Manzur-Valdivia Hachi, Alvarez-Ruf Joel
Red de Salud Universidad Católica-Christus, Santiago, Chile.
Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.
Front Neurol. 2020 Oct 15;11:578829. doi: 10.3389/fneur.2020.578829. eCollection 2020.
Surface electromyography (sEMG) has long been used in research, health care, and other fields such as ergonomics and brain-machine interfaces. In health care, sEMG has been employed to diagnose as well as to treat musculoskeletal disorders, pelvic floor dysfunction, and post-stroke motor deficits, among others. Despite the extensive literature on sEMG, the clinical community has not widely adopted it. We believe that in developing countries, such as Chile, this phenomenon may be explained by several interacting barriers. First, the socioeconomics of the country creates an environment where only high cost-effective treatments are routinely applied. Second, the majority of the sEMG literature on clinical applications has not extensively translated into decisive outcomes, which interferes with its applicability in low-income contexts. Third, clinical training on rehabilitation provides inadequate instruction on sEMG. And fourth, accessibility to equipment (i.e., affordability, availability, portability) may constitute another barrier, especially among developing countries. Here, we analyze socio-economic indicators of health care in Chile and comment on current literature about the use of sEMG in rehabilitation. Then we analyze the curricula of several physical therapy schools in Chile and report some estimations of the training on sEMG. Finally, we analyze the accessibility of some available sEMG devices and show that several match predefined criteria. We conclude that in developing countries, the insufficient use of sEMG in health might be explained by a shortage of evidence showing a crucial role in specific outcomes and the lack of training in rehabilitation-related careers, which interact with local socioeconomic factors that limit the application of these techniques.
表面肌电图（sEMG）长期以来一直用于研究、医疗保健以及人体工程学和脑机接口等其他领域。在医疗保健领域，sEMG已被用于诊断和治疗肌肉骨骼疾病、盆底功能障碍以及中风后运动功能缺陷等。尽管关于sEMG的文献众多，但临床界尚未广泛采用它。我们认为，在智利等发展中国家，这种现象可能由几个相互作用的障碍来解释。首先，该国的社会经济状况营造了一种环境，即只有高性价比的治疗方法才会被常规应用。其次，大多数关于临床应用的sEMG文献尚未广泛转化为决定性的成果，这妨碍了其在低收入环境中的适用性。第三，康复方面的临床培训对sEMG的指导不足。第四，设备的可及性（即可承受性、可用性、便携性）可能构成另一个障碍，尤其是在发展中国家。在此，我们分析智利医疗保健的社会经济指标，并对当前关于sEMG在康复中应用的文献进行评论。然后我们分析智利几所物理治疗学校的课程，并报告一些关于sEMG培训的估计情况。最后，我们分析一些现有sEMG设备的可及性，并表明其中几种符合预先定义的标准。我们得出结论，在发展中国家，健康领域对sEMG使用不足可能是由于缺乏证据表明其在特定结果中起关键作用，以及康复相关职业缺乏培训，这些因素与限制这些技术应用的当地社会经济因素相互作用。
