The objective of this study was to explore whether there was a functional link between trigeminal proprioception and the oculomotor system mediated through jaw muscle afferents.Electromyography(EMG) was undertaken of ...The objective of this study was to explore whether there was a functional link between trigeminal proprioception and the oculomotor system mediated through jaw muscle afferents.Electromyography(EMG) was undertaken of the levator palpebrae(LP) and superior rectus(SR),and Fos expression was detected in the brainstem following consecutive down-stretching of the lower jaw at 2-4 Hz in rats.Retrograde tracing was undertaken of the interstitial nucleus of Cajal and Darkschewitsch nucleus(INC/DN) pre-oculomotor neurons.FMG-like responses were recorded from the LP/SR during down-stretching of the lower jaw at 2-4 Hz in 3 out of 11 rats.Fos expression was induced by consecutive down-stretching of the lower jaw at 2-4 Hz for 20-30 seconds.Interestingly,Fos expression was distributed mainly in the bilateral INC/DN area.We also examined Fos-like immunoreactivity in central mesencephalic and paramedian pontine reticular formation that harbors premotor neurons controlling horizontal eye movement,but no Fos-like staining was observed therein.By injection of retrograde tracers into the oculomotor nucleus combined with Fos immunostaining,double labeled pre-oculomotor neurons were visualized to distribute in the INC/DN.In conclusions,there may exist a trigeminal proprioceptive-oculomotor system neural circuit through jaw muscle afferents in rats.Judging from Fos distribution pattern,this pathway might be related to vertical and torsional eye movements.展开更多
An enhanced algorithm is proposed to recognize multi-channel electromyography(EMG) patterns using deep belief networks(DBNs). It is difficult to classify the EMG features because an EMG signal has nonlinear and time-v...An enhanced algorithm is proposed to recognize multi-channel electromyography(EMG) patterns using deep belief networks(DBNs). It is difficult to classify the EMG features because an EMG signal has nonlinear and time-varying characteristics.Therefore, in several previous studies, various machine-learning methods have been applied. A DBN is a fast, greedy learning algorithm that can find a fairly good set of weights rapidly, even in deep networks with a large number of parameters and many hidden layers. To evaluate this model, we acquired EMG signals, extracted their features, and then compared the model with the DBN and other conventional classifiers. The accuracy of the DBN is higher than that of the other algorithms. The classification performance of the DBN model designed is approximately 88.60%. It is 7.55%(p=9.82×10-12) higher than linear discriminant analysis(LDA) and 2.89%(p=1.94×10-5) higher than support vector machine(SVM). Further, the DBN is better than shallow learning algorithms or back propagation(BP), and this model is effective for an EMG-based user-interfaced system.展开更多
AIM: To determine the accuracy of 2-channel surface electromyography(sE MG) for diagnosing oropharyngeal dysphagia(OPD) in patients with cerebral palsy.METHODS: Participants with cerebral palsy and OPD between 5 and 3...AIM: To determine the accuracy of 2-channel surface electromyography(sE MG) for diagnosing oropharyngeal dysphagia(OPD) in patients with cerebral palsy.METHODS: Participants with cerebral palsy and OPD between 5 and 30 years of age and age- and sexmatched healthy individuals received s EMG testing during swallowing. Electrodes were placed over the submental and infrahyoid muscles, and s EMG recordings were made during stepwise(starting at 3 mL) determination of maximum swallowing volume. Outcome measures included submental muscle group maximum amplitude, infrahyoid muscle group maximum amplitude(IMGMA), time lag between the peak amplitudes of 2 muscle groups, and amplitude difference between the 2 muscle groups.RESULTS: A total of 20 participants with cerebral palsy and OPD(OPD group) and 60 age- and sex-matched healthy volunteers(control group) were recruited. Among 20 patients with OPD, 19 had Dysphagia Outcome and Severity Scale records. Of them, 8 were classified as severe dysphagia(level 1), 1 was moderate dysphagia(level 3), 4 were mild to moderate dysphagia(level 4), 3 were mild dysphagia(level 5), and 3 were within functional limits(level 6). Although the groups were matched for age and sex, participants in the OPD group were significantly shorter, weighed less and had lower body mass index than their counterparts in the control group(both, P < 0.001). All s EMG parameter values were significantly higher in the OPD group compared with the control group(P < 0.05). Differences were most pronounced at the 3 mL swallowing volume. IMGMA at the 3 mL volume was the best predictor of OPD with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 85.0%, 90.0%, 73.9%, 94.7% and 88.8%, respectively.展开更多
BACKGROUND Functional epiphora is a clinical condition which is not due to an anatomic defect.Most studies agree that it involves the action of the orbicularis oculi muscle,particularly its deeper segment(Horner’s mu...BACKGROUND Functional epiphora is a clinical condition which is not due to an anatomic defect.Most studies agree that it involves the action of the orbicularis oculi muscle,particularly its deeper segment(Horner’s muscle),but the exact mechanism is not clear.AIM To evaluate the orbicularis oculi muscle in functional epiphora patients using electromyography(EMG).METHODS A total of 8 Chinese patients(16 eyes)with functional epiphora were enrolled in this study,and ten volunteers(10 eyes)were included as normal controls.Five epiphora patients(five eyes)with facial palsy served as positive controls.Quantitative EMG was performed in the deeper segment of orbicularis oculi muscle.The average duration of each EMG waveform was measured.RESULTS The average duration of EMG waveforms in the normal control group,the functional epiphora group,and the facial palsy group were 6.39±0.73 ms,9.39±1.32 ms and 11.2±1.42 ms,respectively.The duration of EMG waveforms was significantly longer in the functional epiphora group than in the normal control group(P<0.05),and shorter than that in the facial palsy group(P<0.05).CONCLUSION These data indicate the presence of neurogenic orbicularis oculi muscle damage in epiphora patients,which may be the cause of functional epiphora.The etiology of neurogenic damage in the orbicularis oculi muscle requires further investigation.展开更多
