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M Moffroid

Publications and source records attributed to M Moffroid.

3 recordsLinked to original sources

A technique for needle localization in paraspinal muscles with cadaveric confirmation.

Invasive electromyography (EMG) of the paraspinal muscles is useful in clinical and research settings. No technique for localization of the needle in specific fascicles has been validated. Recent descriptions of the segmented innervation of the multifidus imply that such a technique would add greatly to the EMG determination of root level of a radiculopathy. We have developed a technique for localization which relies on palpation of bony structures and needle insertion at certain angles and depths. The technique was evaluated by injecting latex dye in 199 locations in 13 cadavers. Dissection demonstrated that the technique was accurate in 91 of 112 injections into specific fascicles of the multifidus (originating from different spinous processes), 39 of 43 injections into the longissimus, and 35 of 44 injections into the iliocostalis. Certain types of errors would not have occurred with the aid of EMG in vivo. When these are added to the correct injections, accuracy improves 97%, 93%, and 82%, respectively. The technique described here should be useful for kinesiological studies, biopsies and injections, as well as for the EMG confirmation of a radiculopathy.

Back

EMG to torque relationship in rectus abdominis muscle. Results with repeated testing.

Rectus abdominis muscles of young healthy female volunteers were studied to determine both the maximum strength in isometric flexion and the relation between the surface electromyogram (RMS EMG) and torque. Both the upper and lower portions of the abdominal muscle were studied during graded increase and decrease of torque. Repeated testing was performed over 6 weeks. The form of the relation between torque and EMG was better described by a quadratic than by a linear regression relationship, but with considerable variability about the best-fit line. The torque-increasing and torque-decreasing parts of each test were different and were analyzed separately. After 6 weeks of repeated testing, maximum voluntary isometric flexion torque increased 16.8% (P less than 0.01). There was a decrease in the ratio of electromyographic activity to torque production, which was statistically significant in the torque-increasing recordings. These changes in maximum torque and in the EMG-torque relation were attributed to learning through a test-retest effect, rather than to a true change in muscle characteristics. These findings, which show changes in normal subjects undergoing repeated testing, do not support the reliability of isometric strength measurements, or measurements based on RMS EMG recordings, for quantifying abdominal muscle function in patients with back pain, or those undergoing strengthening exercises.

Abdominal Muscles

Trunk extensor EMG-torque relationship.

The integrated surface electromyogram (IEMG) of the lumbar erectores spinae and the torque generated were simultaneously recorded from 27 healthy subjects in the standing posture while they pulled isometrically against resistance provided by a harness around the shoulders. The IEMG-torque ratio (efficiency of electrical activity, or EEA) was used to characterize each subject. Individual recordings showed evidence of nonlinearity of the IEMG-torque relationship in that a statistically better fit to experimental recordings was obtained by using two straight lines with a breakpoint between them. However, with repeated testing, the gradients of these two lines were more variable than the slope of the single straight line fitted to the entire recording. The slope of the best fit line (EEA) was less for recordings made during torque decrease than for increasing-torque recordings. This also showed as a "hysteresis" pattern in the recordings. The coefficient of variability (within subjects) of the EEA was greater in day-to-day testing (24%) than with repeated pulls at the same testing session (14%). This was similar to variability of the maximum generated torque. About 25% of the variability between subjects was found to be due to anthropometric differences. The residual variability of the relationship would limit the accuracy of IEMG as a measure of muscular effort under changing torque conditions. However, the EEA may be useful for characterizing muscle performance, especially when maximum effort cannot be achieved.

Adult