tures and to more complex movement patterns. A very strong focus on activities of daily living is encouraged. If excessive upper trapezius activity returns, more work is needed to promote generalization. In fact, it is better not to assume that the generalization of motor skills will occur. The training of the neuromuscular system is typi- cally very specific, and generalization should be built into treatment procedures (see Figure 5–5).
major contribution to dysfunction will probably need to have this issue resolved before SEMG feedback for func- tional gains will be effective. A practitioner who knows his
or her own discipline but is also aware of the other areas of concern can more effectively treat the patient through cross-referral when appropriate.
REFERENCES
1. Whatmore G, Kohli D. The Physiopathology and Treatment of Functional Disorders.New York, NY: Grune & Stratton;
1974.
2. Headley B. Muscle Scanning.Boulder, CO: IPR; 1990.
3. Iacona C. Muscle scanning: Caveat emptor. Biofeedback Self Regul.1991;16:227–241.
4. Mathiassen SE, Winkel J, Hagg GM. Normalization of surface EMG amplitude from the upper trapezius muscle in ergonomic studies: a review. J Electromyogr Kinesiol.
1995;5:197–226.
5. Zipp P. Recommendations for the standardization of lead positions in surface electromyography. Eur J Appl Physiol.
1982;50:41–54.
6. Veiersted KB. The reproducability of test contractions for calibration of electromyographic measurements. Eur J Appl Physiol.1991;62:91–98.
7. DeLuca C. Myoelectric manifestations of localized muscular fatigue in humans. CRC Crit Rev Biomed Eng.
1984;11:251.
8. DeLuca C. Keynote presentation. Presented at the Applied Psychophysiology and Biofeedback Conference, March 1992, Colorado Springs, CO.
9. Ahern DK, Follick MJ, Council JR, Laser-Wolston N.
Reliability of lumbar paravertebral EMG assessment in chronic low back pain. Arch Phys Med Rehab.
1986;76:762–765.
10. Cram JR, Lloyd J, Cahn T. The reliability of EMG muscle scanning. Int J Psychosom.1990;37:68–72.
11. Cram JR, Steger JC. Muscle scanning and the diagnosis of chronic pain. Biofeedback Self Regul.1983;8:229–241.
12. Klein AB, Snyder Mackler L, Roy S, DeLuca C. Compari- son of spinal mobility and isometric trunk extensors forces with electromyographic spectral analysis in identifying low back pain. Phys Ther.1991;71:
445–453.
13. Triano J, Schultz AB. Correlation of objective measure- ment of trunk motion and muscle function with low back disability ratings. Spine.1987;12:561–565.
14. Dolce JJ, Raczynski JM. Neuromuscular activity and electromyography in painful backs: psychological and biomechanical models in assessment and treatment.
Psychol Bull.1985;97:502–520.
15. Robinson ME, Cassisi JE, O’Connor PD, MacMillan M.
Lumbar iEMG during isotonic exercise: chronic low back pain patients vs controls. J Spinal Disord.1992;5:1.
16. Donoghue W. How to Measure Your Percent Bodyfat.
Plymouth, MN: Creative Health Products; 1990.
17. Cram JR. EMG muscle scanning and diagnostic manual for surface recordings. In: Cram JR, ed. Clinical EMG for Surface Recordings, II.Nevada City, CA: Clinical Resources;
1990:1–142.
18. Wolf L, Segal R, Wolf S, Nieberg R. Quantitative analysis of surface and percutaneous electromyographic activity and lumbar erector spinae of normal young women.
Spine.1991;16:155–161.
19. Matheson D, Toben TP, De Lacruz DE. EMG scanning:
normative data. J Psychopathology Behav Assess.1988;10:
9–20.
20. Berman FS, Marcarian D. The Berman technique: a proposed standard protocol for chiropractic EMG scanning. Am Chiropractor.November 1990:34–40.
21. Kent C, Hyde R. Potential applications for EMG in chiropractic practice. Digest Chiropractic Econ.1987;9:
20–25.
