There are many companies now producing wireless Semg units.  The software program is the bulwark of the unit.  If the software is limited, then the measurements, reports and knowledge gleaned will also be limited.  Monies spent on purchasing Semg has a cost at the front end, with good units costing in the range of $65K – $80k.  These units will also do more than just show Semg and video, as these units have the capability, using sensors in elastic bands that show avatar skeletal movement in real time as the client is moving.  Investing in a multi-functional unit  that establishes muscle firing patterns, video in real time, and how the skeletal component of the person is moving as a whole is the power to solving many patients’ frustrations.   The dynamism of these multi capable devices hones in on muscle firing patterns, whether normal or aberrant and increases just how the person is compensating using a skeletal avatar.  The treatment of the patient is more focused with dramatically better outcomes that are longer lasting.

Imagine this Semg concept as comparing two types of telescopes: a cheap telescope and a telescope that costs thousands of dollars.  Envision now you are viewing through the less expensive telescope.  You view one star.  Now viewing that same star through the more expensive telescope, you see that there are really 2 stars. This is because the more expensive telescope has a higher resolving power.  This is what multi-functional Semg units are capable of.  These machines allow the user to see more clearly to what is happening with their client’s movements.   Our naked eye does not have this ability.  Nor do physicians of any specialty.

Physical therapists are keenly aware of the multitude of movement compensations that are a result of life experiences, disease processes, past surgeries, where tissue adhesions prevent normal tissue motion.  No one is exempt from this process.  When a patient walks through our doors, there is an expectation level higher than most therapists realize.  Yes, therapists have a specific knowledge base that encompasses listening, watching, treating, and then re-evaluate to examine if the patient’s symptoms are less with less movement compensations.  Even the most talented of therapists can only advance so far; human abilities have a limit.  Our eyes can only see a limited amount.  Our hands and fingers can only perform to a certain level.

To further illustrate, why cannot humans see through skin.  That would certainly make our job easier.   It is because tissues are “highly scattering, which means that light waves careening through the tissue instead of straight through, as they would through the tissue of that jellyfish, explains Changhuei Yang of the California Institute of Technology.” Feb 13, 2008 (Yang, 2008)

Our fingers can only feel to a point.  Why? Yes, some manual therapists have a more acute feel when touching; again, this can only progress so far.  The way humans and objects are made, or engineered, our capacity to touch, literally, into a person, is not a capability yet.  Quantum mechanics may say maybe, yet scientists have not figured that out yet.

BACK ON TRACK: Multiple Uses of Semg in the Clinic Setting

Young client with difficulty toe touching. Semg revealed hamstrings firing to the point that toe touching was difficult. One verbal cue increased reach by 6 inches and less compensation at the T spine!

Technology is advancing at an exponential rate; the time is now to begin to use this equipment and catch up to other industries. I am bulleting a list of the usefulness of Semg in a clinical setting, and you can certainly add to the list.

 

  • Post-surgical: a multi-functional Semg unit yields objective evidence valuable for the therapist, patient and certainly, the surgeon.  Semg can view how, post-surgery, “sleepy” muscles can increase firing capability with more specific movement exercises to awaken the weakened or “sleepy” muscles.  Remember, one size fits one.  Best evidence of exercises is not for everyone, or most, or some.  Each movement must be tailored for that patient.  Semg allows for increased efficiency with time in choosing which movements are best that week (Physical Performance Solutions, 2019) (T. G. Balshaw, et al., 2017).
  • Chronic pain patterns: typically, an area where someone experiences pain, may not be the source.  There is pain, but Semg often shows other areas, where, when manually therapy is applied to these other areas combined with specific movements, the original pain begins to wane.  This is not saying that the original pain the patient is coming to you with does not need attention.  Semg does often show Mohammad Pouretezad, et al. (2018). Effects of cognitive loading on lumbar flexion relaxation phenomenon in health people, that other tissue regions of the body are large contributing factors (Peacock, 2018).
  • Re-injuries: This is what sports research has shown therapists.  That the common denominator of athletes is the re-injury.  I take this personally that I have not performed my best to optimize all tools prior to that athlete returning to their sport.
  • Early Intervention Musculoskeletal Injury Prevention: Employees do not want to become injured at work or at home. Our current information is clear that soft tissue adhesions can create altered movement patterns, abnormal torque forces on joints and more (David Marcarian, 2008) (Mohammad Pouretezad, et al., 2018) (Sergio Fuentes del Toro, et al., 2019).

