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      Identification and classification of involuntary leg muscle contractions in electromyographic records from individuals with spinal cord injury.

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          Abstract

          Involuntary muscle contractions (spasms) are common after human spinal cord injury (SCI). Our aim was to compare how well two raters independently identified and classified different types of spasms in the same electromyographic records (EMG) using predefined rules. Muscle spasms were identified by the presence, timing and pattern of EMG recorded from paralyzed leg muscles of four subjects with chronic cervical SCI. Spasms were classified as one of five types: unit, tonic, clonus, myoclonus, mixed. In 48h of data, both raters marked the same spasms most of the time. More variability in the total spasm count arose from differences between muscles (84%; within subjects) than differences between subjects (6.5%) or raters (2.6%). Agreement on spasm classification was high (89%). Differences in spasm count, and classification largely occurred when EMG was marked as a single spasm by one rater but split into multiple spasms by the other rater. EMG provides objective measurements of spasm number and type in contrast to the self-reported spasm counts that are often used to make clinical decisions about spasm management. Data on inter-rater agreement and discrepancies on muscle spasm analysis can both drive the design and evaluation of software to automate spasm identification and classification.

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          Author and article information

          Journal
          J Electromyogr Kinesiol
          Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology
          Elsevier BV
          1873-5711
          1050-6411
          Oct 2014
          : 24
          : 5
          Affiliations
          [1 ] The Miami Project to Cure Paralysis, University of Miami, Miami, FL 33136, USA; Department of Neurological Surgery, University of Miami, Miami, FL 33136, USA. Electronic address: cthomas@miami.edu.
          [2 ] The Miami Project to Cure Paralysis, University of Miami, Miami, FL 33136, USA.
          [3 ] Department of Human Genetics, University of Miami, Miami, FL 33136, USA.
          Article
          S1050-6411(14)00110-2 NIHMS612906
          10.1016/j.jelekin.2014.05.013
          4167713
          25023162
          99d723e8-a18e-4518-afc5-af520152cb91
          History

          Clonus,Motor unit action potentials,Muscle spasm count,Myoclonus

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