Introduction: Surface electromyography (sEMG) changes as a result of traumatic spinal cord injury (SCI), which disrupts spinal and supraspinal pathways. The sEMG is a useful addition to current clinical testing and can capture the residual motor command in great detail, even in muscles below the level of injury with seemingly absent motor activities. We aimed to explain how the sEMG properties are altered after SCI in this in-depth review.

Material and Methods: Following a thorough review of the literature, we focused on sEMG analysis methods and signal characteristics post-SCI. Early reports, according to what we discovered, tended to be primarily concerned with the qualitative analysis of sEMG patterns before moving on to semi-quantitative scores and a more thorough amplitude-based quantification.

Results: On the other hand, recent studies are still limited to an amplitude-based analysis of the sEMG, and there are opportunities to more thoroughly characterize the time- and frequency-domain properties of the signal as well as to fully utilize high-density EMG techniques. We advise incorporating a wider variety of signal properties into the neurophysiological evaluation following SCI and gaining a better understanding of the relationship between these sEMG properties and underlying physiology.

Conclusion: Improved sEMG analysis may help in understanding the mechanisms of change after neuromodulation or exercise therapy, as well as provide a more thorough description of how SCI affects upper and lower motor neuron function and their interactions.