Quantitative Assessment of Traumatic Upper-Limb Peripheral Nerve Injuries Using Surface Electromyography

Front Bioeng Biotechnol. 2020 Jul 17:8:795. doi: 10.3389/fbioe.2020.00795. eCollection 2020.

Abstract

Background: There is a great demand for convenient and quantitative assessment of upper-limb traumatic peripheral nerve injuries (PNIs) beyond their clinical routine. This would contribute to improved PNI management and rehabilitation.

Objective: The aim of this study was to develop a novel surface EMG examination method for quantitatively evaluating traumatic upper-limb PNIs.

Methods: Experiments were conducted to collect surface EMG data from forearm muscles on both sides of seven male subjects during their performance of eight designated hand and wrist motion tasks. All participants were clinically diagnosed as unilateral traumatic upper-limb PNIs on the ulnar nerve, median nerve, or radial nerve. Ten healthy control participants were also enrolled in the study. A novel framework consisting of two modules was also proposed for data analysis. One module was first used to identify whether a PNI occurs on a tested forearm using a machine learning algorithm by extracting and classifying features from surface EMG data. The second module was then used to quantitatively evaluate the degree of injury on three individual nerves on the examined arm.

Results: The evaluation scores yielded by the proposed method were highly consistent with the clinical assessment decisions for three nerves of all 34 examined arms (7 × 2 + 10 × 2), with a sensitivity of 81.82%, specificity of 98.90%, and significate linear correlation (p < 0.05) in quantitative decision points between the proposed method and the routine clinical approach.

Conclusion: This study offers a useful tool for PNI assessment and helps to promote extensive clinical applications of surface EMG.

Keywords: clinical assessment; machine learning; non-invasive examination; peripheral nerve injury; surface electromyography.