Neurophysiological assessment of lower-limb voluntary control in incomplete spinal cord injury.

STUDY DESIGN: Cross-sectional retrospective study of a neurophysiological method of voluntary motor control characterization. OBJECTIVES: This study was undertaken to validate the surface electromyography (sEMG)-based voluntary response index (VRI) as an objective, quantitative, laboratory measure o...

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Publicado en:Spinal Cord Vol. 43; no. 5; pp. 283 - 291
Autores principales: Lim HK, Lee DC, McKay WB, Priebe MM, Holmes SA, Sherwood AM
Formato: equations & formulas research tables/charts Journal Article
Publicado: Springer Nature May2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2005
      vid: 43
      iid: 5
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      pub: Springer Nature
      place: Dordrecht, <Blank>
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        106331534
        2009267507
        10.1038/sj.sc.3101679
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        106331534
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        atl: Neurophysiological assessment of lower-limb voluntary control in incomplete spinal cord injury.
      aug:
        au:
          Lim HK
          Lee DC
          McKay WB
          Priebe MM
          Holmes SA
          Sherwood AM
        affil: Baylor College of Medicine, Houston, TX
      sug:
        subj:
          Lower Extremity Physiopathology
          Muscle, Skeletal Physiopathology
          Psychomotor Performance
          Spinal Cord Injuries Physiopathology
          Adult
          Cross Sectional Studies
          Descriptive Statistics
          Disability Evaluation
          Dominance, Cerebral Physiology
          Electromyography Methods
          Female
          Funding Source
          Male
          Middle Age
          Neurophysiology
          Nonparametric Statistics
          Retrospective Design
          ROC Curve
          Scales
          Sensitivity and Specificity
          Texas
          Trauma Severity Indices
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: STUDY DESIGN: Cross-sectional retrospective study of a neurophysiological method of voluntary motor control characterization. OBJECTIVES: This study was undertaken to validate the surface electromyography (sEMG)-based voluntary response index (VRI) as an objective, quantitative, laboratory measure of spinal cord injury severity in terms of voluntary motor control disruption. SETTING: VA Medical Centers in Houston and Dallas Texas, USA. METHODS: A total of 67 subjects with incomplete spinal cord injury (iSCI), American Spinal Injury Association Impairment Scale (AIS)-C (n = 32) and -D (n = 35) were studied. sEMG recorded during a standardized protocol including eight lower-limb voluntary motor tasks was analyzed using the VRI method that relates multi-muscle activation patterns of SCI persons to those of healthy-subject prototypes (n = 15). The VRI is composed of a measure of the amount of the sEMG activity (magnitude) and the distribution of activity across muscle groups compared to that of healthy subjects for each motor task (similarity index, SI). These resulting VRI components, normalized magnitude and SI, were compared to AIS clinical findings in this study. Receiver operating characteristic analysis was performed to determine the SI values best separating AIS-C and AIS-D subjects. RESULTS: Magnitude and SI for AIS-C subjects had mean values of 0.27 +/- 0.32 and 0.65 +/- 0.21, respectively. Both parameters were significantly larger in the AIS-D subjects (0.78 +/- 0.43 and 0.93 +/- 0.06), respectively (P < 0.01). An SI value of 0.85 was found to separate AIS-C and AIS-D groups with a sensitivity of 0.89 and a specificity of 0.81. Further, the VRI of each leg strongly correlated with the respective AIS motor score (0.80, r < 0.01). CONCLUSIONS: In the domains of voluntary motor control, the sEMG-based VRI demonstrated adequate face validity and sensitivity to injury severity as currently measured by the AIS. SPONSORSHIP: Veterans Affairs Medical Center.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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