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[Contributions of histochemistry to the development of electromyography: pathological genesis of the subunit and heterogeneity of recruitment of the motor units].

Histochemical homogeneity of the motor unit and depletion of muscle unit glycogen by motoneurone repetitive-stimulation (Kugelberg and Edström) have offered the most suitable way of investigating how the fibres of the individual motor unit are distributed in skeletal muscles of animals. Revised analysis of the potential field of motor units action potentials in human beings (Buchthal and Rosenfalk) confirms that the fibres of a motor unit in normal human muscle lie solitary. Therefore the concept of the motor subunit in normal human muscle has been abandoned, while bundles of fibres belonging to the same motor unit are now known to occur only by reinnervation. Because of these findings, single fibre electromyography, as developed since 1963 by Ekstedt and Stalberg, appears as a main method to investigate the properties of different muscle fibres within the muscle unit. With regard to the heterogeneity of fibres and motor units, one must consider that statistical analysis of motor units and single fibre electrophysiological parameters have never shown any evidence of bi-or pluri-modal distribution in the histograms of duration and amplitude values. Consistent differences however have been found in the patterns of recruitment frequency of at least two types of motor units (Grimby and Kugelberg). It is suggested that these differences may represent the primary fact by which the structural, histochemical and other functional properties may be affected and maintained. The typization of muscle fibres should be conceived as the effect of a plastic process (in accordance with the continuous range of values) rather than a static one (in the absence of bimodal distribution).

Electromyography↗

Lung function and surface electromyography of intercostal muscles in cement mill workers.

Impairment of pulmonary function in cement mill workers has been previously reported without considering a variety of parameters that can help evaluate more thoroughly the effect of cement dust on the respiratory system. In addition, an integrated approach has not been considered to assert the involvement of respiratory muscles. Therefore, in the present study spirometry and surface electromyography (SEMG) of intercostal muscles were used for indicating pulmonary impairment. In this study, a group of 50, apparently healthy volunteers, male cement mill workers aged 20-60 years with exposure of 13 years on average, were randomly selected. They were matched with another group of 50 control healthy male subjects in terms of age, height, weight and socioeconomic status. Both groups met the standard exclusion criteria. Spirometry was performed on an electronic spirometer, while SEMG of intercostal muscles was performed by using a chart recorder. The results demonstrated statistically significant reduction in lung function parameters i.e., force vital capacity (FVC) (p < 0.0005); force expiratory volume in first second (FEV1) (p < 0.0005); peak expiratory flow (PEF) (p < 0.005); and maximum voluntary ventilation (MVV) (p < 0.0005) in cement mill workers, when compared with controls. However, the FEV1/FVC ratio was significantly higher (p < 0.025) in cement mill workers. Similarly, the parameters obtained from SEMG of intercostal muscles, i.e. number of peaks (NOP) (p < 0.0005); maximum peak amplitude (MPA) (p < 0.0005); peak to peak amplitude (PPA) (p < 0.0005); duration of response (DOR) (p < 0.0005) and maximum peak duration (MPD) (p < 0.0005), were significantly lower in cement mill workers than in controls. It is concluded that exposure to cement dust not only impairs lung function but also affects costal muscle performance, thus possibly indicating the decreased lung and thoracic compliance.

Adult↗

Disposable concentric needle electromyography electrodes artifact discharge mimicking positive sharp waves.

OBJECTIVES: To determine a new artifact discharge produced from the disposable concentric needle (DCN) electromyography (EMG) electrodes. METHODS: We have recorded the activity obtained after the first insertion of 41 DCN (37 mm) and 36 DCN (50 mm) in several muscles during the rest. The number of the patients was 77 (26 males, 51 female). RESULTS: We observed an artifact discharge (AD) resembling positive sharp waves (PSWs) in 31 patients of 77 insertions. The AD occurred with 18 of 41 insertions of DCN 37 mm and 13 of DCN 50 mm. The artifact resolved when the needle has been moved in the muscle or in the adipose subcutaneous tissue. CONCLUSION: This AD should be recognized when using DCN electrodes to avoid confusion with PSWs. Recognizing these artifacts during needle EMG is important to avoid false positive results.