We analyze muscular dystrophy recorded by sEMG and use standard methodologies and nonlinear chaotic methods here including the RQA. We reach sufficient evidence that the sEMG signal contains a large chaotic component....We analyze muscular dystrophy recorded by sEMG and use standard methodologies and nonlinear chaotic methods here including the RQA. We reach sufficient evidence that the sEMG signal contains a large chaotic component. We have estimated the correlation dimension (fractal measure), the largest Lyapunov exponent, the LZ complexity and the %Rec and %Det of the RQA demonstrating that such indexes are able to detect the presence of repetitive hidden patterns in sEMG which, in turn, senses the level of MU synchronization within the muscle. The results give also an interesting methodological indication in the sense that it evidences the manner in which nonlinear methods and RQA must be arranged and applied in clinical routine in order to obtain results of clinical interest. We have studied the muscular dystrophy and evidence that the continuous regime of chaotic transitions that we have in muscular mechanisms may benefit in this pathology by the use of the NPT treatment that we have considered in detail in our previous publications.展开更多
The overall goal of this project is to develop a humane non-human primate model of traumatic spinal cord injury that will facilitate the development and evaluation of therapeutic interventions. The model utilizes neur...The overall goal of this project is to develop a humane non-human primate model of traumatic spinal cord injury that will facilitate the development and evaluation of therapeutic interventions. The model utilizes neurophysiological techniques to identify the location of the upper motor neuron axons that innervate the lower motor neurons that control tail musculature. This facilitates the placement of a selective lesion that partially disconnects the upper and lower motor neuron supply to the musculature of the tail. An implanted transmitter quantitatively measures electromyography data from the tail. The preliminary data indicates that this model is feasible. The subject was able to tolerate the implantation of the transmitter, without adverse effects. As well, there was no limb impairment, bowel dysfunction or bladder dysfunction. The histopathologic and electromyographic features of the selective experimental lesion were similar to human spinal cord injury.展开更多
BACKGROUND Bruxism is a rhythmic masticatory muscle activity that occurs involuntarily in a non-physiologically functional state.There is a lack of research classifying the functional status of masticatory muscles in ...BACKGROUND Bruxism is a rhythmic masticatory muscle activity that occurs involuntarily in a non-physiologically functional state.There is a lack of research classifying the functional status of masticatory muscles in patients with different mandibular movement types(centric clenching or eccentric grinding)of bruxism.AIM To assess the differences of the masticatory muscle activity in patients with different types of bruxism.METHODS A total of 21 subjects with centric bruxism(CB)and 21 subjects with eccentric bruxism(ECB)were screened from college students according to a questionnaire and their tooth wear features.Sixteen subjects with no bruxism were also recruited.The surface electromyography(EMG)signals of the temporalis anterior(TA)and superficial masseter muscle(MM)were measured in different mandibular positions and during the chewing task.The EMG amplitude and chewing cycle duration parameters were then analyzed.RESULTS The CB group showed fewer muscle maximal motor units,with the MM being more pronounced,a higher proportion of muscle contractions to be recruited for the same load of chewing activity,and a longer chewing cycle.The ECB group showed more TA maximal motor units and higher MM activity on the nonworking side in unilateral chewing.CONCLUSION CB mainly affects the MM,and patients with CB show reduced masticatory muscle contraction efficiency and chewing cycle efficiency.ECB mainly affects the TA,and patients with ECB show enhanced contraction of non-functional lateral muscle bundles.展开更多
Objective:Prostate cancer is the most frequent cancer in men and radical retropubic prostatectomy(RRP)is one of the first-line treatment.However,RRP has some side effects and can lead to chronic perineal pain.The obje...Objective:Prostate cancer is the most frequent cancer in men and radical retropubic prostatectomy(RRP)is one of the first-line treatment.However,RRP has some side effects and can lead to chronic perineal pain.The objective of the study was to determine in patients suffering from perineal pain after RRP the possibility of a neurogenic damage by means of a specific questionnaire dedicated to track down neuropathic pain.Methods:Forty patients were explored by a specific and validated questionnaire,the Neuropathic Pain Symptom Inventory(NPSI).Patients were divided into two groups:Group A with an NSPI score≥4 was considered as suffering from neuropathic pain,and Group B was considered as a control group without neuropathic pain(NSPI score<4).All patients had a perineal electrophysiological testing to confirm the possibility of a neurogenic damage.Results:Group A was composed by 13 men and Group B by 27 men,with mean age 72.45 years and mean duration of pain 2.7 years.In Group A,the most frequent symptoms were burning sensation,electrical shock and numbness.Location of the pain was global perineal area(8/13),anus(10/13),penis(5/13)and glans penis(2/13).Electromyography(EMG)findings confirmed the presence of denervation and neurogenic damages compared with controls(p<0.001).Conclusion:One third of the patients consulting for chronic pain following RRP had probably a neuropathic lesion leading to a chronic perineal pain as suggested by an NSPI score≥4 and EMG alterations.展开更多
Sports compression garments are common-selected sportswear to improve athletic performance and reduce sports injury. Since they consist of elastic textile that exerts compression and pressure onto the muscle,muscle ac...Sports compression garments are common-selected sportswear to improve athletic performance and reduce sports injury. Since they consist of elastic textile that exerts compression and pressure onto the muscle,muscle activation is of interest to sports compression garment manufactures who seek to enhance sports performance through gradient compression garment design.However,there are few scientific investigations to explore this effect of muscle activation to evaluate the performance of sports compression garments during sport activity. In this paper, a systemic experimental protocol was presented to improve the quality of evaluation test under a standardized running test. Then muscle activation with and without wearing sport compression garments to highlight the changes caused by compression garment was investigated. The electromyography( EMG) signal was collected and processed by the proposed method to represent the muscle activation combined with gait analysis of running. As a result,the average muscle activation of gait cycle for the major muscles such as rectus femoris( RF) and gastrocnemius medialis( GM) revealed that they needed to exert more muscle force without wearing garment at certain periods for mid-stand and pre-swing phase within gait cycle. These lower muscle activation levels prolonged activity duration,reduced fatigue,and presented low risk for sport injury.Such an evaluation study therefore would scientifically prove the effect of compression garment and provide information on muscle activation and the ergonomic efficacy of gradient compression garment design.展开更多
