Needle electromyography of the diaphragm: A new technique

“…Bolton reported that a telephone survey of 1,000 individuals after diaphragm EMG examination identified 2 cases of pneumothorax, a similar frequency (0.2%) to our finding (0.149%). Saadeh et al . reported no complications in 108 individuals who underwent diaphragm EMG by a different technique.…”

Section: Discussionmentioning

confidence: 99%

The risk of iatrogenic pneumothorax after electromyography

2015

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“…Additionally, apart from recording potentials following nerve stimulation, needle electrodes can be used to examine the spontaneous activity of the diaphragm [41,42]. The disadvantage is that needle electrodes only sample the portion of the diaphragm into which they are inserted.…”

Section: Magnetic Stimulation and The Inspiratory Musclesmentioning

confidence: 99%

Magnetic stimulation for the measurement of respiratory and skeletal muscle function

Man¹

2004

European Respiratory Journal

117

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Respiratory and skeletal muscle function is of interest in many areas of pulmonary and critical care medicine. The capacity of the respiratory muscle pump to respond to the load imposed by disease is the basis of an understanding of ventilatory failure. Over the last four decades, considerable progress has been made in quantifying the capacity of the respiratory muscles, in terms of strength, endurance and fatigue. With the development of magnetic stimulation, it has recently become possible to nonvolitionally assess the respiratory muscles in a clinically acceptable way. This is of particular interest in the investigation of patients receiving critical care, those with neuromuscular disease, and in children where volitional efforts are either not possible or likely to be sub-maximal. Furthermore, the adaptation of these techniques to quantify the strength of peripheral muscles, such as the quadriceps, has allowed the effects of muscle training or rehabilitation, uninfluenced by learning effect, to be assessed. This article focuses on the physiological basis of magnetic nerve stimulation, and reviews how the technique has been applied to measure muscle strength and fatigue, with particular emphasis upon the diaphragm. The translation of magnetic stimulation into a clinical tool is described, and how it may be of diagnostic, prognostic and therapeutic value in several areas of pulmonary medicine. In particular, the use of magnetic stimulation in neuromuscular disease, the intensive care setting, chronic obstructive pulmonary disease and paediatrics will be discussed. The nonvolitional assessment of skeletal musclesFor routine muscle strength measurements, the force generated from a maximum voluntary contraction (MVC) is often used. However volitional, effort-dependent manoeuvres for measuring strength are not always suitable for patients as the ability to perform a true MVC relies upon subject motivation and cooperation. This is particularly so in patients on intensive care units (ICU), children, patients with cognitive difficulties, and those patients prevented from performing a true MVC by pain (for example, following surgery). However, even in well-motivated subjects, sub-maximal muscle activation is common in routine clinical practice [1]. As volitional manoeuvres are influenced by a learning effect, the value of MVC is also limited in studies of training or rehabilitation. Consequently, there has been a need for nonvolitional methods to assess muscle strength. Skeletal muscle physiologySkeletal muscle is controlled by electrical impulses conducted by motor neurones that lead to the release of acetylcholine from the motor end plate, thus depolarising the muscle cell membrane. The force generated by muscle contraction is dependent upon a number of factors, including the number of muscle fibres stimulated, muscle length at the time of stimulation and the frequency of stimulation. The force-frequency curve of a muscle is of particular relevance in the understanding of nonvolitional techniques to asse...

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Needle electromyography of the diaphragm: A new technique

Cited by 48 publications

References 22 publications

Potential risks of iatrogenic complications of nerve conduction studies (NCS) and electromyography (EMG)

Potential risks of iatrogenic complications of nerve conduction studies (NCS) and electromyography (EMG)

The risk of iatrogenic pneumothorax after electromyography

Magnetic stimulation for the measurement of respiratory and skeletal muscle function

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