Use of Surface EMG in Clinical Rehabilitation of Individuals With SCI: Barriers and Future Considerations

Frontiers in Neurology, 2020 · DOI: 10.3389/fneur.2020.578559 · Published: December 18, 2020

Simple Explanation

Surface electromyography (sEMG) is a technique used to measure the electrical activity of muscles. While it's useful in research, it's not widely used in clinics for people with spinal cord injuries (SCI). This is due to barriers such as time constraints for clinicians and lack of confidence in using the technology. Technical challenges also contribute, including slow technology transfer from research to clinical systems and the need for a multidisciplinary approach to interpret data. Specific challenges related to SCI include non-standardized approaches to recording and interpreting EMGs. Addressing these barriers requires a collaborative approach, including enhancing user experience through revised curricula, hands-on research involvement, and a common platform for clinicians and technicians to share knowledge.

Study Duration

Not specified

Participants

22 clinicians in one study, 35 EMG experts in another

Evidence Level

Perspective

Key Findings

1
Limited clinician time is a significant barrier to the uptake of sEMG technology in clinics due to time-consuming setup and data collection processes.
2
Many clinicians lack sufficient background and training in sEMG technology through professional curricula, leading to a lack of confidence in its utilization.
3
There is a lack of technology transfer from research to clinical practice, with many existing sEMG systems not implementing advanced EMG analysis techniques.

Research Summary

This perspective discusses barriers restricting the widespread use of sEMG in clinical rehabilitation of individuals with spinal cord injury (SCI). The barriers include time-consuming aspects of sEMG, lack of clinician confidence due to limited exposure and mathematical foundation, and technical challenges such as limited technology transfer and lack of user-friendly interfaces. Addressing these barriers requires a collaborative, interdisciplinary approach, including enhancing user experience, knowledge sharing, and revised curricula.

Practical Implications

Curriculum Enhancement

Integrate hands-on sEMG experience in educational programs through case studies and research projects.

Knowledge Sharing Platform

Create a centralized knowledge-base for clinicians to develop their understanding of sEMG and interact with researchers.

Standardized EMG Ranking System

Develop a standardized sEMG ranking system to quantify residual neuromuscular output during FES-based rehabilitation for SCI.

Study Limitations

1
Limited spatial resolution of sEMG results in poor fidelity recordings of high-frequency signals.
2
Electrical cross-talk between neighboring muscles restricts sEMG's ability to identify the origin of the electrical signal.
3
Existing off-the-shelf systems are not specifically tuned to address SCI-specific challenges, such as stimulation artifact during FES.

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