This paper evaluates the efficiency of using a downward breaststroke kick in a sample of eight elite swimmers.Using a downward breaststroke kick increases the one stroke velocity and max speed but also increases produ...This paper evaluates the efficiency of using a downward breaststroke kick in a sample of eight elite swimmers.Using a downward breaststroke kick increases the one stroke velocity and max speed but also increases production of lactate acid.Utilizing the downward breaststroke kick we find the 100-meter and 100-yard breaststroke times decrease from 1:05.10s to 1:01.97s and find the downward breaststroke kick increases muscle activity of the quadriceps,biceps,and calves.The increases in performance were observed from measuring the world class swimmers are highly correlated to duration of the kick aerodynamic buoyant force in breaststroke.展开更多
Human arm movements may be adversely affected in the event of stroke or spinal cord injuries, eventually causing the patient to lose control of arm movements. Electromyography (EMG) is con-sidered the most effective t...Human arm movements may be adversely affected in the event of stroke or spinal cord injuries, eventually causing the patient to lose control of arm movements. Electromyography (EMG) is con-sidered the most effective technique for the restoration of arm movement in such cases. The reha-bilitation period for such patients is usually long. Moreover, complex treatment techniques may demoralize them. Therefore, this study, attempts to contribute to the development of a relaxing rehabilitation environment through electromyography control of a computer model of the arm. The model is created using MATLAB? and Data LINK software and other requisite components for training the targeted participants to control their arm movements. Six male participants with no history of injury to the arms or back were selected using the set protocol. The results and data collected are analysed using three performance measures i.e. the number of target hits, average time to target, and path efficiency for each target. Then, the main results in terms of the obtained performance measures are discussed and compared with those of previous studies.展开更多
BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with ...BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.展开更多
A feasibility assay is conducted for electromyography measure in sternocleidomastoid and platysma, tenting to use it on Brain-Computer Interface (BCI) feedback. It is proposed a case of study for four healthy subjects...A feasibility assay is conducted for electromyography measure in sternocleidomastoid and platysma, tenting to use it on Brain-Computer Interface (BCI) feedback. It is proposed a case of study for four healthy subjects with an average of 35 years old, two females and two males. Methodology proposed includes signal acquisition and processing with feature extraction of RMS, Mean and Variance. The data are acquired with the AD board NI USB-6009, interfaced with LabView and processed in MatLab. An uncertainty analysis was made obtaining a system uncertainty of ±2.31 mV. ANOVA analysis was done, with a Randomized Complete Block Design (RCBD) experiment and interaction of factors and residues obtained with the software Minitab.展开更多
The human-computer interaction (HCI) is now playing a great role in computer technology. This study introduces an automatic document control technique which is based on the human hand waving movements. The recognition...The human-computer interaction (HCI) is now playing a great role in computer technology. This study introduces an automatic document control technique which is based on the human hand waving movements. The recognition of hand movement is realized according to the surface electromyography (sEMG). A collector is set on the forearm. The sEMG signal is recorded and conveyed to a PC terminal by using wireless Zigbee. An automatic algorithm is developed in order to extract the characteristics of sEMG, recognize the waving movements, and transmit to document control command. The developed human-computer interaction technique can be used as a new gallery for teaching, as well as an assistant tool for disabled person.展开更多
Objective: Health care providers refer their patients to electromyography (E<span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdan...Objective: Health care providers refer their patients to electromyography (E<span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">MG) laboratories for the evaluation of various sensory symptoms in the extremities and spine. The procedure is usually performed in conjunction with transcutaneous electrical stimulation of peripheral nerves and elicitation of the F-</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">wave and H-reflex. The present study aimed to determine the real value of these procedures in the diagnosis of sensory symptoms in the setting of a normal neurologic examination. Method: The EMG reports and clinical histories of 100 patients, including 10 patients evaluated by other electromyographers, were reviewed. The study was focused on those with normal neurological examinations and those without histories of ongoing medical disorders and major surgeries to the extremities and spine.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Results: All EMGs, F-wave, and H-reflex reports reviewed were normal, including those obtained </span><span style="font-family:Verdana;">from the second procedure performed in some patients and of those who su</span><span style="font-family:Verdana;">bsequently underwent spinal surgery. Neurologic examination in all patients</span><span style="font-family:Verdana;"> was </span><span style="font-family:Verdana;">normal. Conclusion: Needle EMG, F-wave and H-Reflex examinations are pr</span><span style="font-family:Verdana;">edictably normal in patients with non-dermatomal, non-neuropathic sensory symptoms with normal neurologic examination and without history of pre</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">existing medical and surgical disorders. A good neurologic examination sh</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ould determine the need to perform these procedures. Our findings have important diagnostic, therapeutic, prognostic, economic and legal implications</span></span></span><span style="font-family:Verdana;">.</span>展开更多
