  Spinal cord stimulation has enabled humans with motor complete spinal cord
injury (SCI) to independently stand and recover some lost autonomic function.
Quantifying the quality of bipedal standing under spinal stimulation is
important for spinal rehabilitation therapies and for new strategies that seek
to combine spinal stimulation and rehabilitative robots (such as exoskeletons)
in real time feedback. To study the potential for automated electromyography
(EMG) analysis in SCI, we evaluated the standing quality of paralyzed patients
undergoing electrical spinal cord stimulation using both video and
multi-channel surface EMG recordings during spinal stimulation therapy
sessions. The quality of standing under different stimulation settings was
quantified manually by experienced clinicians. By correlating features of the
recorded EMG activity with the expert evaluations, we show that multi-channel
EMG recording can provide accurate, fast, and robust estimation for the quality
of bipedal standing in spinally stimulated SCI patients. Moreover, our analysis
shows that the total number of EMG channels needed to effectively predict
standing quality can be reduced while maintaining high estimation accuracy,
which provides more flexibility for rehabilitation robotic systems to
incorporate EMG recordings.
