1 Pattern View
This graph is the Insight’s sEMG “Pattern View”. This analysis is a unique, patent pending sEMG application that only the Insight provides. Of primary importance to the chiropractor is the way muscle energy is being distributed throughout the spine. Patterns can demonstrate ‘efficiency’ or they can exhibit lack thereof. Think of it sort of as the motor systems ‘miles per gallon’ rating. A person’s somatotype or age may affect sEMG amplitude signals. But with the Insight’s breakthrough pattern view, clinical impressions will not be skewed due to these factors. Colors and the shape of the lines serve as visual cues to easily assess the results.

2 Symmetry Graph
This scan of a patient’s muscle asymmetry depicts the amount of muscle pull from one side to another. Normal is marked by white spikes or no spikes at all. The same colors are used here – green, blue and red for mild, moderate and severe levels of muscle asymmetry respectively.

3 Amplitude Graph
The patient’s sEMG scan is compared to normal. We are viewing the amplitude (amount of tension) of paraspinal muscle activity, along with hyper- or hypo-tonicity as it compares to a normal population. Green bars indicate one standard deviation over normal, or mild elevation. Blue bars indicate moderate elevation and Red bars indicate severe elevation. Yellow indicates one standard deviation below normal.

4 Dynamic Graph
The Dynamic EMG Scan can track up to four channels of muscle activity while the patient moves through various ranges of motion. The Insight ‘event marker’ feature assists interpretation by marking the position of the patient during the test. This graph is accompanied by a dynamic narrative report.

5 Quantifications Report
The Quantifications Report Graph documents each patient’s progress.

6 sEMG – an accepted technology for clinical use
According to other sEMG manufacturers who market to the medical profession, the following medical specialties have utilized surface EMG since the late 1980’s:

• Urologists for diagnosis and treatment of urinary incontinence
• Orthopedists for muscle rehab and training
• Physiologists for anxiety, tension/migraine headaches, rehab
• General practitioners for circulation problems, anxiety, desensitization, distonia [muscle tonus], incontinence, spasms, relaxation, psychosomatic symptoms
• Family practitioners for circulation problems, anxiety, desensitization, distonia [muscle tonus], incontinence, spasms, relaxation, psychosomatic symptoms
• Neurologists for anxiety, muscle training and rehab, spasms
• Speech pathologists for anxiety, relaxation
• Sports Medicine for muscle training and rehab
• Corporate Medicine for muscle training and rehab
• Psychiatrists and psychologists for anxiety, desensitization, psychosomatic symptoms, tortocollis, writer’s cramp, phobias
• Rehab centers for muscle training, relaxation, spasms, and urinary incontinence
• Occupational therapists for muscle training/rehab, relaxation, migraine headaches
• Dentists for TMJ, anxiety, tension/migraine headaches

Go to www.bio-medical.com to see how sEMG is currently being used by physical therapists, physiatrists, massage therapists, and RNs.

7 Independent Studies
Christopher Kent, DC, FCCI, JD, CLA Co-Founder and Research Director, and one of the chiropractic profession’s leading researchers, sums up the issue on reliability of sEMG: “Studies spanning decades consistently report high levels of reliability. Quite simply, no other procedure I am aware of in chiropractic, except measurements on x-rays, approach the reliability of sEMG. Studies from the Mayo Clinic to the NZ Chiropractic College have demonstrated this. NONE OF THESE STUDIES WERE PERFORMED OR FUNDED BY CLA.”

Price, Clare, Ewerhardt (1) observed that surface electrode paraspinal electromyography has been employed since 1948 to measure muscular activity.

Cobb et al (2) concluded that “…muscle spasm (even when mild) is accompanied by muscular hyperactivity which can be evaluated by suitable electromyographic techniques. Our data suggest that surface electrodes allow better sampling than Teflon coated needles…” and that “…integration procedures (surface EMG) allow better quantification than does the visual evaluation of a (needle) EMG…”

Surface electrode electromyography with attached electrodes exhibits very good to excellent test-retest reliability. Reliability is a measure of the ability to reproduce a measurement, which is expressed as a coefficient ranging from 0.00 to 1.00. Perfect reliability results in a coefficient of 1.00, while chance agreement would be 0.0. As presented below, research data indicates that the reliability of sEMG is clearly superior to palpation for muscle tension.

Spector (3) reported a surface EMG study performed at New York Chiropractic College which yielded correlation coefficients ranging from 0.73 and 0.97.

Komi and Buskirk (4) compared the test-retest reliability of surface electrodes vs. needle electrodes in the deltoid muscle. The test-retest reliability for surface electrodes was 0.88 compared to 0.62 for inserted electrodes.

Giroux and Lamontagne (5) compared the reliability of surface vs. intramuscular wire EMG of the trapezius and deltoid muscles during isometric and dynamic contractions. The statistical analysis on the integrated EMG was a factorial analysis model with repeated measures. They found that surface EMG was more reliable than inserted wire EMG on day-to-day investigations.

Andersson et al (6) compared the electrical activity in lumbar erector spinae muscles using inserted electrodes and surface electrodes. They found that the standard deviations and coefficients of variation for wire electrodes was greater than those for surface electrodes. They concluded, “Wire electrodes are more sensitive to electrode location and give estimates with less precision than surface electrodes.”

Thompson et al (7) found that the scanning electrode technique correlated well with the “gold standard” of attached electrode technique (The Insight sEMG has both static and attached electrode techniques).

Cram et al (8) evaluated the reliability of surface EMG scanning in 102 subjects in the sitting and standing positions. sEMG scans were performed on three occasions approximately one hour apart on the same day. The median correlation between hand-held and patch electrodes was high, with a correlation coefficient of 0.64. The authors concluded, “With adequate attention given to skin preparation, EMG sensors held in place by hand with a light pressure provide reliable results.”