Adolescent↗

[Electromyography activities of the head, neck and upper trunk muscles with mandibular movement in normal adults].

OBJECTIVE: To investigate the activities of head, neck and upper trunk muscles with mandibular movement in normal adults. METHODS: The integral data of surface electromyography (EMG) had been recorded to analyze the activities of anterior temporal (Ta), posterior temporal (Tp), sternocleidomastoid (SCM) and trapezius (TRAP) muscles with mandibular movement in ten normal adults. RESULTS: The former mentioned muscles acted constantly when the mandible was in the rest position. The activities of Ta, Tp and SCM muscles increased with protrusion of mandible, mouth opening, tapping, maximum clenching, and chewing movements. The amplitudes of the increased activity of these muscles were correlated significantly with each other. When the activities of Ta and Tp muscles increased to 56 times and 25 times respectively, the activity of SCM muscle increased to 5 - 6 times. The activity of trapezius muscle increased with protrusion of mandible and opening movement, but tended to stop with the maximum clenching and chewing movement. The correlations of left and right sides of the same muscles had been found. CONCLUSIONS: The muscles of head, neck and upper trunk can act as contributors to keep the mandibular positions and take part in the mandibular movements.

Adult↗

Evaluation of motor unit firing rates by standard concentric needle electromyography.

Motor unit firing rates at slight voluntary contraction were studied by standard concentric needle electromyography. Employing digital signal analysis techniques firing rates of motor units (MU) could be evaluated as long as four or less different MUs were activated in the vicinity of the concentric needle electrode. The extension of the recording area is defined by the recording properties of the electrode and the upper limit of rise-time for all MUPs being evaluated. Distant MUs, generating volume conducted potentials with rise-times greater than 0.8 ms, were excluded. In biceps muscles of 15 healthy controls the firing rate of the MU activated first was evaluated at that moment, when a second MU was recruited and was found to be 12.1 +/- 2.1 Hz (mean +/- S.D., n = 40). The firing rate of the fastest MU out of 2, 3, or 4 simultaneously active MUs was 10.7 +/- 2.5 Hz, 10.9 +/- 2.5 Hz and 10.6 +/- 2.4 Hz respectively. Hence at low innervation level there is no increase of firing rate with rising number of activated MUs. The upper normal limit of MU firing rate (3 sigma interval) is calculated as 17 Hz, irrespective whether 1, 2, 3 or 4 MUs are active within the recording area. Fifteen patients with partially denervated biceps muscles were investigated. Maximal firing rates were increased in 10 patients, all showing moderate or severe paresis (grade 1-3). In 10 patients suffering from myopathies firing rates always were normal. The presented data may serve as an additional criterion in evaluating MU firing rates during standard clinical EMG.

Action Potentials↗

[Electromyography findings of pelvic floor muscles in patients with anorectal incontinence].

In the presented study the electromyographical signs of the sphincter muscle of 14 patients with incontinence of the faeces are described and compared with those of a group of continent controls. We found significant differences in the duration of the action potential, the average amplitude, the frequency of polarity turns and the integral of the curves. The application of automatic EMG-analysers allows exact differentiation between neurogenic and myogenic disturbances as well as conclusions about the functional integrity of the m. sphincter ani externus and m. puborectalis. The electromyography as a dynamic diagnostic method is a valuable enrichment of the equipment for diagnostic evaluation of the diseases of the pelvic floor. It will be of increasing importance in the differential diagnosis of the incontinence of the faeces and of pudendus nerve lesions as well as in any disease in which a denervation of the parietal or visceral muscles of the pelvic floor is involved.

Adult↗

[A method for performing stimulation electromyography of the masticatory muscles in man].