Background Electromyography (EMG) biofeedback has been used in spinal cord injury rehabilitation, but optimal indication and treatment protocols still need to be identified. Objectives To use an operant conditioning l...Background Electromyography (EMG) biofeedback has been used in spinal cord injury rehabilitation, but optimal indication and treatment protocols still need to be identified. Objectives To use an operant conditioning learning paradigm to compare the EMG responses in subjects with spinal cord injury for optimal indication of EMG biofeedback treatment. Participants Thirty rehabilitation outpatients with incomplete cervical spinal cord injury. The subjects were divided into three groups based on their scores on the ASIA scale (ASIA B, ASIA C and ASIA D groups), with ten patients in each group. Methods Repeated-measure trials were conducted to compare patients’ EMG responses between pre-initial and post-biofeedback treatment. In the sessions, visual feedback of EMG activity of the triceps brachii muscle was provided to the patient in accordance with the treatment protocol. Results One-way ANOVA and the Kruskal-Wallis test were used to examine the differences in the measures between groups. The initial EMG and final EMG measures were not significantly different between the ASIA C and D groups, but these measures were different between the ASIA B group and the ASIA C and D groups. In the ASIA B group, the EMG responses started out lower than those in the other groups and varied less, especially in comparison to the ASIA C group. Conclusion: These results reveal that the patients classified as ASIA C and D achieved better responses of the operant conditional learning protocol and optimal indication for the biofeedback treatment.展开更多
Objective: To study the correlation of electromyography parameters with serum ferritin (SF) and oxidative stress response in patients with diabetic peripheral neuropathy. Methods: A total of 184 patients who were diag...Objective: To study the correlation of electromyography parameters with serum ferritin (SF) and oxidative stress response in patients with diabetic peripheral neuropathy. Methods: A total of 184 patients who were diagnosed with type 2 diabetes mellitus in Bazhong Central Hospital between June 2014 and February 2017 were selected as the research subjects and divided into the DPN group who were combined with peripheral neuropathy and the control group who were not combined with peripheral neuropathy according to the electromyography results. The serum was collected to measure the contents of SF and oxidative stress indexes, the peripheral blood was collected to determine the expression of oxidative stress molecules, and the electromyograph was used to measure sensory nerve conduction velocity. Results: Serum SF level of DPN group was higher than that of control group;the sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve, serum Trx, SOD and GSH-Px levels as well as peripheral blood Keap1 mRNA expression of DPN group were greatly lower than those of control group and negatively correlated with SF level while serum MDA and Txnip levels as well as peripheral blood Nrf2 and HO-1 mRNA expression were greatly higher than those of control group and positively correlated with SF level;serum Trx, SOD and GSH-Px levels as well as peripheral blood Keap1 mRNA expression of DPN group were positively correlated with sensory nerve conduction velocity while serum MDA and Txnip levels as well as peripheral blood Nrf2 and HO-1 mRNA expression were negatively correlated with sensory nerve conduction velocity. Conclusion: The increase of SF in patients with diabetic peripheral neuropathy can activate the oxidative stress response to change the electromyography parameters and damage the nerve conduction function.展开更多
BACKGROUND Paramyotonia congenita(PMC)stands as a rare sodium channelopaty of skeletal muscle,initially identified by Eulenburg.The identification of PMC often relies on electromyography(EMG),a diagnostic technique.Th...BACKGROUND Paramyotonia congenita(PMC)stands as a rare sodium channelopaty of skeletal muscle,initially identified by Eulenburg.The identification of PMC often relies on electromyography(EMG),a diagnostic technique.The child’s needle EMG unveiled trains of myotonic discharges with notably giant amplitudes,alongside irregular wave trains of myotonic discharges.This distinctive observation had not surfaced in earlier studies.CASE SUMMARY We report the case of a 3-year-old female child with PMC,who exhibited la-ryngeal stridor,muffled speech,myotonia from birth.Cold,exposure to cool water,crying,and physical activity exacerbated the myotonia,which was relieved in warmth,yet never normalized.Percussion myotonia was observable in bilateral biceps.Myotonia symptoms remained unchanged after potassium-rich food consumption like bananas.Hyperkalemic periodic paralysis was excluded.Cranial magnetic resonance imaging yielded normal results.Blood potassium remained within normal range,while creatine kinase showed slight elevation.Exome-wide genetic testing pinpointed a heterozygous mutation on chromosome SCN4A:c.3917G>A(p.G1306E).After a six-month mexiletine regimen,symptoms alleviated.CONCLUSION In this case revealed the two types of myotonic discharges,and had not been documented in other studies.We underscore two distinctive features:Giant-amplitude potentials and irregular waves.展开更多
Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with st...Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study,and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers.Both groups received conventional medication and rehabilitation therapy.The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area(M1)of the healthy side,with the treatment coil tangent to the skull surface;the sham stimulation group underwent the same procedures as the experimental group,but the treatment coil was perpendicular to the skull surface instead.Lower-extremity subscale of the Fugl-Meyer Assessment(FMA-LE),Berg Balance Scale(BBS),gait analysis,and lower-extremity surface electromyography(LESEM)were performed in both groups before and after rTMS treatment.Results:All 96 patients completed the test with no shedding and no adverse reactions.After treatment,the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment(P<0.05),and the TUG test time was reduced as compared with the pre-treatment(P<0.05).The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group(P<0.05).After treatment,the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly.The step length,step speed,and step frequency were also significantly improved in both groups after treatment,and the symmetrical ratio of step length and support time was reduced(P<0.05).Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group(P<0.05).Conclusion:1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.展开更多
Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi?electrode catheter can be used as a feasible clinical physiological parameter in patients with chro...Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi?electrode catheter can be used as a feasible clinical physiological parameter in patients with chronic obstructive pulmonary disease (COPD) to provide useful information on the treatment response. However, it remains unknown whether the surface diaphragm electromyogram (EMGdi) could be used to identify the deterioration of clinical symptoms and to predict the necessity of hospitalization in acute exacerbation of COPD (AECOPD) patients. Methods: COPD patients visiting the outpatient department due to acute exacerbation were enrolled in this study. All patients who were subjected to EMGdi and classical parameters such as spirometry parameters, arterial blood gas analysis, COPD assessment test (CAT) score, and the modified early warning score (MEWS) in outpatient department, would be treated effectively in the outpatient or inpatient settings according to the Global Initiative for Chronic Obstructive Lung Disease guideline. When the acute exacerbation of the patients was managed, all the examination above would be repeated. Results: We compared the relationships of admission?to?discharge changes (Δ) in the normalized value of the EMGdi, including the change of the percentage of maximal EMGdi (ΔEMGdi%max) and the change of the ratio of minute ventilation to the percentage of maximal EMGdi (ΔVE/EMGdi%max) with the changes of classical parameters. There was a significant positive association between ΔEMGdi%max and ΔCAT,ΔPaCO2, and ΔpH. The change (Δ) of EMGdi%max was negatively correlated with ΔPaO2/FiO2 in the course of the treatment of AECOPD. Compared with the classical parameters including forced expiratory volume in 1 s, MEWS, PaO2/FiO2, the EMGdi%max (odds ratio 1.143, 95% confidence interval 1.004–1.300) has a higher sensitivity when detecting the early exacerbation and enables to predict the admission of hospital in the whole cohort. Conclusions: The changes of surface EMGdi parameters had a direct correlation with classical measures in the whole cohort of AECOPD. The measurement of NRD by surface EMGdi represents a practical physiological biomarker, which may be helpful in detecting patients who should be hospitalized timely.展开更多
基金partially supported by Natural Sciences Research Funding 2006C225 and 2009K0174 from Shaanxi Province awarded to Dr.Liang HC
文摘The objective of this study was to explore whether there was a functional link between trigeminal proprioception and the oculomotor system mediated through jaw muscle afferents.Electromyography(EMG) was undertaken of the levator palpebrae(LP) and superior rectus(SR),and Fos expression was detected in the brainstem following consecutive down-stretching of the lower jaw at 2-4 Hz in rats.Retrograde tracing was undertaken of the interstitial nucleus of Cajal and Darkschewitsch nucleus(INC/DN) pre-oculomotor neurons.FMG-like responses were recorded from the LP/SR during down-stretching of the lower jaw at 2-4 Hz in 3 out of 11 rats.Fos expression was induced by consecutive down-stretching of the lower jaw at 2-4 Hz for 20-30 seconds.Interestingly,Fos expression was distributed mainly in the bilateral INC/DN area.We also examined Fos-like immunoreactivity in central mesencephalic and paramedian pontine reticular formation that harbors premotor neurons controlling horizontal eye movement,but no Fos-like staining was observed therein.By injection of retrograde tracers into the oculomotor nucleus combined with Fos immunostaining,double labeled pre-oculomotor neurons were visualized to distribute in the INC/DN.In conclusions,there may exist a trigeminal proprioceptive-oculomotor system neural circuit through jaw muscle afferents in rats.Judging from Fos distribution pattern,this pathway might be related to vertical and torsional eye movements.
基金supported by Inha University Research Grant,Korea
文摘An enhanced algorithm is proposed to recognize multi-channel electromyography(EMG) patterns using deep belief networks(DBNs). It is difficult to classify the EMG features because an EMG signal has nonlinear and time-varying characteristics.Therefore, in several previous studies, various machine-learning methods have been applied. A DBN is a fast, greedy learning algorithm that can find a fairly good set of weights rapidly, even in deep networks with a large number of parameters and many hidden layers. To evaluate this model, we acquired EMG signals, extracted their features, and then compared the model with the DBN and other conventional classifiers. The accuracy of the DBN is higher than that of the other algorithms. The classification performance of the DBN model designed is approximately 88.60%. It is 7.55%(p=9.82×10-12) higher than linear discriminant analysis(LDA) and 2.89%(p=1.94×10-5) higher than support vector machine(SVM). Further, the DBN is better than shallow learning algorithms or back propagation(BP), and this model is effective for an EMG-based user-interfaced system.
文摘AIM: To determine the accuracy of 2-channel surface electromyography(sE MG) for diagnosing oropharyngeal dysphagia(OPD) in patients with cerebral palsy.METHODS: Participants with cerebral palsy and OPD between 5 and 30 years of age and age- and sexmatched healthy individuals received s EMG testing during swallowing. Electrodes were placed over the submental and infrahyoid muscles, and s EMG recordings were made during stepwise(starting at 3 mL) determination of maximum swallowing volume. Outcome measures included submental muscle group maximum amplitude, infrahyoid muscle group maximum amplitude(IMGMA), time lag between the peak amplitudes of 2 muscle groups, and amplitude difference between the 2 muscle groups.RESULTS: A total of 20 participants with cerebral palsy and OPD(OPD group) and 60 age- and sex-matched healthy volunteers(control group) were recruited. Among 20 patients with OPD, 19 had Dysphagia Outcome and Severity Scale records. Of them, 8 were classified as severe dysphagia(level 1), 1 was moderate dysphagia(level 3), 4 were mild to moderate dysphagia(level 4), 3 were mild dysphagia(level 5), and 3 were within functional limits(level 6). Although the groups were matched for age and sex, participants in the OPD group were significantly shorter, weighed less and had lower body mass index than their counterparts in the control group(both, P < 0.001). All s EMG parameter values were significantly higher in the OPD group compared with the control group(P < 0.05). Differences were most pronounced at the 3 mL swallowing volume. IMGMA at the 3 mL volume was the best predictor of OPD with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 85.0%, 90.0%, 73.9%, 94.7% and 88.8%, respectively.
