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European Journal of Physical and Rehabilitation Medicine 2021 Sep 01

DOI: 10.23736/S1973-9087.21.06878-7


lingua: Inglese

Surface electromyography to identify top-down modulation in complete chronic spinal cord injury: case report

Camila R. SIMÃO 1, 2, 3, Ledycnarf J. de HOLANDA 1, 2, Lilian F. URBINI 2, Matheus O. LACERDA 1, Karina da S. FERNANDES 1, Patrícia M. da SILVA 1, 2, Edgard MORYA 2, 3, Ana R. LINDQUIST 1

1 Graduate Program in Physical Therapy, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil; 2 Graduate Program in Neuroengineering. Edmond and Lily Safra International Neuroscience Institute, Santos Dumont Institute, Macaíba, RN, Brazil; 3 Anita Garibaldi Center for Education and Research in Health, Santos Dumont Institute, Macaíba, RN, Brazil


BACKGROUND: Complete spinal cord injury (SCI) is characterized by permanent loss of nerve impulse propagation through the injury level leading to complete loss of voluntary muscle contraction. However, clinically undetectable top-down modulation of lower limbs might be present and can be evidenced using surface electromyography (sEMG).
CASE REPORT: A subject with complete chronic SCI and no spasticity presents voluntary modulation of sEMG signal during a task-specific activity associated with sensory input.
CLINICAL REHABILITATION IMPACT: We present for the first time the spectral characterization of sEMG signal in response to orthostatic training associated with voluntary movement attempts in complete SCI. Behavior of sEMG signal varied according to kinematic properties of movement, reinforcing the voluntary influence of efferent pathways on motor output. Our findings will contribute to elaborate evaluation protocols to investigate the preservation of corticospinal activities, and to evolve more accessible strategies in a clinical setting.

KEY WORDS: Spinal cord injury; Electromyography; Standing position; Corticospinal tracts; Case report

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