A principal block scheme of an apparatus complex is suggested and a method for examination of masticatory muscle function is described. The method is based on electrostimulation of masticatory nerve followed by registration and analysis of the masticatory muscle action evoked potentials. The block scheme of the apparatus complex includes a universal electrostimulator ESU-2. Examinations of 30 healthy volunteers and 30 patients with unilateral fractures of the mandible helped define the major parameters of stimulation electromyography. The patients were treated by splints applied on the teeth with fixation on both jaws. By day 28 of the investigation the M-response amplitude dropped more than twofold and its length by 1.5 times as against the mean parameters in health.

Action Potentials↗

Long-term effect of a single dose of sulfur mustard on nerve conduction velocity and electromyography pattern in rat hindlimb.

OBJECTIVE: Biological effects of sulfur mustard (SM) on various systems have been investigated in both humans and animals. However, few studies are available on the effect of SM on the peripheral nervous system. In the present study, long-term effects of a single dose of SM on nerve conduction velocity and electromyography (EMG) pattern is evaluated in hindlimb of adult male rats. METHODS: SM poisoning was induced by two means: subcutaneous injection of 1 and 3.5 mg/kg SM in two experimental groups (1 and 2) and cutaneous application of 8 and 13 mg/kg SM in groups 3 and 4. Sham and control groups received SM vehicle, isopropyl alcohol, and nothing, respectively. Electrophysiological assessments were performed after 26 weeks as follows: sciatic nerve conduction study that included measuring, amplitude, duration, and latency of M-wave, F-wave latency, and EMG study in resting and minimal contraction states. RESULTS: Results indicate that sciatic nerve conduction velocity did not significantly change in any experimental groups. However, resting EMG records showed some abnormalities very similar to positive sharp waves and fasciculation reported in humans. These abnormalities were observed in 6 of 36 intoxicated rats. CONCLUSIONS: Although the present data are in favor of axonal degeneration, to rule out the possibility of other types of degeneration, additional thorough studies at ultrastructural level are suggested.

Animals↗

[Stimulation single fiber electromyography in rats with myasthenia induced by organophosphorus insecticides and their mixtures poisoning].

OBJECTIVE: To study the neuromuscular function and its relation with the occurrence of myasthenia in rats poisoned by dimethoate (D), phoxim (P), methomyl (M), M + D and M + P respectively. METHODS: The stimulation single fiber electromyography(SSFEMG) at different stimulus frequencies(5, 10 and 20 Hz) was used. The whole blood cholinesterase (ChE) activity was measured 1 h before and after poisoning. RESULTS: (1) Myasthenia occurred in 5 out of 9.5 out of 10.5 out of 5, and 8 rats poisoned by D, P, M + D, and M + P, respectively. (2) The average mean consecutive differences(MCD) at 5, 10, and 20 Hz in myasthenic rats were significantly higher than those of poisoned rats without myasthenia and the control ones. (3) SSFEMG changes at 5, 10 and 20 Hz were significantly consistent with the clinical manifestation of myasthenia, especially at 10 Hz and 20 Hz. (4) ChE activity was significantly lower in rats with P or D poisoning while ChE inhibition was of no difference in rats with M, M + D, and M + P poisoning. In the D poisoning and P poisoning groups, there was no significant difference in ChE inhibition between the rats with and without myasthenia. CONCLUSION: Muscle weakness was associated with neuromuscular transmission dysfunction, but not well correlated with ChE inhibition. The SSFEMG with stimulus frequency at 10 Hz or 20 Hz could be used to detect the neuromuscular dysfunction during myasthenia induced by organophosphate insecticides and their mixtures poisoning.

Animals↗

Using weights in abdominal exercises: electromyography response of the Rectus Abdominis and Rectus Femoris muscles.

