Table 3.
Survey items that did not reach consensus.
| Survey items | n | (%) |
|---|---|---|
| 1. Overall, sEMG is rarely used in clinical neurorehabilitation | 19/34 | (56) |
| 2. sEMG is currently more relevant for researchers than clinicians | 24/34 | (71) |
| 3. Regarding the role of sEMG in patient's assessment, sEMG may be useful to: | ||
| Identify pathological patterns of motor unit behavior | 24/35 | (69) |
| Evaluate the percent of maximal voluntary activation | 19/35 | (54) |
| Characterize motor fiber conduction velocity | 22/33 | (67) |
| 4. Regarding the utility of sEMG in the definition of an intervention plan, sEMG may be useful when there is need to investigate or quantify: | ||
| Muscular fatigue | 19/33 | (58) |
| Abnormalities in the motor unit behavior(muscle/balance/imbalance/synergy/function) | 22/33 | (67) |
| Abnormalities in the percent of maximal voluntary activation | 16/34 | (47) |
| Abnormalities in motor fiber conduction velocity | 20/31 | (65) |
| 5. If a therapeutic intervention is administered, sEMG information may prove useful to track changes from baseline in: | ||
| Muscular fatigue | 20/33 | (61) |
| Muscle imbalance/dyssynergia | 25/34 | (74) |
| The pattern of motor unit behavior | 20/33 | (61) |
| The percent of maximal voluntary activation | 16/34 | (47) |
| Stretch reflex | 22/33 | (67) |
| Motor fiber conduction velocity | 21/32 | (66) |
| 6. sEMG assessment can be performed as a stand-alone technique or to complement/optimize other methods used by neurorehabilitation professionals to quantify muscle and physical function. It seems useful adding sEMG to: | ||
| Mobility assessment (i.e., Timed Up and Go test; 10-Meter Timed Walk, etc.) | 21/34 | (62) |
| Muscle strength assessment | 20/35 | (57) |
| Posture analysis | 19/33 | (58) |
| Assessment of swallowing | 12/27 | (44) |
| Tremor analysis | 20/30 | (67) |
| Goniometric assessments of the joint's passive range of motion | 16/34 | (47) |
| Goniometric assessment of the joint's active range of motion | 18/34 | (53) |
| Stand-alone | 18/32 | (56) |
| 7. sEMG, when used as biofeedback, may help to: | ||
| Learn how to associate intrinsic kinesthesia with the desired movement | 16/26 | (62) |
| 8. Professional figures involved in sEMG signal acquisition, processing, and quality control: | ||
| Clinical neurophysiologist | 15/34 | (44) |
| Kinesiologist/Human motion scientist | 27/34 | (79) |
| 9. Professional figures involved in sEMG interpretation: | ||
| Clinical neurophysiologist | 26/32 | (81) |
| Neurologist | 11/33 | (33) |
| Neurophysiopathology/Biomedical laboratory technician | 19/33 | (58) |
| Occupational therapist | 7/33 | (21) |
| Speech therapist | 3/32 | (9) |
| 10. Greater qualification of clinical neurorehabilitation professionals on sEMG would contribute to reduce the cost of neurorehabilitation care delivery | 22/35 | (63) |
| 11. Assuming proficiency with sEMG techniques, which of the following professions should provide education and training on the use of sEMG to neurorehabilitation professionals? Please judge the adequacy of the following professional figures: | ||
| Neurologist | 15/32 | (47) |
| Neurophysiopathology/Biomedical laboratory technician | 13/32 | (41) |
| Occupational therapist | 5/32 | (16) |
| Physical Medicine and Rehabilitation physician, also known as physiatrist | 20/33 | (61) |
| Speech therapist | 5/29 | (17) |
| 12. In addition to basic know-how on sEMG recording (i.e., correct placement of electrodes, adequate skin preparation, etc.), further technical skills are needed: | ||
| Neurorehabilitation professionals should be able to import EMG data into environments for advanced numerical computing (i.e., MatLab) | 13/35 | (37) |
| 13. EMG-derived variables considered of utmost importance for clinical applications in neurorehabilitation: | ||
| Mean/median envelope | 19/32 | (59) |
| Normalized envelope (i.e., to maximal voluntary contraction) | 25/34 | (74) |
| Myoelectric fatigue estimators (i.e., average rectified value and root mean square increase, mean and median frequency reduction) | 20/33 | (61) |
| Time-frequency / time-scale analysis (wavelet analysis) | 15/33 | (45) |
| Intensity plot with reference histograms (e.g., control activation timing key) | 15/30 | (50) |
| 14. In addition to knowledge on physiological and non-physiological factors that influence sEMG, neurorehabilitation professionals need further competencies to interpret sEMG: | ||
| Knowledge about myoelectric manifestations of muscle fatigue | 23/32 | (72) |
| Knowledge about the use of sEMG to assess spasticity | 21/33 | (64) |
| 15. Potential barriers to the employment of sEMG in clinical neurorehabilitation: | ||
| Lack of widely accepted evidence that the use of sEMG in neurorehabilitation impacts the selection of treatments | 24/34 | (71) |
| Lack of normative ranges to characterize the patient based on sEMG data | 21/34 | (62) |
| Purchase and maintenance costs of sEMG equipment | 15/34 | (44) |
| sEMG device/software not clinician-friendly enough | 19/34 | (56) |
| Uncomfortable for the patient | 2/34 | (6) |
| No multidisciplinary team available | 23/34 | (68) |