Added Value of Dynamic EMG in the Assessment of the Equinus and the Equinovarus Foot Deviation in Stroke Patients and Barriers Limiting Its Usage
| Autor: | Isabella Campanini, Michela Cosma, Mario Manca, Andrea Merlo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
030506 rehabilitation
medicine.medical_specialty Case Report Electromyography lcsh:RC346-429 rehabilitation 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation equinovarus deformity medicine Spasticity physiotherapy lcsh:Neurology. Diseases of the nervous system Neurorehabilitation Muscle contracture equinus deformity medicine.diagnostic_test business.industry dynamic EMG Muscle stiffness stroke medicine.anatomical_structure Hemiparesis Neurology Gait analysis gait analysis Neurology (clinical) medicine.symptom Ankle surface EMG 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Frontiers in Neurology, Vol 11 (2020) Frontiers in Neurology |
| ISSN: | 1664-2295 |
| DOI: | 10.3389/fneur.2020.583399 |
| Popis: | Equinus (EFD) and equinovarus foot deviation (EVFD) are the most frequent lower limb deformities in stroke survivors. The equinus component can be triggered by a combination of dorsiflexor deficits, plantar flexor overactivity, muscle stiffness, and contractures. The varus component is typically due to an imbalance between invertor and evertor muscle actions. An improvement in identifying its causes leads to a more targeted treatment. These deformities are typically assessed via a thorough clinical evaluation including the assessment of range of motions, force, spasticity, pain, and observational gait analysis. Diagnostic nerve blocks are also being increasingly used. An advantage of dynamic electromyography (dEMG) is the possibility of measuring muscle activity, overactivity or lack thereof, during specific movements, e.g., activity of both ankle plantar flexors and dorsiflexors during the swing phase of gait. Moreover, fine-wire electrodes can be used to measure the activity of deep muscles, e.g., the tibialis posterior. An impediment to systematic use of dEMG in the assessment of EFD and EVFD, as a complimentary tool to the clinical evaluation, is a lack of evidence of its usefulness. Unfortunately, there are few studies found in literature. In order to fill this void, we studied three pairs of patients suffering from chronic hemiparesis consequent to a stroke, with EFD or EVFD. At the initial evaluation they all displayed the same clinical traits, very similar walking patterns, and an overlapping gait kinematics. However, the patterns of muscle activity differed considerably. dEMG data acquired during walking provided information that was not available from the sole clinical assessment. The contribution of this information to the subsequent clinical and rehabilitation process was discusses along with the barriers that limit the use of dEMG as a routine tool in neurorehabilitation. |
| Databáze: | OpenAIRE |
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