Among persons who do regular exercises, many include abdominal exercises in their customary routine. For this, there are a growing variety of movements being created for strengthening the abdominal muscles. This work aims to know, through electromyography analysis, the action potencies of the supra and infra umbilical of the Rectus Abdominis and Rectus Femoris muscles during the execution of abdominal exercises with and without the addition of weights. Lying on the backside, seven flexing movements of the trunk--one without weight, three with 2 Kg on the neck, elbow and chest and three with 4 Kg on the same points--were executed. Nine female university students between 18 and 23 years old participated in the study. Surface electrodes were fixed to the supra and infra umbilical areas of the Rectus Abdominis and Rectus Femoris muscles. The results showed that the utilization of weights in the abdominal exercises did not appear to be effective for the Rectus Abdominis muscle since greater action potencies were only verified in the Rectus Femoris muscle. We concluded that the differences observed in the RMS were not relevant to the point of indicating the utilization of weights to improve abdominal exercises because greater action potencies were only observed in the Rectus Femoris muscle.

Action Potentials↗

[Examination of maximum transdiaphragmatic pressure, diaphragm electromyography in patients with obstructive emphysema].

This paper reported the methods and results of maximum transdiaphragmatic pressure (Pdi max) and diaphragm electromyography (EMGdi) in 16 patients with obstructive emphysema. A correlation analysis showed that Pdimax is negatively related to PaCO2, FRC%, and positively to VC, IC, FVC and MVV closely. Diaphragmatic fatigue was induced by inspiratory resistive loaded breathing with the parameters of 60% Pdimax and 5 minutes lasting. The influential effects and clinical value of diaphragm examination were discussed.

Blood Gas Analysis↗

[Assessment of motor impairment with electromyography--the kinesiological EMG].

Kinesiological electromyography means the application of the surface EMG measurement technique during movement and locomotion. The authors investigated the motor impairments of the upper limb of patients with spastic hemiparesis. Surface EMG activity in musculus biceps brachii and musculus triceps brachii were recorded during voluntary elbow flexion and extension movements. In some cases even the raw EMG signals contain the accurate information but more often the recorded signals should further be processed to achieve more valuable data concerning muscle performance. The limitations of the technique underlines the importance of the several steps of the processing. The purpose of this study is to present a systematic description of the methods and the precise application of surface EMG. The authors give a comprehensive view of different processing methods and demonstrate the application areas of the kinesiological EMG.

Adolescent↗

[Spectral analysis of electromyography of low back muscle fatigue induced by simulated driving].

OBJECTIVE: To evaluate the effects of different vibration frequency on the back muscle fatigue during simulated driving. METHODS: Thirty-six subjects performed three simulated driving experiments under three vertical vibration frequencies which were 1.8, 4.0, 6.0 Hz respectively and the driving time was 90 minutes. At the same time the electromyography of low back was recorded. RESULTS: The median frequencies calculated from the power spectrum were decreased exponentially under three vertical vibration frequencies, especially under 4.0 Hz vibration frequency. CONCLUSION: The 4.0 Hz vibration frequency has the most important effect on the back muscle fatigue under simulated driving condition.

Adult↗

[Electromyography of the larynx with skin surface electrodes].

A new method of skin surface electromyography (EMG) was evaluated. Twelve electrodes were placed symmetrically in the cricothyroid and thyroid lamina region. Raw EMG signals were continuously recorded, filtered, and rectified. Phonation of the vowel /a/ triggered a computer, which thereafter stored a 625-ms EMG recording, starting 375 ms before and ending 250 ms after onset of the audible phonation. Sixteen to 64 of these recordings were averaged to eliminate random noise. Twenty-six healthy subjects and 9 patients with unilateral laryngeal paralysis were studied. EMG activity exhibited great intra- and interindividual variation. Often, even in healthy subjects, EMG levels were different between the left and right side of the larynx. Thus, this method is not suitable for diagnosis or follow-up of laryngeal paralysis. Sources of variation in EMG activity are discussed.

Adolescent↗

Analysis of knee movements on leg extension machine: an electromyography study of the rectus femoris muscle.

