Abstract:
BACKGROUND:The pronator teres and pronator quadratus muscles are frequently injected with neuromuscular blocking agents to improve supination in children with spastic cerebral palsy and limited active elbow supination. However, determining by simple clinical examination whether these muscles are overactive during active movement is difficult. OBJECTIVE:This study aimed to develop a semi-automatic method to detect pronator muscle overactivity by using surface electromyography (EMG) during active supination movements in children with cerebral palsy. METHODS:In total, 25 children with unilateral spastic cerebral palsy (10 males; mean [SD] age 10.6 [3.0] years) and 12 typically developing children (7 males; mean age 11.0 [3.0] years) performed pronation-supination movements at 0.50Hz. Kinematic parameters and surface EMG signals were recorded for both pronator muscles. Three experts visually assessed muscle overactivity in the EMG signals of the children with cerebral palsy, in comparison with the reference group. The reliability and discrimination ability of the visual assessments were analysed. Overactivity detection thresholds for the semi-automatic method were adjusted by using the visual assessment by the EMG experts. The positive and negative predictive values of the semi-automatic detection method were calculated. RESULTS:Intra-rater reliability of visual assessment by EMG experts was excellent and inter-rater reliability was moderate. For the 25 children with unilateral spastic cerebral palsy, EMG experts could discriminate different profiles of pronator overactivity during active supination: no pronator overactivity, one overactive pronator, or overactivity of both pronators. The positive and negative predictive values were 96% and 91%, respectively, for this semi-automatic detection method. CONCLUSIONS:Detection of pronator overactivity by using surface EMG provides an important complement to the clinical examination. This method can be used clinically, with the condition that clinicians be aware of surface EMG limitations. We believe use of this method can increase the accuracy of treatment for muscle overactivity, resulting in improved motor function and no worsening of paresis.
journal_name
Ann Phys Rehabil Medjournal_title
Annals of physical and rehabilitation medicineauthors
Sarcher A,Brochard S,Perrouin-Verbe B,Raison M,Letellier G,Leboeuf F,Gross Rdoi
10.1016/j.rehab.2019.08.001subject
Has Abstractpub_date
2019-11-01 00:00:00pages
409-417issue
6eissn
1877-0657issn
1877-0665pii
S1877-0657(19)30116-2journal_volume
62pub_type
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journal_title:Annals of physical and rehabilitation medicine
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journal_title:Annals of physical and rehabilitation medicine
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,实务指引,评审
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journal_title:Annals of physical and rehabilitation medicine
pub_type: 杂志文章
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