Surface Electromyography Applied to Gait Analysis: How to Improve Its Impact in Clinics?

Agostini, Valentina; Ghislieri, Marco; Rosati, Samanta; Balestra, Gabriella; Knaflitz, Marco

doi:10.3389/fneur.2020.00994

Cited by 43 publications

(28 citation statements)

References 93 publications

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“…Nevertheless, the sample of responders was relatively large (n = 28) and included experts in pediatric rehabilitation: physical therapists, neuro-developmental disorders therapists, and medical doctors ( Figure 4A, left panel). It is also worth noting that many of the barriers for the sEMG use were acknowledged for other populations of patients as well [see, for instance, other articles in this research project: (140)(141)(142)(143)(144)(145)]. Therefore, a general need for this innovative technology suggests that "specific education should be part of the rehabilitation professionals' curriculum" (142).…”

Section: Discussionmentioning

confidence: 97%

Clinical Relevance of State-of-the-Art Analysis of Surface Electromyography in Cerebral Palsy

et al. 2020

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Surface electromyography (sEMG) can be used to assess the integrity of the neuromuscular system and its impairment in neurological disorders. Here we will consider several issues related to the current clinical applications, difficulties and limited usage of sEMG for the assessment and rehabilitation of children with cerebral palsy. The uniqueness of this methodology is that it can determine hyperactivity or inactivity of selected muscles, which cannot be assessed by other methods. In addition, it can assist for intervention or muscle/tendon surgery acts, and it can evaluate integrated functioning of the nervous system based on multi-muscle sEMG recordings and assess motor pool activation. The latter aspect is especially important for understanding impairments of the mechanisms of neural controllers rather than malfunction of individual muscles. Although sEMG study is an important tool in both clinical research and neurorehabilitation, the results of a survey on the clinical relevance of sEMG in a typical department of pediatric rehabilitation highlighted its limited clinical usage. We believe that this is due to limited knowledge of the sEMG and its neuromuscular underpinnings by many physiotherapists, as a result of lack of emphasis on this important methodology in the courses taught in physical therapy schools. The lack of reference databases or benchmarking software for sEMG analysis may also contribute to the limited clinical usage. Despite the existence of educational and technical barriers to a widespread use of, sEMG does provide important tools for planning and assessment of rehabilitation treatments for children with cerebral palsy.

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Section: Discussionmentioning

confidence: 97%

Clinical Relevance of State-of-the-Art Analysis of Surface Electromyography in Cerebral Palsy

et al. 2020

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“…Indeed, these abnormal strides can initiate with a forefoot strike, usually complicating the analysis. However, systems specifically designed for clinical gait analysis can overcome this challenge [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous works using Statistical Gait Analysis (SGA) also rely on sessions of continuous walk, recording foot-switch signals for several minutes [ 29 , 30 , 31 ], along a path including both straight-line walking and turnings. However, the analysis is then usually limited to straight-line walking alone.…”

Section: Introductionmentioning

confidence: 99%

Atypical Gait Cycles in Parkinson’s Disease

Ghislieri

Agostini

Rizzi

et al. 2021

Sensors

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It is important to find objective biomarkers for evaluating gait in Parkinson’s Disease (PD), especially related to the foot and lower leg segments. Foot-switch signals, analyzed through Statistical Gait Analysis (SGA), allow the foot-floor contact sequence to be characterized during a walking session lasting five-minutes, which includes turnings. Gait parameters were compared between 20 PD patients and 20 age-matched controls. PDs showed similar straight-line speed, cadence, and double-support compared to controls, as well as typical gait-phase durations, except for a small decrease in the flat-foot contact duration (−4% of the gait cycle, p = 0.04). However, they showed a significant increase in atypical gait cycles (+42%, p = 0.006), during both walking straight and turning. A forefoot strike, instead of a “normal” heel strike, characterized the large majority of PD’s atypical cycles, whose total percentage was 25.4% on the most-affected and 15.5% on the least-affected side. Moreover, we found a strong correlation between the atypical cycles and the motor clinical score UPDRS-III (r = 0.91, p = 0.002), in the subset of PD patients showing an abnormal number of atypical cycles, while we found a moderate correlation (r = 0.60, p = 0.005), considering the whole PD population. Atypical cycles have proved to be a valid biomarker to quantify subtle gait dysfunctions in PD patients.

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“…Despite the aforementioned advantages, and the market availability of wireless, lightweight and minimally invasive sEMG measurement equipment, such as the Myon [17] or the Freeemg [18] devices, sEMG has not witnessed a pervasive and widespread adoption in clinical assessment or rehabilitation yet. This is motivated by education barrier, i.e., understanding the features and information associated with electrical signals measured on the body may be not easy or straightforward by clinical operators [19,20]. Additional complexity is determined by the possibility to apply a huge variety of parameters, indices and figures, differently defined and computed from the measured sEMG signal samples, according to the specific muscle feature or activation pattern one is interested to observe [21].…”

Section: Indices For Semg Variability Analysismentioning

confidence: 99%

Variability of Muscular Recruitment in Hemiplegic Walking Assessed by EMG Analysis

et al. 2020

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Adaptive variability during walking is typical of child motor development. It has been reported that neurological disorders could affect this physiological phenomenon. The present work is designed to assess the adaptive variability of muscular recruitment during hemiplegic walking and to detect possible changes compared to control populations. In the attempt of limiting the complexity of computational procedure, the easy-to-measure coefficient of variation (CV) index is adopted to assess surface electromyography (sEMG) variability. The target population includes 34 Winters’ type I and II hemiplegic children (H-group). Two further healthy populations, 34 age-matched children (C-group) and 34 young adults (A-group), are involved as controls. Results show a significant decrease (p < 0.05) of mean CV for gastrocnemius lateralis (GL) in H-group compared to both C-group (15% reduction) and A-group (35% reduction). Reductions of mean CV are detected also for tibialis anterior (TA) in H-group compared to C-group (7% reduction, p > 0.05) and A-group (15% reduction, p < 0.05). Lower CVs indicate a decreased intra-subject variability of ankle-muscle activity compared to controls. Novel contribution of the study is twofold: (1) To propose a CV-based approach for an easy-to-compute assessment of sEMG variability in hemiplegic children, useful in different experimental environments and different clinical purposes; (2) to provide a quantitative assessment of the reduction of intra-subject variability of ankle-muscle activity in mild-hemiplegic children compared to controls (children and adults), suggesting that hemiplegic children present a limited capability of adapting their muscle recruitment to the different stimuli met during walking task. This finding could be very useful in deepening the knowledge of this neurological disorder.

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Surface Electromyography Applied to Gait Analysis: How to Improve Its Impact in Clinics?

Cited by 43 publications

References 93 publications

Clinical Relevance of State-of-the-Art Analysis of Surface Electromyography in Cerebral Palsy

Clinical Relevance of State-of-the-Art Analysis of Surface Electromyography in Cerebral Palsy

Atypical Gait Cycles in Parkinson’s Disease

Variability of Muscular Recruitment in Hemiplegic Walking Assessed by EMG Analysis

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