The use of surface electromyography (SEMG) has increased exponentially in the past four decades. SEMG is one of the most widespread measures employed today in psychophysiological assessment and one of three primary biofeedback modalities. This article briefly outlines three areas that the author believes are important for SEMG to address if it is to continue to flourish in the future: applications in telehealth, the use of telemetry and ambulatory monitoring, and studies on the stability or reliability of surface electromyography.Surface electromyography (SEMG) has become one of the most widely used tools in psychophysiological assessment and in clinical biofeedback treatment. The present article examines three areas critical to the expanded clinical and research role of SEMG: the use of SEMG in telehealth, the use of telemetry and ambulatory SEMG monitoring, and evidence for the temporal stability or reliability of SEMG measures.
Applications in TelehealthTelehealth, a relatively new medium for treatment delivery, has become more widely available and utilized in the past decade. Telehealth involves the use of highresolution television cameras and monitors and high-speed communications lines to deliver treatment over a distance. This delivery system allows the clinician to remain in his or her office or medical facility while the patient is seen at a remote site nearer to the patient's home or work. This technology potentially has the advantage of saving both the patient and the provider considerable time, effort, and monetary cost (i.e., travel time and associated expenses). In relatively large states, provinces, or countries with sizable and broadly dispersed rural populations, such direct and indirect cost savings could be considerable. These savings are, of course, predicated on the assumption that the telemedicine-delivered treatment is as efficacious as the office-based intervention. Arena and Stoddard (in press) have delineated some pitfalls in the use of telehealth psychophysiological applications, including (a) privacy and meeting HIPAA requirements, (b) state licensing board requirements and malpractice insurance, (c) providers' comfort levels, (d) insurance reimbursement, (e) informed consent, and (f) use of support personnel.Although this is likely the key direction that SEMG biofeedback and, indeed, biofeedback in general will be going in the future, there have been few applications of biofeedback in telehealth. Earles, Folen, and James (2001) described a videophone procedure for psychotherapy and psychophysiological treatment used in the military. They also presented three uncontrolled case reports: two patients suffering from vascular headache and another from irritable bowel syndrome. The two headache patients decreased their headache activity by 50% each and reported improved mood. All patients had both office and telemedicine sessions and reported no difference between the office and telemedicine settings. Folen, James, Earles, and Andrasik (2001) presented some data on two headache patients: on...