QSEMG Therapy & Benefits Over Traditional SMEG Biofeedback

A Deeper Look At QSEMG (Quantitative Surface Electromyography Treatment)

For those who have lost the ability to use their muscles the ultimate goal is the return of function. For a child with cerebral palsy this may mean discovering healthy patterns of muscle use. For an adult recovering from a stroke it may mean relearning what previously was automatic such as the ability to pour a cup of coffee. Very often the child with cerebral palsy may need help “finding” the correct muscles to use to perform a movement. This is where traditional SEMG biofeedback falls short, as it only targets one or two muscles.  Quantitative Surface Electromyography targets as many as ten muscles.

The whole constellation of muscles must be brought into play for a treatment to be successful. This constellation of muscles, (also called the myotatic unit) produces a symphony of muscle use. The “players” in the symphony are muscle agonists, antagonists, and facilitators all firing at an amplitude and frequency to efficiently perform a movement.  To meet these needs, Dr. Jeffrey Bolek created a new form of surface electromyography called Quantitative Surface Electromyography, or QSEMG. With QSEMG each patient receives an individualized program to maximize muscle use efficiency and minimize activity that is detrimental to the patient. For example, it is common after a head injury to have difficulty finding the muscles to use to produce graded muscle use. Even more difficult is the ability to relax or inhibit muscles after successful rediscovery. For example, post-stroke hemiparesis is weakness on an entire side of the body, which results in difficulty moving the muscles on a patient’s left or right side.

Also important to patients is the ability to return to their normal activities of daily living (ADLs). To achieve this, one must be able to reach with the arm. Treatment using traditional SMEG is inefficient, again, because of the limited number of muscles involved in the therapy. When reaching, we all self-correct, automatically, at our base of support. If the muscles used in this motion are not included in therapy (for example back muscles such as the lower trapezius, upper, middle, lower paraspinals), the treatment will fail. Worse yet, the patient may become discouraged or learn alternative movement strategies that could be harmful in the long run. As the patient continues to advance in treatment, movement strategies that were learned early in treatment may need to be changed. This is because later treatment has likely increased the repertoire of available movement strategies. Associative reactions (similar muscles firing) and co-contractions (muscles that perform opposite movements) are a common occurrence for patients working to regain the muscle use.  Depending on when they occur in treatment, they should be modified or reduced as much as possible.

A major strength of my method, QSEMG, is the ability to modify both the amplitude and frequency of muscle firing.  Knowledge of the muscle frequency change is especially important with patients whose motivation to do the work is an issue. This is most common in young children and cognitively compromised adults. A drop in the frequency of muscle firing is indicative of true muscle fatigue. I understand this phenomenon, and is mindful of it when treating patients. Knowing the difference between genuine complaints of muscle fatigue and lack of motivation is an important part of successful treatment.

Other rehabilitation issues that are frequently addressed are concentric vs. eccentric contractions, treatment in open vs. closed chain muscle use, muscle substitution patterns and diagnosis of muscle pathology. I have experience and knowledge of muscle pathology which is a core part of developing the right treatment strategy for each individual patient. Without this knowledge, a chosen strategy has greater potential for failure.

These are just a few examples of how QSEMG assessment and treatment can help a patients advance in their therapy goals. Contact me today to learn more about how QSMEG can help you.

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