scholarly journals Use of Surface EMG in Clinical Rehabilitation of Individuals With SCI: Barriers and Future Considerations

2020 ◽  
Vol 11 ◽  
Author(s):  
Rakesh Pilkar ◽  
Kamyar Momeni ◽  
Arvind Ramanujam ◽  
Manikandan Ravi ◽  
Erica Garbarini ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Education ◽  
Physical Therapists ◽  
Occupational Therapists ◽  
Surface Emg ◽  
Cord Injury ◽  
Knowledge Share ◽  
Hands On ◽  
Intuitive Interfaces ◽  
User Friendly

Surface electromyography (sEMG) is a widely used technology in rehabilitation research and provides quantifiable information on the myoelectric output of a muscle. In this perspective, we discuss the barriers which have restricted the wide-spread use of sEMG in clinical rehabilitation of individuals with spinal cord injury (SCI). One of the major obstacles is integrating the time-consuming aspects of sEMG in the already demanding schedule of physical therapists, occupational therapists, and other clinicians. From the clinicians' perspective, the lack of confidence to use sEMG technology is also apparent due to their limited exposure to the sEMG technology and possibly limited mathematical foundation through educational and professional curricula. Several technical challenges include the limited technology-transfer of ever-evolving knowledge from sEMG research into the off-the-shelf EMG systems, lack of demand from the clinicians for systems with advanced features, lack of user-friendly intuitive interfaces, and the need for a multidisciplinary approach for accurate handling and interpretation of data. We also discuss the challenges in the application and interpretation of sEMG that are specific to SCI, which are characterized by non-standardized approaches in recording and interpretation of EMGs due to the physiological and structural state of the spinal cord. Addressing the current barriers will require a collaborative, interdisciplinary, and unified approach. The most relevant steps could include enhancing user-experience for students pursuing clinical education through revised curricula through sEMG-based case studies/projects, hands-on involvement in the research, and formation of a common platform for clinicians and technicians for self-education and knowledge share.

Proceedings #52: Development of surface EMG- triggered closed loop stimulation for individuals with spinal cord injury

2019 ◽  
Vol 12 (2) ◽  
pp. e125-e126
Author(s):  
Yu-Kuang Wu ◽  
Sana Saeed ◽  
James M. Limonta ◽  
Eric Bailey ◽  
Matthew T. Maher ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Closed Loop ◽  
Surface Emg ◽  
Cord Injury ◽  
Closed Loop Stimulation

scholarly journals Using a Case Report of a Patient With Spinal Cord Injury to Illustrate the Application of the International Classification of Functioning, Disability and Health During Multidisciplinary Patient Management

2010 ◽  
Vol 90 (7) ◽  
pp. 1039-1052 ◽  
Author(s):  
Alexandra Rauch ◽  
Reuben Escorpizo ◽  
Daniel L. Riddle ◽  
Inge Eriks-Hoogland ◽  
Gerold Stucki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Physical Therapy ◽  
Patient Management ◽  
Physical Therapists ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Cord Injury

Background and PurposePhysical therapists require a comprehensive assessment of a patient's functioning status to address multiple problems in patients with severe conditions. The International Classification of Functioning, Disability and Health (ICF) is the universally accepted conceptual model for the description of functioning. Documentation tools have been developed based on ICF Core Sets to be used in multidisciplinary rehabilitation management and specifically by physical therapists. The purposes of this case report are: (1) to apply ICF-based documentation tools to the care of a patient with spinal cord injury and (2) to illustrate the use of ICF-based documentation tools during multidisciplinary patient management.Case DescriptionThe patient was a 22-year-old man with tetraplegia (C2 level) who was 5 months postinjury. The report describes the integration of the ICF-based documentation tools into the patient's examination, evaluation, prognosis, diagnosis, and intervention while he participated in a multidisciplinary rehabilitation program for 2 months.OutcomesThe patient's comprehensive functioning status at the beginning of the program, the rehabilitation goals, the intervention plan, and his improvements in functioning following rehabilitation and the according goal achievement were illustrated with physical therapy–specific and multidisciplinary ICF-based documentation tools.DiscussionThis case report illustrates how the ICF-based documentation template for physical therapists summarizes all relevant information to aid the physical therapist's patient management and how ICF-based documentation tools for multidisciplinary care complement one another and thus can be used to enhance multidisciplinary patient management. In addition, the ICF assists in clarifying clinician roles as part of a multidisciplinary team. The case report demonstrates that the ICF can be a viable framework both for physical therapy and multidisciplinary management and for clinical documentation.

