Editorial: Surface EMG and other measurement techniques in rehabilitation research and practice: are new educational programs needed?

Marco Tramontano ¹ Sheng Li ² Roberto Merletti ^3*

• ¹ 1 Dept of Biomedical and Neuromotor Sciences, University of Bologna, Italy 2 Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy, Bologna, Italy
• ² Department of Physical Medicine and Rehabilitation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States
• ³ LISiN, Dept. of Electronics and Telecommunications, Politecnico di Torino, ITALY, Torino, Italy

This Editorial deals with the seven articles submitted to the Frontiers' project https://www.frontiersin.org/research-topics/61597/ [link] which expands project https://www.frontiersin.org/research-topics/11157/ [link].The education curricula in rehabilitation sciences, particularly the foundational components related to Science, Technology, Engineering, and Mathematics (STEM), vary widely in duration and content among the different healthcare professionals in this field and across countries. Some Universities stress STEM education and offer a Ph.D., some do not. In the European Union the BSc academic curriculum of physiotherapists and occupational therapists (PT and OT) lasts three years while in other countries lasts four to five years. In the USA the BSc is three years but becoming a licenced PT/OT requires 7-8 years. Training in interpretation of bioelectric signals (such as sEMG) is generally neglected. Different aspects of this problem have been addressed in many previous articles on the impact of technology in rehabilitation metrology. See, among many others, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] and the Editorials and articles of Frontiers' projects listed in the sitography [S1-S4].A review of the most relevant articles and international projects in the field of interfacing physical therapy with measurement technology for quantitative assessment of outcome is presented by R. Merletti [link]. This author points out how the lack of a PhD degree precludes, in many countries, the academic career of therapists and the training of qualified researchers and teachers in the field, leading to a vicious circle and limiting the academic development of the profession. This leads to the need of new figures with better STEM background that enables them to manage all aspects of rehabilitation metrology. Filling this gap requires time, experience, and expertise that cannot be acquired in a 3-year BSc program.Other reasons, unrelated to educational issues, likely play a role in limiting the scientific and professional developments of the existing figures [21,22].Prof. S. Gupta and S. Aggarwal [link] point out that in many human activities change in behaviour have been introduced by authorities in the field before it was accepted as a useful habit. The use of sEMG-based and other metrologies in rehabilitation implies a significant learning effort and therefore a policy is needed to upgrade teaching. While new academic courses may be suggested by scientists and scientific societies, through tutorials and consensus papers, as done by ISEK, enforcement should come from statutory bodies and councils like NCAHP, World Physiotherapy, NHS and HCPC acting on the Ministries of Education.These authors also support the strategic role of physiotherapists in creating knowledge and applying measurements and STEM methodology to measure outcome and optimize therapies. This syllabus is meant 1) to provide a basis for discussion and adaptation to the educational entry level in different countries, 2) to outline the topics teachers should be very familiar with, 3) to define a basic body of sEMG knowledge common to movement and sport scientists across countries.Xing-Kai Liu et al (link) recommend that educational policymakers revise the physical therapy curriculum to include the fundamental principles and the application of sEMG techniques as mandatory content. They also recommend 1) that educational institutions should partner with technology companies to incorporate state-of-the-art equipment, providing students with opportunities for hands-on experiences, and 2) that educators should actively participate in sEMG technology training and incorporate it into their teaching designs. Through these initiatives, the integration of sEMG technology into physical therapy education should enrich the learning experience and prepare students to the rapidly evolving healthcare landscape, where technology and clinical research are increasingly intertwined.While the authors of this and of the previous collection of papers [S1] seem to agree on the problems at hand, they somewhat differ on the solutions. Proposed solutions range from:1) the introduction of sEMG and other metrologies at the BSc level (hard to do within a 3year program but possible in longer programs or at the MSc level) to 2) the introduction of new figures trained to address/manage current and future technological challenges.While the contributions to this collection of articles mostly concern sEMG, the same problems relate to many other technologies and to the general issue of metrology in physical therapy, occupational therapy, sport, and movement sciences. Carefully considering solutions adopted in some countries may benefit all. Great help would come from a general agreement (a white book?) concerning a better definition of professionals and their technological training requirements, including AI [16]. While interdisciplinary and evidence-based approaches are growing within the rehabilitation field, more efforts in academic programs are needed to address the gap in STEM education.