Clinical Relevance of State-of-the-Art Analysis of Surface Electromyography in Cerebral Palsy

Surface electromyography (sEMG) can be used to assess the integrity of the
neuromuscular systemand its impairment in neurological disorders. Here we will consider
several issues related to the current clinical applications, difficulties and limited usage
of sEMG for the assessment and rehabilitation of children with cerebral palsy. The
uniqueness of this methodology is that it can determine hyperactivity or inactivity of
selected muscles, which cannot be assessed by other methods. In addition, it can assist
for intervention or muscle/tendon surgery acts, and it can evaluate integrated functioning
of the nervous system based on multi-muscle sEMG recordings and assess motor pool
activation. The latter aspect is especially important for understanding impairments of the
mechanisms of neural controllers rather than malfunction of individual muscles. Although
sEMG study is an important tool in both clinical research and neurorehabilitation, the
results of a survey on the clinical relevance of sEMG in a typical department of pediatric
rehabilitation highlighted its limited clinical usage. We believe that this is due to limited
knowledge of the sEMG and its neuromuscular underpinnings by many physiotherapists,
as a result of lack of emphasis on this important methodology in the courses taught in
physical therapy schools. The lack of reference databases or benchmarking software for
sEMG analysis may also contribute to the limited clinical usage. Despite the existence
of educational and technical barriers to a widespread use of, sEMG does provide
important tools for planning and assessment of rehabilitation treatments for children with
cerebral palsy.