scholarly journals Robotic-Assisted, Body-Weight–Supported Treadmill Training in Individuals Following Motor Incomplete Spinal Cord Injury

2005 ◽  
Vol 85 (1) ◽  
pp. 52-66 ◽  
Author(s):  
T George Hornby ◽  
David H Zemon ◽  
Donielle Campbell
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Physical Therapists ◽  
Treadmill Training ◽  
Neurological Injury ◽  
Walking Ability ◽  
Incomplete Spinal Cord Injury ◽  
Robotic Assisted ◽  
Cord Injury

AbstractBackground and Purpose. Performance of therapist-assisted, body-weight–supported treadmill training (BWSTT) to enhance walking ability of people with neurological injury is an area of intense research. Its application in the clinical setting, however, is limited by the personnel and labor requirements placed on physical therapists. Recent development of motorized (“robotic”) rehabilitative devices that provide assistance during stepping may improve delivery of BWSTT. Case Description. This case report describes the use of a robotic device to enhance motor recovery and ambulation in 3 people following motor incomplete spinal cord injury. Interventions. Changes in motor impairment, functional limitations, and locomotor disability were monitored weekly during robotic-assisted BWSTT and following transition to therapist-assisted BWSTT with the assistance of one therapist. Outcomes. Following this training, 2 patients recovered independent over-ground walking and another improved his gait speed and endurance. Discussion. The use of robotic devices may assist physical therapists by providing task-specific practice of stepping in people following neurological injury.

scholarly journals Client Perspectives on Reclaiming Participation After a Traumatic Spinal Cord Injury in South Africa

2016 ◽  
Vol 96 (9) ◽  
pp. 1372-1380 ◽  
Author(s):  
Conran Joseph ◽  
Kerstin Wahman ◽  
Julie Phillips ◽  
Lena Nilsson Wikmar
Keyword(s):  
South Africa ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Physical Therapists ◽  
Community Dwelling ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Semistructured Interviews ◽  
Insight Into ◽  
The Continuum

AbstractBackgroundThe development of rehabilitation services promoting participation in people living with a traumatic spinal cord injury (TSCI) is of major concern for physical therapists. What the client sees as effective participation, barriers, and facilitators might be different due to their particular context. This study was conducted to gain insight into the experiences of attaining an important outcome in a developing context.ObjectiveThe aim of this study was to explore the experiences of reclaiming participation in community-dwelling people with TSCI in South Africa.DesignThis was an explorative, qualitative study with inductive content analysis.MethodsIndividual semistructured interviews were conducted with 17 adults living with a TSCI in order to explore their experience of participation. The verbatim transcripts were analyzed, and the end result was an overall theme that included 4 emerging categories.ResultsThe theme “participation possibility” denotes the eventual involvement in life situations. Within this theme, there were 4 categories that emerged as a representation of essential aspects along the continuum of reclaiming participation: (1) dealing with the new self, (2) a journey dominated by obstacles, (3) the catalyst of participation, and (4) becoming an agent. Dealing with and recognizing these intervening conditions seem critical for clients to reconstruct the meaning that is necessary for a broader conception of participation.LimitationsThe transferability of these findings to dissimilar contexts may be limited.ConclusionClient perspectives on reclaiming participation after injury affirm the notion of eventual participation, with each person finding strategies to succeed. In order to help clients reclaim participation, health professionals should develop contextually sensitive programs that include peer mentoring and reduce the influence of hindering factors.

scholarly journals Beyond Brushing Teeth: Pilot Study Reveals Community Based Opportunities to Promote Oral Care for Clients with a Spinal Cord Injury

2013 ◽  
Author(s):  
Amy Sullivan ◽  
Christy Morgan
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pilot Study ◽  
Occupational Therapy ◽  
Health Care Services ◽  
Oral Care ◽  
Occupational Therapists ◽  
Community Based ◽  
Cord Injury ◽  
Dental Offices