文摘BACKGROUND Functional epiphora is a clinical condition which is not due to an anatomic defect.Most studies agree that it involves the action of the orbicularis oculi muscle,particularly its deeper segment(Horner’s muscle),but the exact mechanism is not clear.AIM To evaluate the orbicularis oculi muscle in functional epiphora patients using electromyography(EMG).METHODS A total of 8 Chinese patients(16 eyes)with functional epiphora were enrolled in this study,and ten volunteers(10 eyes)were included as normal controls.Five epiphora patients(five eyes)with facial palsy served as positive controls.Quantitative EMG was performed in the deeper segment of orbicularis oculi muscle.The average duration of each EMG waveform was measured.RESULTS The average duration of EMG waveforms in the normal control group,the functional epiphora group,and the facial palsy group were 6.39±0.73 ms,9.39±1.32 ms and 11.2±1.42 ms,respectively.The duration of EMG waveforms was significantly longer in the functional epiphora group than in the normal control group(P<0.05),and shorter than that in the facial palsy group(P<0.05).CONCLUSION These data indicate the presence of neurogenic orbicularis oculi muscle damage in epiphora patients,which may be the cause of functional epiphora.The etiology of neurogenic damage in the orbicularis oculi muscle requires further investigation.
文摘We analyze muscular dystrophy recorded by sEMG and use standard methodologies and nonlinear chaotic methods here including the RQA. We reach sufficient evidence that the sEMG signal contains a large chaotic component. We have estimated the correlation dimension (fractal measure), the largest Lyapunov exponent, the LZ complexity and the %Rec and %Det of the RQA demonstrating that such indexes are able to detect the presence of repetitive hidden patterns in sEMG which, in turn, senses the level of MU synchronization within the muscle. The results give also an interesting methodological indication in the sense that it evidences the manner in which nonlinear methods and RQA must be arranged and applied in clinical routine in order to obtain results of clinical interest. We have studied the muscular dystrophy and evidence that the continuous regime of chaotic transitions that we have in muscular mechanisms may benefit in this pathology by the use of the NPT treatment that we have considered in detail in our previous publications.
文摘The overall goal of this project is to develop a humane non-human primate model of traumatic spinal cord injury that will facilitate the development and evaluation of therapeutic interventions. The model utilizes neurophysiological techniques to identify the location of the upper motor neuron axons that innervate the lower motor neurons that control tail musculature. This facilitates the placement of a selective lesion that partially disconnects the upper and lower motor neuron supply to the musculature of the tail. An implanted transmitter quantitatively measures electromyography data from the tail. The preliminary data indicates that this model is feasible. The subject was able to tolerate the implantation of the transmitter, without adverse effects. As well, there was no limb impairment, bowel dysfunction or bladder dysfunction. The histopathologic and electromyographic features of the selective experimental lesion were similar to human spinal cord injury.
文摘BACKGROUND Bruxism is a rhythmic masticatory muscle activity that occurs involuntarily in a non-physiologically functional state.There is a lack of research classifying the functional status of masticatory muscles in patients with different mandibular movement types(centric clenching or eccentric grinding)of bruxism.AIM To assess the differences of the masticatory muscle activity in patients with different types of bruxism.METHODS A total of 21 subjects with centric bruxism(CB)and 21 subjects with eccentric bruxism(ECB)were screened from college students according to a questionnaire and their tooth wear features.Sixteen subjects with no bruxism were also recruited.The surface electromyography(EMG)signals of the temporalis anterior(TA)and superficial masseter muscle(MM)were measured in different mandibular positions and during the chewing task.The EMG amplitude and chewing cycle duration parameters were then analyzed.RESULTS The CB group showed fewer muscle maximal motor units,with the MM being more pronounced,a higher proportion of muscle contractions to be recruited for the same load of chewing activity,and a longer chewing cycle.The ECB group showed more TA maximal motor units and higher MM activity on the nonworking side in unilateral chewing.CONCLUSION CB mainly affects the MM,and patients with CB show reduced masticatory muscle contraction efficiency and chewing cycle efficiency.ECB mainly affects the TA,and patients with ECB show enhanced contraction of non-functional lateral muscle bundles.
文摘Objective:Prostate cancer is the most frequent cancer in men and radical retropubic prostatectomy(RRP)is one of the first-line treatment.However,RRP has some side effects and can lead to chronic perineal pain.The objective of the study was to determine in patients suffering from perineal pain after RRP the possibility of a neurogenic damage by means of a specific questionnaire dedicated to track down neuropathic pain.Methods:Forty patients were explored by a specific and validated questionnaire,the Neuropathic Pain Symptom Inventory(NPSI).Patients were divided into two groups:Group A with an NSPI score≥4 was considered as suffering from neuropathic pain,and Group B was considered as a control group without neuropathic pain(NSPI score<4).All patients had a perineal electrophysiological testing to confirm the possibility of a neurogenic damage.Results:Group A was composed by 13 men and Group B by 27 men,with mean age 72.45 years and mean duration of pain 2.7 years.In Group A,the most frequent symptoms were burning sensation,electrical shock and numbness.Location of the pain was global perineal area(8/13),anus(10/13),penis(5/13)and glans penis(2/13).Electromyography(EMG)findings confirmed the presence of denervation and neurogenic damages compared with controls(p<0.001).Conclusion:One third of the patients consulting for chronic pain following RRP had probably a neuropathic lesion leading to a chronic perineal pain as suggested by an NSPI score≥4 and EMG alterations.
基金the Special Fund for Basic Scientific Research of Central Colleges,Chang'an University,China(Nos.2014G2320006,2013G3322009,and 2014G1321040)the Key Science and Technology Program of Shaanxi Province,China(No.2014K05-59)
文摘Sports compression garments are common-selected sportswear to improve athletic performance and reduce sports injury. Since they consist of elastic textile that exerts compression and pressure onto the muscle,muscle activation is of interest to sports compression garment manufactures who seek to enhance sports performance through gradient compression garment design.However,there are few scientific investigations to explore this effect of muscle activation to evaluate the performance of sports compression garments during sport activity. In this paper, a systemic experimental protocol was presented to improve the quality of evaluation test under a standardized running test. Then muscle activation with and without wearing sport compression garments to highlight the changes caused by compression garment was investigated. The electromyography( EMG) signal was collected and processed by the proposed method to represent the muscle activation combined with gait analysis of running. As a result,the average muscle activation of gait cycle for the major muscles such as rectus femoris( RF) and gastrocnemius medialis( GM) revealed that they needed to exert more muscle force without wearing garment at certain periods for mid-stand and pre-swing phase within gait cycle. These lower muscle activation levels prolonged activity duration,reduced fatigue,and presented low risk for sport injury.Such an evaluation study therefore would scientifically prove the effect of compression garment and provide information on muscle activation and the ergonomic efficacy of gradient compression garment design.
