Wavelet Analysis of Surface EMG in Cerebral Palsy

描述（由申请人提供）：脑瘫（CP）是一种发育中的大脑非进行性运动障碍的异质性集合，可能发生在出生前或出生后，直到两岁。多项研究表明，美国、西欧和澳大利亚的CP发病率为每1000例活产2至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相关的高发病率和高成本，需要不断发展临床干预措施来改善运动功能，并且需要发展改进的评估策略来衡量临床干预的效果。有几种方法可以评估CP患儿的运动功能，并用于评估临床干预的结果。然而，这些量表并不是针对测量干预可能导致的肌肉活动模式的变化。例如，有用于测量运动功能和功能能力的分类量表，以及步态功能指标。这些分数虽然提供了一种量化功能和力学的方法，但并不能直接测量肌肉的激活特征。因此，这些测试可能对干预如何直接影响肌肉功能不敏感，而肌肉功能通常是干预的重点（即肉毒杆菌毒素、功能性电刺激、背根切断术）。肌肉活组织检查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，并且在儿科人群和/或临床实施的实用性方面存在担忧，特别是因为它们不能提供肌肉在功能性任务中的行为方式。一种可用于以非侵入性和临床意义的方式深入了解肌肉活动的方法是使用表面肌电图（sEMG）。表面肌电图通常是临床评估和评估CP运动损伤的常规部分。然而，在大多数情况下，对数据的分析仅限于检查信号幅度或肌肉发病和偏移时间的差异。本研究的长期目标是开发一种表面肌电信号分析方法，该方法可用于CP的功能任务，用于治疗计划，诊断和评估目的。这将通过使用连续小波变换（CWT）来完成。通过开发一种基于肌肉活动的评估方法，相信可以设计出一种临床可行的测量工具，该工具将提供一种深入了解干预对肌肉病理生理的影响的水平，这是目前无法获得的。实现这一长期目标的第一步是确定在执行有意义的任务（步态）期间，在给定人群（即脑瘫）中可以表达的预期时间-频率模式的可变性和范围，并将时间-频率信息与更标准的评估联系起来

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