The Rectus Femoris muscle was analyzed by electromyography in 10 female subjects between 19 and 22 years old. Surface electrodes were utilized by placing them at the middle of the muscle. The course of the flexing/extending movements of the knee were analyzed on a Leg Extension Machine. The results showed that the MIC value was greater in the series with loads than in the series without loads. For the Maximum Isometric Contraction (MIC) the value was 144.00. In the movement executed without load the value was 73.96. In the first series with the initial 15 Kg load the value was 163.7 and in the last series of the initial load the value was 194.9. With the 19 Kg load in the first series the value was 182.5 and in the last series the value was 205.1. In the first series with the 21 Kg load the value was 165.1 and in the last series with the 21 Kg load the value was 23.09. The values reflecting the need to recruit more muscle fibers to continue executing the movement. The value 23.09 shows the difficulty in proceeding with the movements and can be considered the beginning of a muscular fatigue process in the Rectus Femoris muscle.

Action Potentials↗

Effect of resilient liners on masticatory muscle activity of edentulous patients: clinical and electromyography studies.

This investigation evaluated how the soft lining of both maxillary and mandibular complete dentures influences the activity of the masseter and temporalis muscles. Electromyography was used to determine changes in muscle activity. The findings, expressed by Root Mean Square values, indicated an increase in muscle activity after insertion of dentures and prior to application of soft lining material. These activities decreased gradually throughout the 12-week evaluation period following the application of soft liner. Significant differences were noted between masseter and temporalis muscle activity during mastication of different types of food.

Analysis of Variance↗

Orbicular muscle akinesia: a comparison, using electromyography, of three techniques.

Ninety patients scheduled for elective cataract extraction under local anesthesia received an inferolateral intraconal injection of 4 mL of etidocaine mixed with hyaluronidase. They were divided into three groups of 30 patients each according to the method used to provide orbicular akinesia. Those in group I had a nasal, intraorbital injection; those in group II underwent electrostimulation to locate branches of the facial nerve in the eyelids; and those in group III had the anesthetic agent injected subcutaneously into the lids. Ten minutes after the regional blockade, orbicular muscle activity of the upper eyelid, as measured by electromyography, was found to be higher in group I than in the other two groups. The muscular activity of the lower lid at 10 minutes, or of either of the lids at 20 minutes, was similar in all three groups. The use of electrostimulation did not yield better orbicular akinesia than the infiltration technique alone. Nasal injection improved globe akinesia.

Action Potentials↗

Single fiber electromyography in the diagnosis of ocular myasthenia gravis: report of 90 cases.

BACKGROUND: The aim of this study was to evaluate single fiber electromyography (SFEMG) in the diagnosis of ocular myasthenia gravis (OMG), compared with repetitive nerve stimulation (RNS) and blood concentration of antibody to acetylcholine receptor (AchRAb). METHODS: SFEMG, RNS and AchRAb titration were measured in 90 patients with OMG (44 men, 46 women). RESULTS: Markedly increased jitter and ratio of block in the frontalis and the extensor digitorum communis (EDC) were observed (83.3% and 61.1%, respectively). The mean jitter was 43.6 +/- 14.5 micros, and the percentages of jitter>55 micros and blocking were 16.9% +/- 19% and 3.5% +/- 9.5% respectively in the EDC. The mean jitter was 64.3 +/- 25.6 micros, and the percentages of jitter > 55 micros and blocking were 33.5% +/- 27.6% and 29.3% +/- 23.2% respectively in the frontalis. The percentage of abnormal RNS was 27.8% (25/90). There was an increased AchRAb titration in 29 (32.2%) of the 90 patients. Increased jitter, blocking was negatively correlated with maximum decrement to RNS (P < 0.01). 11.4% (4/35) of patients with abnormal RNS and 24.1% (7/29) patients with abnormal AchRAb were seen in the patients with normal SFEMG in the EDC. CONCLUSION: SFEMG test showed the highest sensitivity in the diagnosis of OMG. To our knowledge, the three methods (SFEMG, RNS and AchRAb) are complementary in the diagnosis and differential diagnosis of OMG.

Adolescent↗