Electromyography Recordings Detect Muscle Activity Before Observable Contractions in Acute Stroke Care.

Small convenience sample of 21 patients from one level 1 trauma hospital. Groups were formed by existing MMT scores, not by random assignment. The study did not test whether EMG monitoring changes care or improves outcomes. The origin of contractions was unknown. They may be voluntary, reflex, random, or related to care. MMT is coarse and may miss subtle strength changes. EMG amplitudes were absolute millivolts, not normalized to maximum voluntary contractions, because participants could not perform those actions. Monitoring was passive during standard care, not during controlled movements, so activity context was limited. Sensors had hardware noise, a wide interelectrode distance that increased crosstalk, and manual contraction identification was time intensive. Passive range of motion checks were done in only 9 of the 11 participants with MMT=0. Follow-up analyses were exploratory. Only the MMT=0 group was used, one participant did not return, and MMT scores reached ceiling in some participants. Only 4 of the MMT >0 participants continued to inpatient rehabilitation, limiting follow-up comparisons.

Do not read EMG contractions as proof of voluntary movement, a therapy effect, or a reliable predictor of recovery. The study had 21 patients, the origin of the contractions was unknown, and the follow-up links were exploratory.