Quantitative Assessment of Traumatic Upper-Limb Peripheral Nerve Injuries Using Surface Electromyography

Abstract

Background: There is a great demand for convenient and quantitative assessment of upper-limb traumatic peripheral nerve injuries (PNIs) beyond their clinical routine. This would contribute to improved PNI management and rehabilitation. Objective: The aim of this study was to develop a novel surface EMG examination method for quantitatively evaluating traumatic upper-limb PNIs. Methods: Experiments were conducted to collect surface EMG data from forearm muscles on both sides of seven male subjects during their performance of eight designated hand and wrist motion tasks. All participants were clinically diagnosed as unilateral traumatic upper-limb PNIs on the ulnar nerve, median nerve, or radial nerve. Ten healthy control participants were also enrolled in the study. A novel framework consisting of two modules was also proposed for data analysis. One module was first used to identify whether a PNI occurs on a tested forearm using a machine learning algorithm by extracting and classifying features from surface EMG data. The second module was then used to quantitatively evaluate the degree of injury on three individual nerves on the examined arm. Results: The evaluation scores yielded by the proposed method were highly consistent with the clinical assessment decisions for three nerves of all 34 examined arms (7 × 2 + 10 × 2), with a sensitivity of 81.82%, specificity of 98.90%, and significate linear correlation (p < 0.05) in quantitative decision points between the proposed method and the routine clinical approach. Conclusion: This study offers a useful tool for PNI assessment and helps to promote extensive clinical applications of surface EMG.

Automatic detection of abnormal hand gestures in patients with radial, ulnar, or median nerve injury using hand pose estimation

“…It can provide expertise more conveniently and spread expert knowledge to primary healthcare providers. Tang et al ( 11 ) reported a quantitative assessment method for upper-limb traumatic PNI. In their study, the presence of radial, ulnar, or median nerve injury was identified under an expert system using the data of surface EMG with 81.82% sensitivity and 98.90% specificity.…”

“…The clinical diagnosis of nerve injury depends on clinical history, clinical symptoms, and physical and neurological examinations ( 7 , 8 ). Among the examinations, electromyography (EMG), nerve conduction studies (NCS), MRI, and high-resolution ultrasonography have been successfully used as diagnostic methods for PNI ( 9 – 11 ). However, these examinations are expensive, invasive, and rely on specialized equipment and professional operators, restricting their application in primary assessment.…”

A scoping review of current and emerging techniques for evaluation of peripheral nerve health, degeneration, and regeneration: part 1, neurophysiology

“…Instrumentation complexities have hindered clinical uptake but use in research is gathering pace [209] and not only due to its painless nature. It provides many opportunities for gathering significant amounts of useful data, including longitudinal monitoring, wireless data capture, and muscle activation patterns [210,211].…”

Multichannel microneedle dry electrode patches for minimally invasive transdermal recording of electrophysiological signals

“…For instance, EMG signals can reflect the activity and functional status of muscles, making them invaluable in clinical diagnostics and rehabilitation training within the neuromuscular system 4,5 . By examining EMG signals from affected areas, parameters such as denervation potentials and nerve conduction velocity can be obtained, aiding in assessing the extent of a nerve injury 6,7 . Additionally, in rehabilitation training, monitoring EMG signals provides quantitative information about muscle electromyographic output, assisting healthcare professionals in developing precise treatment and rehabilitation plans 8 .…”