• 대한통합의학회지
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• 제10권4호
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• pp.137-143
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• 2022

Purpose : The purpose of this study was to evaluate the reliability analysis of the deep tendon reflex by using electromyography (EMG). Methods : The study was tested on 30 volunteers who are women in their 20s. Using an electronic reflective hammer of EMG, deep tendon reflex was measured on all subjects with the participation of three trained physical therapists as raters. First, the subjects were comfortably seated on a table with their knees bent at 90 °. The three raters tapped the electric hammer at intervals of 10 seconds to avoid habituation until a total of 10 compound muscle action potential records were collected. Intraclass correlation coefficients (ICCs) were calculated to assess the inter-rater reliability of the deep tendon reflex with the use of EMG. The items of analysis included amplitude (mV), latency (ms), duration (ms), and area (mV × ms) of the compound evoked potentials. Results : Based on the average records of 10 compound muscle action potential, excellent reliability (ICC: .912) was achieved in terms of area, and there was good reliability in terms of latency (ICC: .795) and duration (ICC: .800). In the shortest latency of the compound muscle action potential, good reliability was achieved in terms of amplitude (ICC: .865), duration (ICC: .781), and area (ICC: .832). In the amplitude of peak-to-peak of compound muscle action potential, excellent reliability was recorded in terms of amplitude (ICC: .924), and good reliability was recorded in terms of duration (ICC: .801) and area (ICC: .874). Conclusion : The findings in this study indicate that electromyography via an electric hammer is a reliable method of assessing and measuring deep tendon reflexes. Especially, it may be an excellent gauge in the area of average values of the compound muscle action potentials and the amplitude of peak-to-peak of compound muscle action potentials.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.11-15
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• 2010

Background: In belly-tendon (bipolar) montage, reference (R2) electrode placed on muscle's tendon has traditionally been considered to be electrically inactive. However, recent studies have revealed that R2 electrode is not simply referential, but actively contributes to compound muscle action potential (CMAP) waveform morphology. These findings suggest that CMAP onset latency and amplitude may also be influenced by the position of R2 electrode. This study was performed in order to evaluate the effect of R2 electrode position on CMAP onset latency and amplitude. Methods: We performed motor nerve conduction studies of median, ulnar, tibial and peroneal nerves on bilateral limbs of 20 normal subjects. We used traditional bipolar and monopolar montage and compared their CMAP onset latencies and amplitudes. In bipolar montage, recording (R1) electrode was placed on mid-belly of muscle with R2 electrode on the tendon of the muscle. In monopolar montage, R1 electrode was placed on the same site of bipolar montage, while R2 electrode was placed on the contralateral limb. Results: The mean CMAP onset latencies of median and peroneal nerves in bipolar montage were significantly different (p<0.05) with those in monopolar montage. And those of ulnar and tibial nerves were not significantly different (p>0.05). The mean CMAP amplitudes of all the tested nerves except ulnar nerve were significantly different (p<0.05). Conclusions: This study shows that change in R2 electrode position can affect the CMAP onset latency and amplitude, and these differences seem to be related to the generation of far field potential by CMAP.

• PNF and Movement
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• 제18권3호
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• pp.393-401
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• 2020

Purpose: In recent years, there has been increasing interest in using blood flow-restricted exercise (BFRE) or KAATSU training. The KAATSU training method, which partially restricts arterial inflow and fully restricts venous outflow in the working musculature during exercise at reduced exercise intensities, has been proven to result in substantial increases in both muscle hypertrophy and strength. The purpose of this study was to investigate the proper level of pressure for KAATSU training using compound muscle action potential (CMAP) analysis. Methods: Twenty-two healthy adults voluntarily participated in this study. CMAP was conducted by measuring the terminal latency and amplitude using a motor nerve conduction velocity test. For reference-line, supramaximal electrical stimulation was applied to the median nerves of the participants to obtain CMAP for the abductor pollicis brevis. For baseline, the intensity of the electrical stimulation was decreased to a level at which the CMAP amplitude was about a third of the CMAP amplitude obtained by the supramaximal electrical stimulation. The pressure levels for the KAATSU were set as a systolic blood pressure (strong pressure), the median values of systolic and diastolic blood pressure (intermediate pressure), and diastolic blood pressure (weak pressure). In the KAATSU condition, CMAP was performed under the same conditions as baseline after low-intensity thumb abduction exercises were performed at the subjects' own pace for one minute. Results: As the pressure increased, the CMAP amplitude was significantly increased, signifying that more muscle fibers were recruited. Conclusion: This study found that KAATSU training recruited more muscle fibers than low-intensity exercise without the restriction of blood flow.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권5호
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• pp.427-435
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• 2005

