Cappellini Germana, Sylos-Labini Francesca, Assenza Carla, Libernini Laura, Morelli Daniela, Lacquaniti Francesco, Ivanenko Yury
Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy.
Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy.
Front Neurol. 2020 Dec 11;11:583296. doi: 10.3389/fneur.2020.583296. eCollection 2020.
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.
表面肌电图（sEMG）可用于评估神经肌肉系统的完整性及其在神经系统疾病中的损伤情况。在此，我们将探讨与sEMG在脑瘫儿童评估和康复中的当前临床应用、困难及有限用途相关的几个问题。该方法的独特之处在于它能够确定选定肌肉的活动亢进或活动不足，而这是其他方法无法评估的。此外，它可辅助进行干预或肌肉/肌腱手术操作，还能基于多肌肉sEMG记录评估神经系统的综合功能以及运动神经元池的激活情况。后一个方面对于理解神经控制器机制的损伤而非个别肌肉的功能故障尤为重要。尽管sEMG研究在临床研究和神经康复中都是一项重要工具，但一项针对典型儿科康复科室中sEMG临床相关性的调查结果凸显了其有限的临床应用。我们认为，这是由于许多物理治疗师对sEMG及其神经肌肉基础的了解有限，原因是物理治疗学校所教授课程中未充分强调这一重要方法。缺乏用于sEMG分析的参考数据库或基准软件也可能导致其临床应用受限。尽管广泛使用sEMG存在教育和技术障碍，但它确实为脑瘫儿童康复治疗的规划和评估提供了重要工具。
