Abstract
Sustained involuntary muscle activity (IMA) is a highly disabling and not completely understood phenomenon that occurs after a central nervous system lesion. We tested the feasibility of in-field IMA measuring at an acute rehabilitation ward. We used wearable probes for single differential surface EMG (sEMG), inclusive of a 3D accelerometer, onboard memory and remote control. We collected 429 h of data from the biceps brachii of 10 patients with arm plegia. Data quality was first verified in the time and frequency domains. Next, IMA was automatically identified based on the steady presence of motor unit action potential (MUAP) trains at rest. Feasibility was excellent in terms of prep time and burden to the clinical staff. A total of 350.5 h of data (81.7%) were reliable. IMA was found in 85.9 h (25%). This was often present in the form of exceedingly long-lasting trains of one or a few MUAPs, with differences among patients and variability, both within and between days in terms of IMA duration, root mean square (RMS) and peak-to-peak amplitude. Our results proved the feasibility of using wearable probes for single differential sEMG to identify and quantify IMA in plegic muscles of bedridden acute neurological patients. Our results also suggest the need for long-lasting acquisitions to properly characterize IMA. The possibility of easily assessing IMA in acute inpatients can have a huge impact on the management of their postures, physiotherapy and treatments.
Highlights
Spastic dystonia is one of several types of muscle overactivity that can develop in patients after an upper motor neuron lesion (UMNL), as a result of pathological processes involving the motor areas of the brain or their connections to the spinal cord, such as cerebrovascular accidents, traumatic brain injuries, and post-anoxic coma [1]
Spastic dystonia contributes to the development of acquired deformities, the alteration of joint mobility caused by an increased resistance of the muscle–tendon unit to its stretch, and it increases the disability of the patient [4,5,6]
The aim of this study was to evaluate the feasibility of assessing involuntary muscle activity (IMA) duration and its characteristics in patients admitted to an acute rehabilitation ward, and receiving everyday clinical activities, by means of surface EMG (sEMG) wearable probes in a single differential configuration
Summary
Spastic dystonia is one of several types of muscle overactivity that can develop in patients after an upper motor neuron lesion (UMNL), as a result of pathological processes involving the motor areas of the brain or their connections to the spinal cord, such as cerebrovascular accidents (stroke), traumatic brain injuries, and post-anoxic coma [1]. Spastic dystonia is defined as a spontaneous muscle activation occurring at rest, in the absence of any phasic stretch or any voluntary command [2,3,4,5]. Spastic dystonia contributes to the development of acquired deformities, the alteration of joint mobility caused by an increased resistance of the muscle–tendon unit to its stretch, and it increases the disability of the patient [4,5,6]. Spastic dystonia is characterized by sustained involuntary muscle activity (IMA) [7,8,9]
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