The purpose of this study was to compare clinical availability of fibrin adhesive technique with microneural suture technique. We applicated fibrin adhesive technique and microneural suture technique on cut sciatic nerve in rat and used to Compound muscle action potential of rat thigh muscle compartment and histologic finding for comparision of clinical availability. The results were as following. 1. Using latency and amplitude in Compound muscle action potential test, we compared microneural suture technique with fibrin adhesive technique for nerve regeneration effect. the means was slightly different between two method. but there's no statistically significant differences. 2. Histologic finding was similar in microneural suture technique and fibrin adhesive technique for regeneration of axon and myelin sheath in destruction site after nerve anastomosis. These results showed that the efficacy of fibrin adhesive technique was similar to that of conventional microneural suture technique. Moreover, fibrin adhesive technique is decreased operating time and imporved of incapability of accessment in conventional suture technique. Therefore this technique is a useful method to nerve anastomosis in nerve enervation and neurotransplantation.

• 대한후두음성언어의학회지
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• 제11권2호
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• pp.178-184
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• 2000

Laryngeal evoked EMG is the objective and quantitative method to measure the innervation of laryngeal muscle. If there is a mobility disorder of vocal cords, the cause and location of neural lesion co be understood by the laryngeal evoked EMG and if there is a vocal cord paralysis, the degree of recovery and the policy of treatment can be determined by it. Recently, the studies of reinnervation after recurrent laryngeal nerve injury have been actively carried out. Laryngeal evoked EMC is useful to these studies. The aim of study is to know whether noninvasive methods for stimulating the recurrent laryngeal nerve and for recording of compound action potential(CAP) using surface electrode are as useful as the invasive method using needle electrode. We obtained EMG of laryngeal muscle by various stimulating and recording methods : 1) Direct nerve stimulation by placing nerve cuff electrode made out of silastic tube and platinum wire and recording by insertion of hook wire electrode into posterior cricoarytenoid(PCA) and thyroarytenoid(TA) muscles, respectively. 2) Recording of compound action potential by surface electrode after stimulation of recurrent laryngeal nerve by the insertion of 27 gauge of needle electrode. 3) Recording of compound action potential by surface electrode after stimulating the recurrent laryngeal nerve by transcutaneous blunt rod electrode at tracheoesophageal groove. The amplitude, duration and latency of the CAP evoked by recurrent laryngeal nerve stimulation were compared among the three groups. The amplitude of CAP was smallest in the group recorded from posterior cricoarytenoid and hyroarytenoid muscle, and that recorded by surface electrode after stimulation by needle electrode was largest. The difference in amplitude between the group by hook wire recording and the two groups by surface electrode recording was significant statistically. There is no significant difference in duration and latency among three groups. Since the waveform of CAP from all three methods has similar duration, latency, we concluded that noninvasive method is a useful as invasive methods.

• 대한물리치료과학회지
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• 제12권4호
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• pp.43-55
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• 2005

This study was performed to investigate the effects of low-power Helium Neon Infra Red(He-Ne IR)laser irradiation and exercise on the regeneration of experimentally cut sciatic nerve in rats. The thrity Sprague-Dawley adult mail rats were assigned to the 6 groups : normal group(1), injured control groups(2), experimental groups(3). There was made artificial injured in the sciatic nerve of rats the each experimental laser group and exercise group were treated from 3 days after being injured for the 5 minutes(laser group), 10 minutes(exercise group), and 15 minutes(exercise and laser group) everyday during 2 weeks. There were measured the changes of amplitude of compound muscle action potential and histological change by the light microscopy on the sciatic nerve injured rats. The results obtained as follows : 1. In the control groups, the regeneration were slowly and slightlly progressed to compared with the experimental groups. Inflammation were much more observed, and fibrous adhesion was also observed around the sutured region of the cut sciatic nerve. 2. The amplitude of compound muscle action potential in the experimental groups were significantly increased to the injured control groups at 1 week(p<.05). The compound muscle action potential of the exercise and lased group was significantly decreased to be similar to normal group at 2 weeks(p<.05). 3. In histologic finding, in the experimental groups were observed the proliferation of the schwann cells, the infiltration of inflammatory cells and the extent of destruction at adjacent tissue were remarkably decreased on the 2 weeks. From these experimental results, it may be suggested that the laser and exercise were effected the heeling process of peripheral nerve injuried rats.