文摘This paper evaluates the efficiency of using a downward breaststroke kick in a sample of eight elite swimmers.Using a downward breaststroke kick increases the one stroke velocity and max speed but also increases production of lactate acid.Utilizing the downward breaststroke kick we find the 100-meter and 100-yard breaststroke times decrease from 1:05.10s to 1:01.97s and find the downward breaststroke kick increases muscle activity of the quadriceps,biceps,and calves.The increases in performance were observed from measuring the world class swimmers are highly correlated to duration of the kick aerodynamic buoyant force in breaststroke.
文摘Human arm movements may be adversely affected in the event of stroke or spinal cord injuries, eventually causing the patient to lose control of arm movements. Electromyography (EMG) is con-sidered the most effective technique for the restoration of arm movement in such cases. The reha-bilitation period for such patients is usually long. Moreover, complex treatment techniques may demoralize them. Therefore, this study, attempts to contribute to the development of a relaxing rehabilitation environment through electromyography control of a computer model of the arm. The model is created using MATLAB? and Data LINK software and other requisite components for training the targeted participants to control their arm movements. Six male participants with no history of injury to the arms or back were selected using the set protocol. The results and data collected are analysed using three performance measures i.e. the number of target hits, average time to target, and path efficiency for each target. Then, the main results in terms of the obtained performance measures are discussed and compared with those of previous studies.
文摘BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.
文摘A feasibility assay is conducted for electromyography measure in sternocleidomastoid and platysma, tenting to use it on Brain-Computer Interface (BCI) feedback. It is proposed a case of study for four healthy subjects with an average of 35 years old, two females and two males. Methodology proposed includes signal acquisition and processing with feature extraction of RMS, Mean and Variance. The data are acquired with the AD board NI USB-6009, interfaced with LabView and processed in MatLab. An uncertainty analysis was made obtaining a system uncertainty of ±2.31 mV. ANOVA analysis was done, with a Randomized Complete Block Design (RCBD) experiment and interaction of factors and residues obtained with the software Minitab.
文摘The human-computer interaction (HCI) is now playing a great role in computer technology. This study introduces an automatic document control technique which is based on the human hand waving movements. The recognition of hand movement is realized according to the surface electromyography (sEMG). A collector is set on the forearm. The sEMG signal is recorded and conveyed to a PC terminal by using wireless Zigbee. An automatic algorithm is developed in order to extract the characteristics of sEMG, recognize the waving movements, and transmit to document control command. The developed human-computer interaction technique can be used as a new gallery for teaching, as well as an assistant tool for disabled person.
文摘Objective: Health care providers refer their patients to electromyography (E<span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">MG) laboratories for the evaluation of various sensory symptoms in the extremities and spine. The procedure is usually performed in conjunction with transcutaneous electrical stimulation of peripheral nerves and elicitation of the F-</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">wave and H-reflex. The present study aimed to determine the real value of these procedures in the diagnosis of sensory symptoms in the setting of a normal neurologic examination. Method: The EMG reports and clinical histories of 100 patients, including 10 patients evaluated by other electromyographers, were reviewed. The study was focused on those with normal neurological examinations and those without histories of ongoing medical disorders and major surgeries to the extremities and spine.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Results: All EMGs, F-wave, and H-reflex reports reviewed were normal, including those obtained </span><span style="font-family:Verdana;">from the second procedure performed in some patients and of those who su</span><span style="font-family:Verdana;">bsequently underwent spinal surgery. Neurologic examination in all patients</span><span style="font-family:Verdana;"> was </span><span style="font-family:Verdana;">normal. Conclusion: Needle EMG, F-wave and H-Reflex examinations are pr</span><span style="font-family:Verdana;">edictably normal in patients with non-dermatomal, non-neuropathic sensory symptoms with normal neurologic examination and without history of pre</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">existing medical and surgical disorders. A good neurologic examination sh</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ould determine the need to perform these procedures. Our findings have important diagnostic, therapeutic, prognostic, economic and legal implications</span></span></span><span style="font-family:Verdana;">.</span>
文摘Background Electromyography (EMG) biofeedback has been used in spinal cord injury rehabilitation, but optimal indication and treatment protocols still need to be identified. Objectives To use an operant conditioning learning paradigm to compare the EMG responses in subjects with spinal cord injury for optimal indication of EMG biofeedback treatment. Participants Thirty rehabilitation outpatients with incomplete cervical spinal cord injury. The subjects were divided into three groups based on their scores on the ASIA scale (ASIA B, ASIA C and ASIA D groups), with ten patients in each group. Methods Repeated-measure trials were conducted to compare patients’ EMG responses between pre-initial and post-biofeedback treatment. In the sessions, visual feedback of EMG activity of the triceps brachii muscle was provided to the patient in accordance with the treatment protocol. Results One-way ANOVA and the Kruskal-Wallis test were used to examine the differences in the measures between groups. The initial EMG and final EMG measures were not significantly different between the ASIA C and D groups, but these measures were different between the ASIA B group and the ASIA C and D groups. In the ASIA B group, the EMG responses started out lower than those in the other groups and varied less, especially in comparison to the ASIA C group. Conclusion: These results reveal that the patients classified as ASIA C and D achieved better responses of the operant conditional learning protocol and optimal indication for the biofeedback treatment.
