is independent of peak amplitude, provides a good measure of repeatability and is insensitive to mean EMG amplitude and the degree of smoothing applied.

Dataset Information

A Survey on the Use and Barriers of Surface Electromyography in Neurorehabilitation.

Publications

A Survey on the Use and Barriers of Surface Electromyography in Neurorehabilitation.

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