22. Leach RA, Owens EF, Giesen IM. Correlates of myoelectric asymmetry detected in low back pain patients using hand held post style surface electromyography. J Manip Phys Ther.1993;16:140–149.
23. Kendall FP, Kendall E, McCreary BA. Muscles, Testing and Function.3rd ed. Baltimore, MD: Williams & Wilkins;
1983.
24. Middaugh SJ, Kee WG, Nicholson JA. Muscle overuse and posture as factors in the development and maintenance of chronic musculoskeletal pain. In: Grzesiak RC, Ciccone DS, eds. Psychological Vulnerability to Chronic Pain.New York, NY: Springer; 1994:55–89.
25. Basmajian N. Fact versus myth in EMG biofeedback.
Biofeedback Self Regul.1976;4:369–371.
26. Perry J, Easterday CS, Antonelli DJ. Surface versus intramuscular electrodes for electromyography of superficial and deep muscles. Phys Ther.1981;61:7–15.
27. Travell J, Simons D. Myofascial Pain and Dysfunction:
A Trigger Point Manual, I and II.Baltimore, MD: Williams
& Wilkins; 1983.
28. Wolf S, Basmajian J, Russe C, Kutner M. Normative data on low back mobility and activity levels. Am J Phys Med.
1979;58:217–229.
29. Brown WF. The Physiological and Technical Basis of Electromyography.Boston, MA: Butterworth; 1984.
30. Kasman GS. Surface EMG in Physical Therapy: Applications in Chronic Musculoskeletal Pain.Seattle, WA: Movements Systems; 1995.
31. Kasman G, Cram JR, Wolf S. Clinical Applications in Surface Electromyography.Gaithersburg, MD: Aspen; 1997.
32. Taylor W. Dynamic EMG biofeedback in assessment and treatment using a neuromuscular reeducation model. In:
Cram JR, ed. Clinical EMG for Surface Recordings, II.
Nevada City, CA: Clinical Resources; 1990:175–196.
33. Janda J. Postural and phasic muscle in the pathogenesis of low back pain. Presented at the Tenth Congress of International Society Rehabilitation, 1969, Dublin, Ireland.
35. Wolf S, LeCraw D, Barton L. Comparison of motor copy and targeted biofeedback training techniques for restitution of upper extremity function among patients with neurologic disorders. Phys Ther.1988;69:719–735.
34. Lewit K. Manipulative Therapy in Rehabilitation of the Locomotor System.Boston, MA: Butterworth Heinemann;
1991.
CHAPTER QUESTIONS
1. Surface EMG can be used:
a. to diagnose nerve damage b. to diagnose herniated disk c. as a “clinical” diagnosis only d. all of the above
2. How does adipose tissue (the fat layer) affect SEMG recordings?
a. It makes them invalid.
b. It reduces the SEMG amplitude.
c. It increases the SEMG amplitude.
d. It has a stronger effect on dynamic recordings than on static recordings.
3. During the static evaluation, which approach should one take toward controlling the posture of the patient?
a. standardize the posture by asking the patient to “sit or stand up straight”
b. retain the patient’s natural posture by asking him or her to sit or stand comfortably
c. ask the patient to go to the end range of motion d. none of the above
4. Surface EMG recordings appear to change as a function of age. In general, what statement can be made concerning this finding?
a. Dynamic SEMG amplitudes decrease over the years (decades).
b. Dynamic SEMG amplitudes increase over the decades.
c. Static SEMG amplitudes increase over the decades.
d. both a and c
5. Issues regarding volume-conducted SEMG are best addressed using the following:
a. single-site SEMG recordings b. multiple-site SEMG recordings c. an Ohm meter
d. a volume conductor
6. Some muscle sites are more affected by volume conduction than others. Which of the following muscle sites has the lowest probability of being affected by volume conduction?
a. frontalis b. upper trapezius c. quadratus lumborum d. supraspinatus
7. Which of the following is not one of the clinical syndromes described in the chapter?
a. simple postural dysfunction b. weakness or deconditioning c. acute reflex spasm or inhibition d. bruxism
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