Critical Appraisal of Surface Electromyography (sEMG) as a Taught Subject and Clinical Tool in Medicine and Kinesiology

Vladimir Medved, Sara Medved, Ida Kovač, Vladimir Medved, Sara Medved, Ida Kovač

Abstract

The characteristics and state of knowledge of bioelectric signals such as ECG, EEG, and EMG are initially discussed. This serves as the basis for exploration of the degree of scholastic coverage and understanding of the level of clinical acceptance of respective bioelectric signal subtypes during the last 60 or so years. The review further proceeds to discuss surface EMG (sEMG). The status of the field in terms of teaching and academic training related to sEMG is examined, and its clinical acceptance in several areas of medicine and kinesiology, including neurology, psychology, psychiatry, physiatry, physical medicine and rehabilitation, biomechanics and motor control, and gnathology, is evaluated. A realistic overview of the clinical utility of the measurement of sEMG signals and their interpretation and usage, as well as of perspectives on its development, are then provided. The main focus is on the state of the field in Croatia. EMG signals are viewed as "windows" into the function of the neuro-muscular system, a complex and hierarchically organized system that controls human body posture and gross body movement. New technical and technological means to enable the detection and measurement of these signals will contribute to increased clinical acceptance, provided current scientific, educational, and financial obstacles can be removed.

Keywords: bioelectric signals; clinical medicine; kinesiology; physiotherapy; rehabilitation; surface electromyography; teaching.

Copyright © 2020 Medved, Medved and Kovač.

Figures

Figure 1
Figure 1
Raw surface EMG recording for three successive contractions of m. vastus medialis during extension-flexion exercise of the lower leg (18) (Permission was received from the Faculty of Electrical Engineering and Computing for the use of this image).
Figure 2
Figure 2
Investigation of local muscle fatigue during lower extremity extension-flexion exercise under loading (18). Subject ready to perform repetitive extension-flexion exercise of lower extremity under loading to induce fatigue (Permission was received from the Faculty of Electrical Engineering and Computing for the use of reproduced image. Written informed consent was obtained from the experimental subject for the publication of identifiable image).
Figure 3
Figure 3
Investigation of local muscle fatigue during lower extremity extension-flexion exercise under loading (18). Myoelectric signal spectral analysis for quantification of muscle fatigue during dynamic contractions: (A) sEMG signal x[n], raw data; (B) extracted data, using window sequence w[n] of length L, with shift of R samples (C–E) estimation of median frequency (MF') using modified periodogram of windowed sequence, (F) course of median frequency (MF'), (G) after low-pass filtering, maximum values of MF during each contraction were calculated, (H) limits of contractions were calculated using shaft angle data, (I) the slope of the regression line (k, expressed in Hz/min) that fit maximum values of MF in a least-square sense was used as a fatigue index. From the regression line, the frequency at the beginning of exercise (f0) was calculated (Permission was received from the Faculty of Electrical Engineering and Computing for the use of reproduced image).
Figure 4
Figure 4
sEMG recording in a 5-year-old child during gait, as a component of a comprehensive gait report. The picture on the left shows the electrodes and the self-powered cases, each of which was provided with a pre-amplifier and antenna for independent transmission of myoelectric signals. Traces on the right-side are illustrative examples of EMG activities recorded from the tibialis anterior (TA), soleus (SOL), gastrocnemius medialis (GAM), and gastrocnemius lateralis (GAL) during a tiptoe walking task (107). Triangles below the diagrams indicate first contacts of the foot with the ground (Permission obtained from Clinical Biomechanics for the use of the image).
Figure 5
Figure 5
The scope of the various EMG techniques. Conventional bipolar sEMG, with one bipolar electrode pair over each muscle, is mainly used in movement studies. It yields information for muscle activity in different muscles simultaneously. The development of HD-sEMG, a technique that utilizes multiple electrodes on each muscle, has additionally made it possible to extract information at the single motor unit (MU) level. With HD-sEMG, information on muscle–fiber conduction velocity (MFCV) can be used to supplement the information at the muscle–fiber level obtained by needle EMG [from (39)] (Permission obtained from J EMG Kinesiol for the use of the image).

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