Electromyography Recordings Reveal Muscle Activity in Flaccid Arm During Initial Days After Stroke

Papazian, Christina; Baicoianu, Nick A.; Peters, Keshia M.; Feldner, Heather A.; Steele, Katherine M.

doi:10.1016/j.apmr.2019.10.047

Cited by 2 publications

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“…This early technology intervention is also supported in the literature, and capitalizes on the principles of neuroplasticity routinely cited as drivers of clinical practice in current stroke rehabilitation ( 43 , 44 ). Further, given that detectable sEMG activity has been seen in flaccid limbs of stroke survivors days after stroke and prior to onset of voluntary muscle contraction, having this resource more readily available in acute recovery phases could serve to build hope and motivation for stroke survivors, in addition to providing information to the medical team about neural pathway integrity ( 45 ). Interestingly, participants in this study also discussed the relative “downtime” during recovery, despite their willingness to work on exercises or activities outside of scheduled therapy visits.…”

Section: Discussionmentioning

confidence: 99%

“It's All Sort of Cool and Interesting…but What Do I Do With It?” A Qualitative Study of Stroke Survivors' Perceptions of Surface Electromyography

et al. 2020

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Background: Stroke is one of the most common neurologic injuries worldwide. Over decades, evidence-based neurorehabilitation research and advancements in wireless, wearable sensor design have supported the deployment of technologies to facilitate recovery after stroke. Surface electromyography (sEMG) is one such technology, however, clinical application remains limited. To understand this translational practice gap and improve clinical uptake, it is essential to include stakeholder voices in an analysis of neurorehabilitation practice, the acceptability of current sEMG technologies, and facilitators and barriers to sEMG use in the clinic and the community. The purpose of this study was to foreground the perspectives of stroke survivors to gain a better understanding of their experiences in neurorehabilitation, the technologies they have used during their recovery, and their opinions of lab-designed and commercially-available sEMG systems. Methods: A qualitative, phenomenological study was completed. In-depth, semi-structured interviews were conducted with eight stroke survivors (age range 49-78 years, 6 months to 12 years post-stroke) and two caregivers from a large metropolitan region. A demonstration of four sEMG systems was provided to gather perceptions of sensor design, features and function, and user interface. Interviews were audio-recorded, transcribed verbatim, and coded for analysis using constant comparison until data saturation was reached. Results: Three themes emerged from the data: (1) "Surface EMG has potential….but…" highlights the recognition of sEMG as a valuable tool but reveals a lack of understanding and need for clear meaning from the data; (2) "Tracking incremental progress over days or years is important" highlights the persistence of hope and potential benefit of sEMG in detecting small changes that may inform neurorehabilitation practice and policy; and (3) "Neurorehabilitation technology is cumbersome" highlights the tension between optimizing therapy time and trying new technologies, managing cost, logistics and setup , and desired technology features. Feldner et al. Stroke Survivor Perceptions of sEMG Conclusion: Further translation of sEMG technology for neurorehabilitation holds promise for stroke survivors, but sEMG system design and user interface needs refinement. The process of using sEMG technology and products must be simple and provide meaningful insight to recovery. Including stroke survivors directly in translational efforts is essential to improve uptake in clinical environments.

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Section: Discussionmentioning

confidence: 99%

“It's All Sort of Cool and Interesting…but What Do I Do With It?” A Qualitative Study of Stroke Survivors' Perceptions of Surface Electromyography

et al. 2020

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“…We manually identified contractions for each muscle, marking the start and stop time and coding each contraction as during periods of movement or rest based upon concurrent accelerometer data. Details on the data collection, EMG processing, and analyses can be found in ( 29 , 30 ) and (REF), while here we aim to share key experiences in deploying this technology.…”

Section: Surface Emg In Acute Carementioning

confidence: 99%

Muscle Activity After Stroke: Perspectives on Deploying Surface Electromyography in Acute Care

2020

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After a stroke, clinicians and patients struggle to determine if and when muscle activity and movement will return. Surface electromyography (EMG) provides a non-invasive window into the nervous system that can be used to monitor muscle activity, but is rarely used in acute care. In this perspective paper, we share our experiences deploying EMG in the clinic to monitor stroke survivors. Our experiences have demonstrated that deploying EMG in acute care is both feasible and useful. We found that current technology can be used to comfortably and non-obtrusively monitor muscle activity, even for patients with no detectable muscle activity by traditional clinical assessments. Monitoring with EMG may help clinicians quantify muscle activity, track recovery, and inform rehabilitation. With further research, we perceive opportunities in using EMG to inform prognosis, enable biofeedback training, and provide metrics necessary for supporting and justifying care. To leverage these opportunities, we have identified important technical challenges and clinical barriers that need to be addressed. Affordable wireless EMG system that can provide high-quality data with comfortable, secure interfaces that can be worn for extended periods are needed. Data from these systems need to be quickly and automatically processed to create round-ready results that can be easily interpreted and used by the clinical team. We believe these challenges can be addressed by integrating and improving current methods and technology. Deploying EMG in the clinic can open new pathways to understanding and improving muscle activity and recovery for individuals with neurologic injury in acute care and beyond.

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Electromyography Recordings Reveal Muscle Activity in Flaccid Arm During Initial Days After Stroke

Cited by 2 publications

References 0 publications

“It's All Sort of Cool and Interesting…but What Do I Do With It?” A Qualitative Study of Stroke Survivors' Perceptions of Surface Electromyography

“It's All Sort of Cool and Interesting…but What Do I Do With It?” A Qualitative Study of Stroke Survivors' Perceptions of Surface Electromyography

Muscle Activity After Stroke: Perspectives on Deploying Surface Electromyography in Acute Care

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