Detection of pronator muscle overactivity in children with unilateral spastic cerebral palsy : development of a semi-automatic method using EMG data

Sarcher, A, Brochard, S, Perrouin-Verbe, B, Raison, M, Letellier, G, Leboeuf, F ORCID: https://orcid.org/0000-0002-6483-9150 and Gross, R 2019, 'Detection of pronator muscle overactivity in children with unilateral spastic cerebral palsy : development of a semi-automatic method using EMG data' , Annals of Physical and Rehabilitation Medicine .

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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 0.50 Hz. 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.

Item Type: Article
Additional Information: ** Article version: AM ** Embargo end date: 31-12-9999 ** From Elsevier via Jisc Publications Router ** Licence for AM version of this article: This article is under embargo with an end date yet to be finalised. **Journal IDs: issn 18770657 **History: issue date 24-08-2019; accepted 01-08-2019
Schools: Schools > School of Health and Society
Journal or Publication Title: Annals of Physical and Rehabilitation Medicine
Publisher: Elsevier
ISSN: 18770657
Related URLs:
SWORD Depositor: Publications Router
Depositing User: Publications Router
Date Deposited: 07 Nov 2019 11:56
Last Modified: 07 Nov 2019 11:56
URI: http://usir.salford.ac.uk/id/eprint/52191

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