Electromyography Clinic Takes Guesswork Out of Physical Therapy

BY RANDI BJORNSTAD
The Register-Guard
Published: Midnight, May 14

Looks can be deceiving, but not at Tensegrity Physical Therapy, where high tech has taken much of the mystery out of traditional physical therapy.  Consider, for instance, the elite soccer player who once contacted Tensegrity owner Sean Roach and PT coach Marc Lyda for a consultation after undergoing treatment for a leg injury.  ”

If you just looked at her and examined her visually as she jumped off a stool and landed flat on both feet, she looked absolutely perfect,” Lyda said. “But then we had her jump off the block onto a force plate connected to a computer, which showed what was actually happening with the muscles in both legs, and we could see she was compensating for the injury by landing with all of her force on her other leg.”

That meant the athlete not only hadn’t resolved the initial problem but also could have sustained even worse injuries later. It also meant that a targeted exercise regimen could be developed, showing her how to activate the muscles in her weaker leg while also protecting the over-compensating limb from trauma.

“I’ve been in coaching for over 30 years, and I’ve never seen anything like what this approach can offer,” Lyda said. “With electromyography we can break down every movement and show the client what needs to be changed, whether for better general health or improving athletic performance.”

The name of the downtown Eugene business, Tensegrity, comes from the term “tensional integrity,” based on the idea that the body’s skeletal and muscular systems are an integrally interconnected whole, and that a dysfunction in one area can affect parts of the body that may seem completely unrelated. Tensegrity uses electromyography — the recording of electrical activity in muscle tissue — to diagram body movement and pinpoint muscle involvement, showing what actually happens as a person walks, runs, squats, kicks, throws or rides a bicycle.  Using the technology, therapists not only can design exercises to treat straightforward joint and muscle ailments, they also can figure out if something else is actually causing the problem.  The business has a dual purpose of running a client practice as well as a nonprofit research organization to further the scientific application of electromyography, Roach said.

“We’re starting a study working with 70 high school runners this summer at South Eugene High School,” he said. “We will evaluate each runner at the beginning and follow them through the running season. We will catalog injuries and other data, and then we will look for relationships between injuries and biomechanical functions.  Eventually, we would like grants to do this with all of the high schools in the area, to be able to predict — and prevent — injury.”

Roach came to Eugene seven years ago. He has dual doctorates in physical therapy and orthopedics and sports medicine, plus extensive post-doc training in joint and soft tissue manipulation, gait analysis and strength and conditioning exercise. His wife and Tensegrity co-owner, Rachel Roach, has a master’s degree in physical therapy. The staff includes seven other physical therapists and researchers.  The necessary equipment for a fully functional electromyography clinic includes a
specially made treadmill, wind trainer, force plates in the floor and wireless electrodes to send signals from patients to computers — those alone cost $26,000, Sean Roach said — so the cost is prohibitive for many nonresearch clinics. But Tensegrity is happy to share the concept.

“We welcome other physical therapists to come with their patients and run through a session with us to diagnose what’s going on,” Roach said. “Then they can take that knowledge and go back and develop their own therapy program. Or, patients can come and do the diagnosis with us and then take all the information to another physical therapist for treatment.”

The services Tensegrity offers can fill another need, too, he said. “We’re also available to see patients who have been released back to work or sports after an injury to do an assessment to make sure they know how to manage their bodies to avoid future injury.”

A few days ago, one of Tensegrity’s therapists watched an older woman with wireless electrodes on her legs as she held onto a support and alternately kicked her legs as far as she could behind her. With each thrust a green line appeared across a computer screen in front of her, showing how much muscle activity she had generated compared with an agreed-upon goal.

“She can see exactly how her muscles are working and also how her right hip works compared with her left, which can’t happen without this kind of technology,” Roach said. “If we couldn’t show her exactly what was happening, none of us would know how far she needed to go to improve her condition.”

Another image shows brightly colored footprints. The left foot is mostly green and blue, with yellow patches on the ball and heel, but the right has an angry-looking red blotch on the ball.

“We get these images from having patients walk on our treadmill, which has a pressure plate that feeds to the computer, Roach said. “This image is of someone with a pattern of stress fractures.”

But the technology also works wonders for people with diabetic neuropathy who lose sensation in their feet. “They can’t feel it, but we can put them on the treadmill and quickly see from the computer images if they have problems developing that could lead to blistering and other conditions that are very dangerous for diabetics,” he said.  “We can break down every aspect of the way people walk and see where the problems are.”

Even though the body is a mechanical system, in some cases what seems logical isn’t necessarily what’s actually going on, and electromyography can ferret that out, Roach said. “In sports, baseball pitchers are often treated for shoulder injuries, but it often happens that the opposite hip — not the shoulder at all — is the root of the problem because of the combination of exaggerated movements they make when they throw.”

Before electromyography, “as physical therapists we often had to make educated guesses about what was going on based on what we could see or determine manually,” Roach said. “Being able to track how well muscles are engaging by the numbers is a huge step forward in keeping people healthy.”

“We can break down every aspect of the way people walk and see where the problems are.”
— SEAN ROACH, TENSEGRITY PHYSICAL THERAPY

http://www.tensegrityphysicaltherapy.com/