McManus Lara, De Vito Giuseppe, Lowery Madeleine M
Neuromuscular Systems Laboratory, School of Electrical and Electronic Engineering, University College Dublin, Dublin, Ireland.
Neuromuscular Physiology Laboratory, Department of Biomedical Sciences, University of Padova, Padova, Italy.
Front Neurol. 2020 Oct 15;11:576729. doi: 10.3389/fneur.2020.576729. eCollection 2020.
Recent decades have seen a move toward evidence-based medicine to inform the clinical decision-making process with reproducible findings from high-quality research studies. There is a need for objective, quantitative measurement tools to increase the reliability and reproducibility of studies evaluating the efficacy of healthcare interventions, particularly in the field of physical and rehabilitative medicine. Surface electromyography (sEMG) is a non-invasive measure of muscle activity that is widely used in research but is under-utilized as a clinical tool in rehabilitative medicine. Other types of electrophysiological signals (e.g., electrocardiography, electroencephalography, intramuscular EMG) are commonly recorded by healthcare practitioners, however, sEMG has yet to successfully transition to clinical practice. Surface EMG has clear clinical potential as an indicator of muscle activation, however reliable extraction of information requires knowledge of the appropriate methods for recording and analyzing sEMG and an understanding of the underlying biophysics. These concepts are generally not covered in sufficient depth in the standard curriculum for physiotherapists and kinesiologists to encourage a confident use of sEMG in clinical practice. In addition, the common perception of sEMG as a specialized topic means that the clinical potential of sEMG and the pathways to application in practice are often not apparent. The aim of this paper is to address barriers to the translation of sEMG by emphasizing its benefits as an objective clinical tool and by overcoming its perceived complexity. The many useful clinical applications of sEMG are highlighted and examples provided to illustrate how it can be implemented in practice. The paper outlines how fundamental biophysics and EMG signal processing concepts could be presented to a non-technical audience. An accompanying tutorial with sample data and code is provided which could be used as a tool for teaching or self-guided learning. The importance of observing sEMG in routine use in clinic is identified as an essential part of the effective communication of sEMG recording and signal analysis methods. Highlighting the advantages of sEMG as a clinical tool and reducing its perceived complexity could bridge the gap between theoretical knowledge and practical application and provide the impetus for the widespread use of sEMG in clinic.
近几十年来，人们已朝着循证医学的方向发展，以便利用高质量研究的可重复结果为临床决策过程提供依据。需要客观、定量的测量工具来提高评估医疗保健干预措施疗效的研究的可靠性和可重复性，特别是在物理和康复医学领域。表面肌电图（sEMG）是一种肌肉活动的非侵入性测量方法，在研究中广泛使用，但在康复医学中作为临床工具的应用却未得到充分利用。医疗从业者通常会记录其他类型的电生理信号（如心电图、脑电图、肌内肌电图），然而，sEMG尚未成功过渡到临床实践。表面肌电图作为肌肉激活的指标具有明显的临床潜力，然而，可靠地提取信息需要了解记录和分析sEMG的适当方法以及对基础生物物理学的理解。在物理治疗师和运动机能学家的标准课程中，这些概念通常没有得到足够深入的涵盖，难以鼓励在临床实践中自信地使用sEMG。此外，人们普遍认为sEMG是一个专业话题，这意味着sEMG的临床潜力以及在实践中的应用途径往往并不明显。本文旨在强调sEMG作为一种客观临床工具的益处，并克服其被认为的复杂性，以解决sEMG转化应用的障碍。文中突出了sEMG许多有用的临床应用，并提供了示例来说明其在实践中如何实施。本文概述了如何向非专业受众介绍基础生物物理学和肌电图信号处理概念。还提供了一个附带的教程，其中包含示例数据和代码，可作为教学或自主学习的工具。在临床常规使用中观察sEMG的重要性被视为有效传达sEMG记录和信号分析方法的重要组成部分。突出sEMG作为临床工具的优势并降低其被认为的复杂性，可以弥合理论知识与实际应用之间的差距，并为sEMG在临床中的广泛应用提供动力。
