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A Proposal of Clinical Report Regarding Dynamic Emg in Gait Disorders Following Upper Motoneuron Lesion

A report which includes patient problems, descriptions of clinical and instrumental assessment and conclusion with suggestions for decision making, is a necessary tool for an adequate approach to the patient. In this paper we tried to define those steps we believe to be useful to produce a clinical report for patients with ambulation disability submitted to dynamic gait emg: Brief description of the patient's history; Description of the deformities; Observational gait analysis; Report of the items relevant to the deformities and/or relevant for treatment proposals; List of recorded muscles; Emg timing pattern; Conclusions leading to treatment proposals. The emg timing pattern can be useful for the identification of peripheral and central impairments (contracture, paretic, spastic, co-contraction components), which can significantly interfere with the gait profile of the single patient. We can use forms and tables which include emg signals features and recording parameters, physical examination and observational gait analysis notes. Attention must be paid for an adequate support of literature. Patients with upper motoneuron (UM) lesions frequently present impairments in lower limb function which influence normal walking. Gait rehabilitation is an important goal because the ability to walk significantly influences the patients' chances of successfully returning to their premorbid environment. To improve the gait of the patients, therapists and rehabilitation teams attempt to improve the various impairments of hemiparetic subjects, such as paretic lower limb muscle strength, balance, motor function, sensation, and muscle tone. Consequently, it is important to understand the characteristics and underlying motor control of gait in patients with UM lesions. Human gait is conventionally described in terms of "gait cycle"(GC) and represents a sequence of events between two sequential initial contacts with the floor by the same limb. The gait cycle is divided into two principal periods: stance and swing. The stance is usually considered the first period of GC and corresponds to when the foot is on the ground for the entire period and lasts for approximately the first 60% of GC time, the swing period begins as the foot is lifted from the floor and continues for the last 40% of the cycle. J. Perry (1) subdivided gait cycle and the stance and swing periods into three functional tasks; each task includes some phases: 1) During the Weight Acceptance (10% of the GC) the challenge is the transfer of body weight onto a limb that has just finished swinging and has an unstable alignment. It includes two phases: Initial Contact (IC) which is the moment when the foot lands on the ground ( the way the foot makes contact will influence the limb's loading) and