A Comparison Between Surface Electromyography and Acceleromyography for Virtual Upper Extremity Spasticity Assessments in Stroke Patients
Creators: Nadeau, Valerie
Publisher: name: University of Alberta Library
Year: 2024

<p>Background: Many elements currently hinder the accessibility to spasticity assessments, such as living rurally or limited mobility. Without access to appropriate care for the assessment and management of spasticity, a patient&#39;s quality of life may be compromised. Electromyography (sEMG) is a potential technique for objective and virtual evaluations of spasticity because of its capacity to extract useful biomechanical information about spasticity. However, there is a need to identify a suitable alternative to sEMG because of its electrical interference and other obstacles that could affect the signal quality if it is misused in a telehealth setting. Acceleromyography (AMG) is a promising alternative sensor due to its ease of use and the potential to overcome barriers to virtual spasticity assessments. It remains to be seen whether the AMG sensor is similar to the sEMG in terms of the information it can give regarding muscle activity for spasticity assessments. </p>

<p>Objectives: The study intends to investigate whether the sEMG and AMG sensors are comparable in gathering information on muscle activity to give clinicians information on muscular spasticity in a virtual environment in the upper extremities. The purpose of this study is to simultaneously compare the biomechanical data that sEMG can acquire regarding muscle activity during active and passive motions to that of AMG for those with and without muscle spasticity.  </p>

<p>Methods: The literature review section of the thesis is covered in the second chapter to determine which significant barriers sEMG currently has in telehealth and if these have been overcome. The initial search allowed for assessing the obstacles to virtual sEMG discovered thus far and how researchers have come up with solutions to overcome them. Furthermore, the design process of the portable device, which is based on Daniel Gillespie&#39;s earlier device, the TONE device, is described in depth in Chapter 3. The device was designed based on what clinicians currently need for spasticity assessments with the goal of providing clinically relevant data. In addition, using the portable device designed to compare these two sensors simultaneously, chapter 4 used a muscle fatigue and reliability tests on a population of participants without spasticity to determine if these gave similar information on the ability to pick up slow and fast fibres. Upper extremity patients with spasticity after a stroke were the intended population for this study. Once it was concluded that the two sensors were comparable in their ability to pick up slow and fast fibres, their signals were compared using the affected and non-affected arms on patients with spasticity during active and passive movements to determine if they obtained similar characteristics that could be used to assess muscle spasticity. </p>

<p>Results: Due to the large volumes of data that sEMG requires to process and its high bandwidth requirement, the most frequently mentioned barrier in the literature review was the unreliability of real-time data. Cybersecurity and poor user-friendliness were two further significant barriers. Few articles offer ways to improve inadequate real-time data, which suggests that no approaches have been effectively used. Prior training before virtual assessments was a common strategy used in the studies to address barriers to usability. Using the designed portable device in chapter 3 to compare the simultaneous data obtained from sEMG and AMG, it was discovered that AMG&#39;s ability to identify slow and fast fibres is similar to that of sEMG. Additionally, sEMG and AMG were comparable in the way they could identify and distinguish particular spasticity characteristics in the affected arm of individuals with spasticity after a stroke. Among these were the low signal-to-noise ratio and the lack of fast fibres in power spectra during active movements.</p>

<p>Conclusion: Based on its capacity to provide information on muscle contractions and its lack of barriers, the research suggests that AMG is an excellent alternative to sEMG. However, to provide healthcare professionals with adequate insight into the severity of spasticity and to enable them to establish appropriate treatment and care plans, it is crucial to emphasize the need for future research. This research should focus on enabling the development of a new, standardized method for conducting these assessments, thereby engaging healthcare professionals in the ongoing research process.</p>