OBJECTIVE: This study identified opportunities for occupational therapists serving those with a spinal cord injury needing community based dental care. METHODS: Dental professionals answered survey questions on attitudes toward treating clients with a spinal cord injury, knowledge of transfer skills, occupational therapy as a community resource, and dental clinic physical design. The data collected for this pilot study were analyzed using descriptive statistics. RESULTS: The participants revealed hesitation toward treating these clients, some knowledge of occupational therapy as a community referral source, limited knowledge for transfer skills, and questionable clinic designs for meeting accessibility guidelines. CONCLUSIONS: Findings from this pilot study should spark interest in more similar study’s and expand sample size. Based upon the initial findings, it would seem occupational therapists should search for appropriate dental offices in which to refer clients with a spinal cord injury. In addition, occupational therapists could serve as consultants to local dental clinics ensuring adequate quality of care for a variety of disabilities. Ultimately, the profession is uniquely positioned to educate clients and providers promoting utilization of community oral health care services.

scholarly journals A Canine's Behavior and Cognitive State as It Relates to Immobility and the Success of Physical Rehabilitation in the Non-ambulatory Spinal Cord Patient

2021 ◽  
Vol 8 ◽  
Author(s):  
Stephanie A. Thomovsky ◽  
Niwako Ogata
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Physical Therapists ◽  
Critical Role ◽  
Physical Rehabilitation ◽  
Psychological State ◽  
Cognitive State ◽  
Injury Rehabilitation ◽  
Cardiopulmonary Fitness ◽  
Cord Injury

Physical rehabilitation (PR) is recommended following spinal cord injury to help improve and maintain muscle elasticity, joint mobility, and nerve health. It can also be used to relieve pain and improve cardiopulmonary fitness in an immobile patient. There is evidence, in human medicine, that PR plays a critical role in mental health and the psychological state of the patient. As part of the assessment phase, human physical therapists often identify psychosocial symptoms and barriers at the start of PR that ultimately may affect improvement in human patients suffering from injury and the loss of mobility. Patient psychological state plays an integral role in healing and outcome during treatment and rehabilitation. Specific interventions set to address these symptoms can better outcome. Arguably, one of the most emotionally traumatizing injuries suffered by a canine patient can be immobility secondary to spinal cord injury. Poorly understood is the role the canine cognitive state plays in the success of rehabilitation following spinal cord injury. Should breed, age, sex, physical fitness, personality, previous experiences and history or home lifestyle, affect the PR assessment of these patients? Do these factors affect eventual outcome following PR? The purpose of this manuscript is to explore psychosocial barriers encountered during injury rehabilitation in humans and determine if the similar barriers need to be considered when assessing a canine patient for spinal cord injury rehabilitation.

scholarly journals Characterization of Volitional Electromyographic Signals in the Lower Extremity After Motor Complete Spinal Cord Injury

2017 ◽  
Vol 31 (6) ◽  
pp. 583-591 ◽  
Author(s):  
Elizabeth Heald ◽  
Ronald Hart ◽  
Kevin Kilgore ◽  
P. Hunter Peckham
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Extremity ◽  
Visual Inspection ◽  
Surface Emg ◽  
Emg Activity ◽  
Automatic Identification ◽  
Emg Signal ◽  
Cord Injury ◽  
Complete Spinal Cord Injury

Background. Previous studies have demonstrated the presence of intact axons across a spinal cord lesion, even in those clinically diagnosed with complete spinal cord injury (SCI). These axons may allow volitional motor signals to be transmitted through the injury, even in the absence of visible muscle contraction. Objective. To demonstrate the presence of volitional electromyographic (EMG) activity below the lesion in motor complete SCI and to characterize this activity to determine its value for potential use as a neuroprosthetic command source. Methods. Twenty-four subjects with complete (AIS A or B), chronic, cervical SCI were tested for the presence of volitional below-injury EMG activity. Surface electrodes recorded from 8 to 12 locations of each lower limb, while participants were asked to attempt specific movements of the lower extremity in response to visual and audio cues. EMG trials were ranked through visual inspection, and were scored using an amplitude threshold algorithm to identify channels of interest with volitional motor unit activity. Results. Significant below-injury muscle activity was identified through visual inspection in 16 of 24 participants, and visual inspection rankings were well correlated to the algorithm scoring. Conclusions. The surface EMG protocol utilized here is relatively simple and noninvasive, ideal for a clinical screening tool. The majority of subjects tested were able to produce a volitional EMG signal below their injury level, and the algorithm developed allows automatic identification of signals of interest. The presence of this volitional activity in the lower extremity could provide an innovative new command signal source for implanted neuroprostheses or other assistive technology.

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