• 생명과학회지
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• 제16권1호
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• pp.114-119
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• 2006

저출력 적외선 레이저가 손상된 말초신경의 재생에 미치는 영향을 알아보기 위하여 흰쥐의 양측 좌골신경에 압궤손상을 준 뒤, 레이저 조사 기간에 따라 1, 3, 5 및 7주군으로 나누어 손상된 좌골신경의 신경전도속도와 진폭을 측정하여 신경재생의 정도를 관찰한 결과는 다음과 같았다. 좌골신경전도속도 검사에서 압궤손상 유발후에 손상전보다 유의하게 전도속도가 지연되었으나, 레이저를 조사한 실험측은 치료후 3주에 현저하게 신경전도 속도가 증가하였다. 좌골신경 진폭 검사에서 압궤손상 유발후에 손상전보다 유의하게 진폭이 감소하였으나, 레이저를 조사한 실험측은 치료후 3주에 복합근 활동전위의 진폭이 유의하게 증가하였다. 이상의 결과로 보아, 저출력 레이저 조사는 손상된 좌골신경의 기능회복에 있어, 주로 손상 초기의 회복속도에 영향을 주는 것으로 생각되는 바, 향후 말초신경 손상의 재활치료에 고려해야 할 것으로 생각된다.

• 전자공학회논문지SC
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• 제48권5호
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• pp.81-92
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• 2011

본 논문에서는 표면 근전도(surface electromyogram : SEMG)와 근육모델링을 이용하여 신경근육 접합부(neuromuscular junction, NMJ)의 종판(end plate) 폭(widths)과 분포(distribution)에 따른 운동단위(motor unit, MU)수를 추정하는 새로운 방법을 제안하였다. 이를 위하여 MU-시뮬레이터(motor unit simulator)와 EPZ-시뮬레이터(end plate zone simulator)를 설계하고, 본 연구에서 제안된 방법과 기존방법들을 비교하였다. 제안된 MU-시뮬레이터로 시뮬레이션 된 SMUAP(single motor unit action potential : 단일운동단위활동전위)와 CMAP(compound muscle action potential : 복합근활동전위)은 검출된 근신호와 유사하였다. EPZ-시뮬레이터는 신경근육 접합부의 종판 폭과 분포를 바꾸어 가면서 운동단위수를 추정하기 위하여 설계하였다. 실험결과 운동단위 수는 약 450 개, 근섬유수 약 340 개, 종판 폭은 약 6 mm이고, 종판분포는 불규칙하게 분포된 것 (randomly distributed)으로 추정되었다. 본 연구에서 제안된 방법은 인간 근육의 생체조직검사로 측정한 운동단위의 수와 비교 가능한 결과가 나왔다.

• 전기학회논문지
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• 제56권11호
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• pp.2040-2050
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• 2007

In this study, we present a novel method for estimating the information of MU(motor unit) which is the basic element of human muscle by using surface EMG. Some of the method developed in this field could only estimate the numbers of MU that is activated. However, in our study the MU-simulator based on the line source model was designed to estimate the MU information including the numbers of MU and muscle fiber, conduction velocity, MU diameter, fiber diameter, and end plate position. The SMUAP(single motor unit action potential) detector was designed and CMAP(compound muscle action potential) by electrical stimulus was recorded. With these data, the MU-simulator can estimate the MU information by varying muscle paramater settings through MSE(mean square error) method. Our results shows that the proposed method can be comparable with the method of anatomical studies. Moreover, our system can be utilized to build a tool for diagnosis and treatment assessment of neuromuscular patients.

• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.125-134
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• 2006

Among the various physiological factors that affect nerve conduction velocity (NCV), temperature is the most important. Because the influence of temperature is the most important source of error. It is known from animal experiments that conduction is eventually completely blocked at low temperatures, the myelinated A fibers being the first affected and the thin fibers of group C the last. Many studies showed that the NCV decreases linearly with lowering temperature within the physiological range. The distal motor latency increased by $0.2msec/^{\circ}C$ drop in temperature between $25^{\circ}C$and $35^{\circ}C$ in the median, ulnar and peroneal nerves. The temperature affect the neuromuscular transmission; The miniature endplate potential (MEPP) and endplate potential (EPP) are increase with increasing temperature. In myasthenia gravis, the reduction in the decremental response is observed following cooling. The lowering temperature make increase the amplitude of sensory compound action potential; make enlarge the surface area of compound muscle action potential with very little increase in amplitude; make diminish the fibrillation potential and increase the myotonia in needle electromyography (EMG). Because of these findings mentioned above, the skin temperature should be routinely monitored and controlled during nerve conduction tests and needle EMG and should be taken into account when interpreting the findings.