Ranavolo Alberto, Serrao Mariano, Draicchio Francesco
Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy.
Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
Front Neurol. 2020 Dec 22;11:572069. doi: 10.3389/fneur.2020.572069. eCollection 2020.
Patients affected by neurological pathologies with motor disorders when they are of working age have to cope with problems related to employability, difficulties in working, and premature work interruption. It has been demonstrated that suitable job accommodation plans play a beneficial role in the overall quality of life of pathological subjects. A well-designed return-to-work program should consider several recent innovations in the clinical and ergonomic fields. One of the instrument-based methods used to monitor the effectiveness of ergonomic interventions is surface electromyography (sEMG), a multi-channel, non-invasive, wireless, wearable tool, which allows in-depth analysis of motor coordination mechanisms. Although the scientific literature in this field is extensive, its use remains significantly underexploited and the state-of-the-art technology lags expectations. This is mainly attributable to technical and methodological (electrode-skin impedance, noise, electrode location, size, configuration and distance, presence of crosstalk signals, comfort issues, selection of appropriate sensor setup, sEMG amplitude normalization, definition of correct sEMG-related outcomes and normative data) and cultural limitations. The technical problems are being resolved minimized also thanks to the possibility of using reference books and tutorials. Cultural limitations are identified in the traditional use of qualitative approaches at the expense of quantitative measurement-based monitoring methods to design and assess ergonomic interventions and train operators. To bridge the gap between the return-to-work rehabilitation and other disciplines, several teaching courses, accompanied by further electrodes and instrumentations development, should be designed at all Bachelor, Master and PhD of Science levels to enhance the best skills available among physiotherapists, and ergonomists.
患有神经病理学且伴有运动障碍的患者在处于工作年龄时，必须应对与就业能力、工作困难以及过早中断工作相关的问题。事实证明，合适的工作调整计划对患病个体的整体生活质量具有有益作用。一个精心设计的重返工作岗位计划应考虑临床和人体工程学领域的一些最新创新。用于监测人体工程学干预效果的基于仪器的方法之一是表面肌电图（sEMG），它是一种多通道、非侵入性、无线、可穿戴的工具，能够深入分析运动协调机制。尽管该领域的科学文献丰富，但它的使用仍未得到充分利用，且现有技术水平滞后于预期。这主要归因于技术和方法（电极 - 皮肤阻抗、噪声、电极位置、尺寸、配置和距离、串扰信号的存在、舒适度问题、合适传感器设置的选择、sEMG幅度归一化、正确的sEMG相关结果和规范数据的定义）以及文化方面的限制。借助使用参考书和教程的可能性，技术问题也正在得到解决或最小化。文化限制体现在传统上以定性方法为主，而牺牲了基于定量测量的监测方法来设计和评估人体工程学干预以及培训操作人员。为了弥合重返工作岗位康复与其他学科之间的差距，应在所有理学学士、硕士和博士层面设计若干教学课程，并进一步开发电极和仪器，以提升物理治疗师和人体工程学家现有的最佳技能。
