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

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Background

The last 30-50 years have been transformational for our ability to quantify human movement.
New instruments, sensors, and signal processing techniques applied in the sEMG and related fields have demonstrated the utility of integrating science, technology, engineering, and mathematics (STEM) to advance our understanding of human movement in clinical populations. This is requiring rehabilitation researchers and clinicians to acquire new knowledge in order to (1) investigate which technology-based approaches are beneficial for clinical use, and (2) integrate approaches with supporting evidence into clinical practice.

Technology-based assessment offers many potential opportunities to enhance clinical decision-making in rehabilitation. However, clinical uptake of rehabilitation technologies has lagged research innovation and created a wide gap between the available knowledge in biomechanics and electrophysiology and its clinical applications.

The need to fill this gap by developing new educational programs to train and guide the educators of the next generation of physical and occupational therapists and movement scientists has been outlined in the Frontiers Open Book https://www.frontiersin.org/research-topics/11157/ and in a number of tutorials (mostly written by engineers), assays, and consensus papers to be found in:

doi.org/10.1515/tnsci-2022-0279,
https://www.mdpi.com/1424-8220/22/11/4150,
doi.org/10.1016/j.jelekin.2019.102363,
doi:10.1016/j.jelekin.2022.102656,
doi:10.1016/j.jelekin.2020.102440,
doi:10.1016/j.jelekin.2020.102438,
doi.org/10.1016/j.jelekin.2023.102807,
doi:10.1016/j.jelekin.2021.102565.

The first objective of this project is to discuss how rehabilitation clinicians should neither ignore nor be passive users of rehabilitation technologies. Rather, they should play a fundamental role in the development and testing of new technologies, and they should be appropriately educated critical consumers of those on the market. To ensure the necessary foundational knowledge and critical thinking skills, educational content related to science, technology, engineering, and math (STEM) in the curricula of rehabilitation clinicians needs to be upgraded or enhanced. This may look different in different parts of the world as clinical programs and standards vary widely among different countries.

The second objective is to define how much STEM competence would be needed, including when, how, and by whom this knowledge should be taught to a new generation of physical and occupational therapists and movement scientists. In particular, the issue of metrology in biomechanics and electrophysiology should be addressed as a foundation of Evidence Based Practice (EBP).

Contributions dealing with innovation in hardware, software, or signal processing and artificial intelligence, as well as purely clinical studies would not be suitable for this project. However, they could be mentioned as examples or areas of STEM applications.
Articles should address the following issues/questions:

1. the need for upgrading the training of existing professional figures and/or the need for new or specialized practitioners (clinical technologists, academic and/or clinical PTs, neurophysiology technicians, others),

2. is there sufficient evidence that sEMG and related technologies are or will soon be beneficial and clinically meaningful to justify the step from consensus papers to clinical applications and training? Point and counter-point papers are invited,

3. how does the lack of a Ph.D. degree, or clinical doctorate, in many countries, limit the academic career of potential teachers/researchers?

4. discussion of the research, clinical, and educational infrastructure in countries offering a clinical doctorate degree in physical therapy and/or a research doctorate in relevant fields compared to those who do not, including a discussion of the extent to which such degrees are needed in those countries,

5. how, and to what degree, STEM competencies should be prioritized, framed, and delivered in a 3 or 4 year BS curriculum, or in post-baccalaureate Master's or Doctoral curricula, possibly pruning existing coursework,

6. how to frame and deliver STEM competencies with an accessible level math in classroom activities, online educational resources, and educational repositories,

7. how to engage clinicians and engineers in curricula changes, how to increase the interaction between STEM and rehabilitation teachers/students, how to share teaching and research experiences to jointly face and manage the rapid evolution of technology,

8. how to overcome the fact that rehabilitation clinicians are a greatly underused resource for biomedical engineers (and vice-versa) and how forms of co-teaching could be developed to prepare future practitioners to manage the current and impending technological developments in signal processing and AI.

9. the shifting roles and tasks between professions in clinical rehabilitation.

10. how to update reimbursement policies by National Health Services and/or insurance companies and extend coverage for sEMG applications and other emerging rehabilitation technologies.

Keywords: surface electromyography, sEMG, movement analysis, physical therapy, occupational therapy, physiotherapy, education, training, neurorehabilitation metrology

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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