Clinical Applications in Surface Electromyography: Chronic Musculoskeletal Pain.

Gaitherburg, MD 1998, 415 pp. $57.00 hardcover

Clinical Applications in Surface Electromyography: Chronic Musculoskeletal Pain, discusses the innovative, complex, and multipurpose technology of Surface Electromyography (SEMG) for the assessment and treatment of chronic musculoskeletal pain. It is the companion publication to the text, Introduction to Surface Electromyography: Clinical Applications in Surface Electromyography.

Potentially, a wide audience can benefit from reading Clinical Applications in Surface Electromyography. Most notably are physical therapists, the primary utilizers of SEMG technology in their clinical practice. However, given the increasingly multi and interdisciplinary health care environment, allied health professionals who work alongside physical therapists can also benefit from this book by becoming more familiar with available treatment options for their clients experiencing chronic musculoskeletal pain. Among these professionals include physicians, nurses, rehabilitation counselors, psychologists, occupational therapists, and social workers.

SEMG monitors neuromuscular activity and generates results through output on an electronic monitor. It is a non-invasive procedure and can provide information to clinicians for both assessment and treatment purposes. SEMG procedures can generate information on such areas as joint, muscles, and various musculoskeletal systems.

In the book's preface, Glenn Kasman notes that chronic musculoskeletal pain significantly affects the U.S. population, as approximately one third between the ages of 25 and 74 report it as a medical problem. It is a medical disorder associated with rising health care use, disability, and financial costs.

Kasman suggests the assessment and treatment of chronic musculoskeletal pain can be extraordinarily complex. Historically, attempts at chronic musculoskeletal pain intervention have largely focused on psychological aspects. With this publication, clinicians are reminded that chronic pain also includes a kinesthetic dimension. Clinical Applications in Surface Electromyography explicates this consideration through discussion of SEMG's potential to ameriolate chronic musculoskeletal pain.

As noted in the preface, the book's 14 chapters correspond to one of two major areas of focus. Chapters one through seven present basic theoretical and practical aspects on chronic musculoskeletal pain treatment as well as the general use of SEMG technology. In these chapters, areas such as assessment procedures, SEMG assisted motor learning, SEMG feedback training, neuromuscular electrical stimulation, and muscle dysfunction impairment syndromes are reviewed. A particular strength in the book's first section is its Chapter one discussion of chronic musculoskeletal pain. In this review, readers are reminded that chronic musculoskeletal pain can be caused by a variety of etiological factors including histologic, psychologic, sensorimotor, and mechanical dysfunction. Separate from the SEMG focus of the book, this chapter stands alone as an excellent overview of chronic musculoskeletal pain.

Chapters eight through 14 review SEMG applications for specific pathologies associated with the occurrence of chronic musculoskeletal pain. Pathologies reviewed include tension-type headaches, myofacial pain, and temporomandibular joint, cervical, low back, hip, shoulder girdle, upper extremity, and knee dysfunctions. Each chapter presents etiological information and SEMG's role in either the assessment or treatment of each disorder.

A useful feature of the book's second section is that following chapters eight through 14, application guides containing practical, hands-on information (e.g., step-by-step procedural checklists) guide clinicians in using SEMG technology for reviewed pathologies. Information in these guides includes ideal candidate descriptions for SEMG intervention, evaluation objectives, feed-back training objectives, recording sites, evaluation procedures, symptom presentation, and assessment protocols.

Clinical Applications in Surface Electromyography demonstrates several effective means to explicate content. First, the authors make frequent use of tables, decision trees, and checklists to summarize material. This strategy can be especially helpful for clinicians that want to review essential steps in a procedure without needing to reread an entire chapter. Moreover, this strategy for information condensing may enhance the ability of readers new to the material to more fully absorb all of the content. Second, the book displays numerous actual SEMG profiles for different assessment and treatment procedures. This serves to contextualize the material, as readers can see firsthand content described in the text. Third, the book is soundly based on the available literature. Beyond validating content, the book's frequent use of literature citations provides a comprehensive list of research studies that can further explicate the subject matter at hand.

A few words of caution are noted. First, as stressed in the preface, readers should have a fundamental understanding of SEMG applications before reviewing and utilizing the SEMG procedures described in the book. SEMG procedures are commonly described in a technical manner. For those who lack a sound understanding of SEMG, it may be prudent to first read the companion text, Introduction to Surface Electromyography: Clinical Applications in Surface Electromyography. Second, the book employs heavy use of anatomical and kinesiologic terms. Those weak in this vocabulary may struggle in trying to read and understand the book. Third, as also mentioned in the preface, assessment and treatment for chronic musculoskeletal pain focuses mostly on SEMG applications. Little mention is made of other intervention approaches such as relaxation-based methods.

Clinical Applications in Surface Electromyography positively contributes to the rehabilitation literature. For many rehabilitation professionals, this book may serve as a useful reference book on SEMG technology and chronic musculoskeletal pain management.

Charles Degeneffe, MSSW Ph.D. Candidate Rehabilitation Counseling Psychology Program University of Wisconsin-Madison 

Glenn S. Kasman, M.S. P.T. Jeffrey R. Cram, Ph.D. Steven L. Wolf, Ph.D., F.A.P.T.A. Lisa Barton, M.M.Sc., P.T.

Gaitherburg, MD 1998, 415 pp. $57.00 hardcover