文摘Objective: To study the correlation of electromyography parameters with serum ferritin (SF) and oxidative stress response in patients with diabetic peripheral neuropathy. Methods: A total of 184 patients who were diagnosed with type 2 diabetes mellitus in Bazhong Central Hospital between June 2014 and February 2017 were selected as the research subjects and divided into the DPN group who were combined with peripheral neuropathy and the control group who were not combined with peripheral neuropathy according to the electromyography results. The serum was collected to measure the contents of SF and oxidative stress indexes, the peripheral blood was collected to determine the expression of oxidative stress molecules, and the electromyograph was used to measure sensory nerve conduction velocity. Results: Serum SF level of DPN group was higher than that of control group;the sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve, serum Trx, SOD and GSH-Px levels as well as peripheral blood Keap1 mRNA expression of DPN group were greatly lower than those of control group and negatively correlated with SF level while serum MDA and Txnip levels as well as peripheral blood Nrf2 and HO-1 mRNA expression were greatly higher than those of control group and positively correlated with SF level;serum Trx, SOD and GSH-Px levels as well as peripheral blood Keap1 mRNA expression of DPN group were positively correlated with sensory nerve conduction velocity while serum MDA and Txnip levels as well as peripheral blood Nrf2 and HO-1 mRNA expression were negatively correlated with sensory nerve conduction velocity. Conclusion: The increase of SF in patients with diabetic peripheral neuropathy can activate the oxidative stress response to change the electromyography parameters and damage the nerve conduction function.
文摘BACKGROUND Paramyotonia congenita(PMC)stands as a rare sodium channelopaty of skeletal muscle,initially identified by Eulenburg.The identification of PMC often relies on electromyography(EMG),a diagnostic technique.The child’s needle EMG unveiled trains of myotonic discharges with notably giant amplitudes,alongside irregular wave trains of myotonic discharges.This distinctive observation had not surfaced in earlier studies.CASE SUMMARY We report the case of a 3-year-old female child with PMC,who exhibited la-ryngeal stridor,muffled speech,myotonia from birth.Cold,exposure to cool water,crying,and physical activity exacerbated the myotonia,which was relieved in warmth,yet never normalized.Percussion myotonia was observable in bilateral biceps.Myotonia symptoms remained unchanged after potassium-rich food consumption like bananas.Hyperkalemic periodic paralysis was excluded.Cranial magnetic resonance imaging yielded normal results.Blood potassium remained within normal range,while creatine kinase showed slight elevation.Exome-wide genetic testing pinpointed a heterozygous mutation on chromosome SCN4A:c.3917G>A(p.G1306E).After a six-month mexiletine regimen,symptoms alleviated.CONCLUSION In this case revealed the two types of myotonic discharges,and had not been documented in other studies.We underscore two distinctive features:Giant-amplitude potentials and irregular waves.
文摘Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study,and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers.Both groups received conventional medication and rehabilitation therapy.The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area(M1)of the healthy side,with the treatment coil tangent to the skull surface;the sham stimulation group underwent the same procedures as the experimental group,but the treatment coil was perpendicular to the skull surface instead.Lower-extremity subscale of the Fugl-Meyer Assessment(FMA-LE),Berg Balance Scale(BBS),gait analysis,and lower-extremity surface electromyography(LESEM)were performed in both groups before and after rTMS treatment.Results:All 96 patients completed the test with no shedding and no adverse reactions.After treatment,the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment(P<0.05),and the TUG test time was reduced as compared with the pre-treatment(P<0.05).The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group(P<0.05).After treatment,the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly.The step length,step speed,and step frequency were also significantly improved in both groups after treatment,and the symmetrical ratio of step length and support time was reduced(P<0.05).Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group(P<0.05).Conclusion:1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.
基金grants from the National Natural Science Foundation of China (No.81470273)Chinical Medicine Science and Technology Special Project of Jiangsu Province (No.BL2014083)Science and Technology Plan Project of Nanjing (No.201803064).
文摘Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi?electrode catheter can be used as a feasible clinical physiological parameter in patients with chronic obstructive pulmonary disease (COPD) to provide useful information on the treatment response. However, it remains unknown whether the surface diaphragm electromyogram (EMGdi) could be used to identify the deterioration of clinical symptoms and to predict the necessity of hospitalization in acute exacerbation of COPD (AECOPD) patients. Methods: COPD patients visiting the outpatient department due to acute exacerbation were enrolled in this study. All patients who were subjected to EMGdi and classical parameters such as spirometry parameters, arterial blood gas analysis, COPD assessment test (CAT) score, and the modified early warning score (MEWS) in outpatient department, would be treated effectively in the outpatient or inpatient settings according to the Global Initiative for Chronic Obstructive Lung Disease guideline. When the acute exacerbation of the patients was managed, all the examination above would be repeated. Results: We compared the relationships of admission?to?discharge changes (Δ) in the normalized value of the EMGdi, including the change of the percentage of maximal EMGdi (ΔEMGdi%max) and the change of the ratio of minute ventilation to the percentage of maximal EMGdi (ΔVE/EMGdi%max) with the changes of classical parameters. There was a significant positive association between ΔEMGdi%max and ΔCAT,ΔPaCO2, and ΔpH. The change (Δ) of EMGdi%max was negatively correlated with ΔPaO2/FiO2 in the course of the treatment of AECOPD. Compared with the classical parameters including forced expiratory volume in 1 s, MEWS, PaO2/FiO2, the EMGdi%max (odds ratio 1.143, 95% confidence interval 1.004–1.300) has a higher sensitivity when detecting the early exacerbation and enables to predict the admission of hospital in the whole cohort. Conclusions: The changes of surface EMGdi parameters had a direct correlation with classical measures in the whole cohort of AECOPD. The measurement of NRD by surface EMGdi represents a practical physiological biomarker, which may be helpful in detecting patients who should be hospitalized timely.
