Wavelet Analysis of Surface EMG in Cerebral Palsy

描述（由申请人提供）：脑性瘫痪（CP）是一种异质性集合的非进行性运动障碍的大脑发育，可能发生在出生前或出生后长达两岁。在美国、西欧和澳大利亚的多项研究中，CP的发病率为每1000例活产2 - 3例，估计终生净经济成本超过90万美元，估计医疗成本超过110万美元（2003年美元）。由于与CP相关的高发病率和成本，需要持续开发临床干预措施以改善运动功能，并且需要开发改进的评估策略以衡量临床干预的效果。有几种方法可以评估脑瘫患儿的运动功能，并用于评估临床干预的结果。然而，这些量表并不针对测量干预可能导致的肌肉活动模式的变化。例如，有旨在测量运动功能和功能能力的分类量表，以及步态功能指数。这些分数虽然提供了一种量化功能和力学的方法，但并不直接测量肌肉激活特征。因此，这些测试可能对干预如何直接影响肌肉功能不敏感，这通常是干预的重点（即肉毒杆菌毒素，功能性电刺激，背根切断术）。肌肉活检和运动诱发电位可以提供有关肌肉激活特征的信息，然而，它们是侵入性的，并且存在对儿科人群和/或临床实施的实用性使用这些技术的担忧，特别是因为它们不能提供对肌肉在功能任务期间如何表现的洞察。可以用于以非侵入性和临床上有意义的方式提供对肌肉活动的洞察的一种方法是使用表面肌电图（sEMG）。表面肌电图通常是临床评估和CP运动障碍评估的常规部分。然而，在大多数情况下，数据分析仅限于检查信号幅度或肌肉起始和偏移时间的差异。本研究的长期目标是开发一种表面肌电分析方法，可用于功能任务期间的治疗计划，诊断，评估目的在CP。这是通过使用连续小波变换（CWT）来实现的。通过开发基于肌肉活动的评估方法，相信可以设计出临床上可行的测量工具，其将提供对干预对肌肉病理生理学的影响的一定程度的了解，这是目前不可用的。朝着这个长期目标前进的第一步是确定可以在给定群体中表达的预期时间-频率模式的可变性和范围（即，大脑性麻痹），并将时间-频率信息与更标准的评估相关联

DESCRIPTION (provided by applicant): Cerebral palsy (CP) is a heterogeneous collection of non-progressive motor disorders of the developing brain that may occur before or after birth up to the age of two years. The incidence of CP in the United States, Western Europe, and Australia across multiple studies is between 2 and 3 cases per 1000 live births, with an estimated net lifetime economic cost of over $900,000 and estimated medical costs of over $1,100,000 (2003 dollars). Due to the high incidence and costs associated with CP, there is the need for the continual development of clinical interventions to improve motor function, and a need for the development of improved assessment strategies to gauge the effects of clinical intervention. Several methods exist to evaluate motor function in the child with CP and are used to assess the outcome of a clinical intervention. However, these scales are not directed towards measuring the changes in muscle activity patterns that can result from the intervention. For example, there are classification scales aimed at measuring motor function and functional abilities, and indices of gait function. These scores, while providing a way to quantify function and mechanics, do not directly measure muscle activation characteristics. Therefore, these tests may be insensitive to how the intervention has directly affected muscle function, which is usually the focus of the intervention (i.e. botulinum toxin, functional electrical stimulation, dorsal rhizotomy). Muscle biopsies and motor evoked potentials can provide information about the muscle activation characteristics, however, they are invasive and there are concerns about using these techniques on the pediatric population and/or the practicality of clinical implementation, especially since they do not provide insight into how the muscle behaves during a functional task. One method that can be used to provide insight into muscle activity in a non-invasive and clinically meaningful manner is the use of surface electromyography (sEMG). Surface EMG is typically a routine part of clinical assessment and the evaluation of motor impairment in CP. However, the analysis of the data has been limited in most cases to examination of signal amplitude or differences in muscle onset and offset timing. The long-term goal of this research is to develop an analysis method for sEMG that can be used during functional tasks for treatment planning, diagnostic, assessment purposes in CP. This is to be accomplished through the use of the continuous wavelet transform (CWT). By developing an assessment method based on muscle activity, it is believed that a clinically viable measurement tool can be devised that will provide a level of insight into the effects of an intervention on muscle pathophysiology that is not currently available. The first step in progressing towards this long-term goal is to determine the variability and range of expected time-frequency patterns that can be expressed in a given population (i.e., cerebral palsy) during the execution of a meaningful task (gait), and relate the time-frequency information back to more standard assessments