Electromyographic activity of the vastus intermedius muscle in patients with stiff-knee gait after stroke. A retrospective observational study

Mazzoli, Davide; Giannotti, E.; Manca, M.; Longhi, Maria Serena; Prati, P.; Cosma, M.; Ferraresi, G.; Morelli, Moreno; Zerbinati, Paolo; Masiero, Stefano; Merlo, Andrea

doi:10.1016/j.gaitpost.2017.07.002

Cited by 21 publications

(12 citation statements)

References 32 publications

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“…Gait analysis is a functional evaluation that provides a quantification of the observed performance and identifies motor deficits and the underlying causes of the observed pathological patterns [58][59][60]. This evaluation allows for the formulation of a precise and targeted therapeutic plan, such as surgical, pharmacological, orthotics or physiotherapy plans [57,58,[61][62][63][64]. In the study of muscle activation during the gait of neurological patients, it is of paramount importance to avoid common errors that could possibly lead to incorrect clinical decisions [39,65,66].…”

Section: Issues Of Bipolar Semg Detection In Neurorehabilitation Appl...mentioning

confidence: 99%

Fundamental Concepts of Bipolar and High-Density Surface EMG Understanding and Teaching for Clinical, Occupational, and Sport Applications: Origin, Detection, and Main Errors

Campanini

Merlo

Disselhorst‐Klug

et al. 2022

Sensors

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Surface electromyography (sEMG) has been the subject of thousands of scientific articles, but many barriers limit its clinical applications. Previous work has indicated that the lack of time, competence, training, and teaching is the main barrier to the clinical application of sEMG. This work follows up and presents a number of analogies, metaphors, and simulations using physical and mathematical models that provide tools for teaching sEMG detection by means of electrode pairs (1D signals) and electrode grids (2D and 3D signals). The basic mechanisms of sEMG generation are summarized and the features of the sensing system (electrode location, size, interelectrode distance, crosstalk, etc.) are illustrated (mostly by animations) with examples that teachers can use. The most common, as well as some potential, applications are illustrated in the areas of signal presentation, gait analysis, the optimal injection of botulinum toxin, neurorehabilitation, ergonomics, obstetrics, occupational medicine, and sport sciences. The work is primarily focused on correct sEMG detection and on crosstalk. Issues related to the clinical transfer of innovations are also discussed, as well as the need for training new clinical and/or technical operators in the field of sEMG.

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Section: Issues Of Bipolar Semg Detection In Neurorehabilitation Appl...mentioning

confidence: 99%

Fundamental Concepts of Bipolar and High-Density Surface EMG Understanding and Teaching for Clinical, Occupational, and Sport Applications: Origin, Detection, and Main Errors

Campanini

Merlo

Disselhorst‐Klug

et al. 2022

Sensors

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“…Next, the recruitment of dorsiflexor muscles during walking, regardless of their voluntary activation during tests at the besides, is useful to further tune the surgical plan (e.g., split and transfer of the tibialis anterior tendon) ( 66 , 148 ). Similarly, sEMG of the quadriceps muscle during walking can be used to support the clinical assessment for selecting the best treatment for stiff-knee gait ( 22 , 65 ). In stroke survivors, surface EMG can also have a fundamental role in the planning of functional surgery of the upper limb, to support the surgeon's decision about which muscle to lengthen and which muscle insertion to transfer ( 64 ).…”

Section: Surface Emg Applicationsmentioning

confidence: 99%

Surface EMG in Clinical Assessment and Neurorehabilitation: Barriers Limiting Its Use

et al. 2020

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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.

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“…For each patient, the surgical procedure was decided based on both clinical and instrumental gait assessment with gait analysis and dynamic EMG ( 11 , 19 ). The complete description of the surgical procedures is provided in Supplementary Data .…”

Section: Methodsmentioning

confidence: 99%

Surgical quadriceps lengthening can reduce quadriceps spasticity in chronic stroke patients. A case-control study

Merlo¹,

Galletti²,

Zerbinati³

et al. 2022

Front. Neurol.

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BackgroundMuscle overactivity is one of the positive signs of upper motor neuron lesions. In these patients, the loss of muscle length and extensibility resulting from soft tissue rearrangement has been suggested as a contributing cause of muscle overactivity in response to stretching.ObjectiveTo assess the effects of surgical lengthening of the quadriceps femoris (QF) muscle-tendon unit by aponeurectomy on muscle spasticity.MethodsThis is a case-control study on chronic stroke patients with hemiparesis that have undergone lower limb functional surgery over a 8-year period. CASEs underwent corrective surgery for both the foot and knee deviations, inclusive of a QF aponeurectomy. Controls (CTRLs) underwent corrective surgery for foot deviations only. QF spasticity was assessed with the Modified Tardieu Scale (MTS) before and 1 month after surgery. The Wilcoxon test was used to assess MTS variations over time and the Mann–Whitney test was used to verify the presence of group differences at the 1 month mark.ResultsNinety-three patients were included: 57 cases (30F, 1–34 years from lesion) and 36 controls (12F, 1–35 years from lesion). Before surgery, both CASEs and CTRLs had similar MTS scores (median MTS = 3) and functional characteristics. One month after surgery, QF spasticity was significantly lower in the CASEs compared to CTRLs (p = 0.033) due to a significant reduction of the median MTS score from 3 to 0 in the CASE group (p < 0.001) and no variations in the CTRL group (p = 0.468). About half of the cases attained clinically significant MTS reductions and complete symptom relief even many years from the stroke.ConclusionsFunctional surgery inclusive of QF aponeurectomy can be effective in reducing or suppressing spasticity in chronic stroke patients. This is possibly a result of the reduction in neuromuscular spindle activation due to a decrease in muscle shortening, passive tension, and stiffness.

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Electromyographic activity of the vastus intermedius muscle in patients with stiff-knee gait after stroke. A retrospective observational study

Cited by 21 publications

References 32 publications

Fundamental Concepts of Bipolar and High-Density Surface EMG Understanding and Teaching for Clinical, Occupational, and Sport Applications: Origin, Detection, and Main Errors

Fundamental Concepts of Bipolar and High-Density Surface EMG Understanding and Teaching for Clinical, Occupational, and Sport Applications: Origin, Detection, and Main Errors

Surface EMG in Clinical Assessment and Neurorehabilitation: Barriers Limiting Its Use

Surgical quadriceps lengthening can reduce quadriceps spasticity in chronic stroke patients. A case-control study

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