 

 

 

 

 

 

 

Before: Worker carries 75lbs of plywood into container.  Semg shows how much muscles must work

 

 

 

 

 

 

 

 

After 2 minutes of verbal training, the worker is able to easily slide the 75 lbs. of plywood with less muscular effort!

  • Work related injuries: Semg multi-functional units can detect much more than the original reason why you are treating the worker (Physical Performance Solutions, 2017).  Often, the worker injury is a time bomb of multiple compensations, comorbidities, that lead to that one incident.  Some research suggests that for low back pain injuries, current chiropractic and physical therapy treatments may not be best for the worker (Jason Busse, et al., 2014).  The use of Semg will again hone in areas that require attention, or the risk of re-injury or surgery inevitable (GULSAH KINALI, et al., 2016).
  • Return to work: here Semg can either be used to determine fit for work (Physical Performance Solutions, 2018), or for the employee returning to work from an FMLA.  This is powerful; our documented evidence is 100% effective when using this type of technology for return to work.
  • FCE: not many clinics offer Functional Capacity Evaluations. For those that do, this is the perfect form of determining fears, remaining dysfunction, and a better objective evidence during the test of how the employee functions at a physical level.

Take Home Point

Our allied health profession is in desperate need of advancement to the current technologies that is offered.  When considering the outpatient clinic budget, one must begin to think how best we can efficiently, effectively, and affordably treat patients with the fastest and long-lasting outcomes.   To consider Semg multi-functional equipment, doing with less therapeutic equipment and sacrificing the fancy sign is a strong consideration.  There are so many methods to developing your loyal client base for referrals when you can truly demonstrate how quickly patients heal as the equipment performs the majority of where to go.  Patients co-pays are increasing, so, to treat them for six, eight, or more sessions are not typically financially possible for them.  The goal is to educate thoroughly, treat, test and retest.

 

Semg multi-functional units are for now, not a few years from now.

 

References

David Marcarian, M. (2008). Validity of Surface EMG Testing. Surface EMG and Validity.

GULSAH KINALI, et al. (2016). Electromyographic analysis of an ergonomic risk Factor: Overhead Work. J. Phys. Ther. Sci., 28: 1924–1927.

J Phys Ther Science, Jun; 30(6): 744–747. (n.d.). Jun; 30(6): 744–747.

Jason Busse, et al. (2014). PREDICTORS OF WORKERS’ COMPENSATION CLAIM DURATION AMONG WORKERS DISABLED DUE TO LOW BACK PAIN. Occup Environ Med , Occup Environ Med 2014;71.

Mohammad Pouretezad, et al. (2018). Musculoskeletal disorders early diagnosis: A retrospective study in the occupational medicine setting. Journal Phys Ther Science, Jun; 30(6): 744–747.

Peacock, L. L. (2018, December 9). Left QL firing less creates increases in right lateral lean with right leg stance. Aiken, SC, US: Physical Performance Solutions.

Physical Performance Solutions. (2017, March 25). Right Shoulder: Partial Tear: Semg determines better movement strategies. Physical Performance Solutions. Evans, GA, US: Physical Performance Solutions.

Physical Performance Solutions. (2018, June 25). Return To Work: Left Shoulder Pain from Lifting. Physical Performance Solutions. Waynesboro, VA, US: Physical Performance Solutions.

Physical Performance Solutions. (2019, December 22). Post Operative Knee Replacement Movements and Strategies. Documentation from PPS. Aiken, SC, US: Physical Performance Solutions.

Sergio Fuentes del Toro, et al. (2019). Is the Use of a Low-Cost sEMG Sensor Valid to Measure Muscle Fatigue? sensors, 19, 3204; doi:10.3390/s19143204.

  1. G. Balshaw, et al. (2017). Reliability of quadriceps surface electromyography measurements is Improved by Two two vs. single site recordings. Eur J Appl Physiology, 117(6): 1085–1094.

Yang, C. (2008). New Technology Makes Tissues Transparent. Retrieved from Science Daily: www.sciencedaily.com/releases