Top

Published in:

01-05-2008 | Original Article

Surface EMG signal alterations in Carpal Tunnel syndrome: a pilot study

Authors: A. Rainoldi, M. Gazzoni, R. Casale

Published in: European Journal of Applied Physiology | Issue 2/2008

Abstract

Carpal Tunnel syndrome (CTS) is one of the most common compartmental syndromes and nerve conduction studies are widely considered as the standard to diagnose the pathology. The purpose of this pilot study was to investigate whether multichannel surface electromyography can detect muscle alterations in patients diagnosed with severe CTS. Surface EMG signals were recorded at 10, 20, 30, and 80% MVC from the flexor and abductor pollicis brevis muscles of five patients with CTS and five control subjects. Subjects with severe CTS showed different interference patterns, lower signal amplitude, lower neuromuscular efficiency, and lower myoelectric manifestations of fatigue with respect to the control group. At submaximal levels, action potentials recorded from the flexor and abductor pollicis brevis muscles of the CTS group were characterized by lower conduction velocity and lower mean spectral frequency than the healthy group. These findings support, among others, the hypothesis of a selective loss of fast motor units (type II fiber) associated with CTS.

AAEM, AAN, AAPMR (1993) Practice parameter for elctrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 16:1390–1391

AAN, AAEM, AAPMR (1993) Practice parameter for carpal tunnel syndrome (summary statement). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 43:2406–2409

Armstrong TJ, Castelli WA, Evans FG, Diaz-Perez R (1984) Some histological changes in carpal tunnel contents and their biomechanical implications. J Occup Med 26:197–201PubMed

Casale R, Farina D, Merletti R, Rainoldi A (2004) Myoelectric manifestations of fatigue during exposure to hypobaric hypoxia for 12 days. Muscle Nerve 30:618–625PubMedCrossRef

Chauvet E, Fokapu O, Hogrel JY, Gamet D, Duchene J (2003) Automatic identification of motor unit action potential trains from electromyographic signals using fuzzy techniques. Med Biol Eng Comput 41:646–653PubMedCrossRef

Cruz-Martinez A, Arpa J (1999) Muscle fiber conduction velocity in situ (MFCV) in denervation, reinnervation and disuse atrophy. Acta Neurol Scand 100:337–340PubMedCrossRef

de Krom MC, Knipschild PG, Kester AD, Spaans F (1990) Efficacy of provocative tests for diagnosis of carpal tunnel syndrome. Lancet 335:393–395PubMedCrossRef

Dimitru D (1995) Electrodiagnostic medicine. Philadelphia, Hanley & Belfus

Drost G, Stegeman DF, van Engelen BG, Zwarts MJ (2006) Clinical applications of high-density surface EMG: a systematic review. J Electromyogr Kinesiol 16:586–602PubMedCrossRef

El Dassouki M, Lefaucheur JP (2002) The correlation between muscle and nerve fiber conduction velocities in thenar muscle is lost in case of carpal tunnel syndrome. Clin Neurophysiol 113:1121–1124PubMedCrossRef

Enoka RM, Fuglevand AJ (2001) Motor unit physiology: some unresolved issues. Muscle Nerve 24:4–17PubMedCrossRef

Falla D, Rainoldi A, Merletti R, Jull G (2003) Myoelectric manifestations of sternocleidomastoid and anterior scalene muscle fatigue in chronic neck pain patients. Clin Neurophysiol 114:488–495PubMedCrossRef

Farina D, Rainoldi A (1999) Compensation of the effect of sub-cutaneous tissue layers on surface EMG: a simulation study. Med Eng Phys 21:487–497PubMedCrossRef

Farina D, Fortunato E, Merletti R (2000) Noninvasive estimation of motor unit conduction velocity distribution using linear electrode arrays. IEEE Trans Biomed Eng 47:380–388PubMedCrossRef

Farina D, Fosci M, Merletti R (2002) Motor unit recruitment strategies investigated by surface EMG variables. J Appl Physiol 92:235–247PubMedCrossRef

Gazzoni M, Farina D, Merletti R (2001) Motor unit recruitment during constant low force and long duration muscle contractions investigated with surface electromyography. Acta Physiol Pharmacol Bulg 26:67–71PubMed

Gazzoni M, Farina D, Merletti R (2004) A new method for the extraction and classification of single motor unit action potentials from surface EMG signals. J Neurosci Methods 136:165–177PubMedCrossRef

Gerdle B, Henriksson-Larsen K, Lorentzon R, Wretling ML (1991) Dependence of the mean power frequency of the electromyogram on muscle force and fibre type. Acta Physiol Scand 142:457–465PubMedCrossRef

Hagberg M (2000) Epidemiology of neck and upper limb disorders and work place factors. Work related musculoskeletal disorders of the upper limb and back. In: Violante F, Armstrong TJ, Kilbom A (eds) Work related musculoskeletal disorders of the upper limb and back, New York, Taylor & Francis

Haig AJ, Gelblum JB, Rechtien JJ, Gitter AJ (1996) Technology assessment: the use of surface EMG in the diagnosis and treatment of nerve and muscle disorders. Muscle Nerve 19:392–395PubMedCrossRef

Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G (2000) Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol 10:361–374PubMedCrossRef

Huppertz HJ, Disselhorst-Klug C, Silny J, Rau G, Heimann G (1997) Diagnostic yield of noninvasive high spatial resolution electromyography in neuromuscular diseases. Muscle Nerve 20:1360–1370PubMedCrossRef

Hutson MA (1997) Work-Related Upper Limb Disorders: Recognition and Management. Butterworth-Heinemann, Oxford

Kerwin G, Williams CS, Seiler JG III (1996) The pathophysiology of carpal tunnel syndrome. Hand Clin 12:243–251PubMed

Koc F, Yerdelen D, Sarica Y, Sertdemir Y (2006) Motor unit number estimation in cases with Carpal Tunnel Syndrome. Int J Neurosci 116:1263–1270PubMedCrossRef

Komi PV, Tesch P (1979) EMG frequency spectrum, muscle structure, and fatigue during dynamic contractions in man. Eur J Appl Physiol Occup Physiol 42:41–50PubMedCrossRef

Kupa EJ, Roy SH, Kandarian SC, De Luca CJ (1995) Effects of muscle fiber type and size on EMG median frequency and conduction velocity. J Appl Physiol 79:23–32PubMed

Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 75:1585–1592PubMed

Mannion AF, Dumas GA, Stevenson JM, Cooper RG (1998) The influence of muscle fiber size and type distribution on electromyographic measures of back muscle fatigability. Spine 23:576–584PubMedCrossRef

Masuda K, Masuda T, Sadoyama T, Inaki M, Katsuta S (1999) Changes in surface EMG parameters during static and dynamic fatiguing contractions. J Electromyogr Kinesiol 9:39–46PubMedCrossRef

Masuda T, Miyano H, Sadoyama T (1985) A surface electrode array for detecting action potential trains of single motor units. Electroencephalogr Clin Neurophysiol 60:435–443PubMedCrossRef

Mazur A (1998) Role of thenar electromyography in the evaluation of carpal tunnel syndrome. Phys Med Rehabil Clin N Am 9:755–764PubMed

Merletti R, De Luca CJ (1989) New techniques in surface electromyography. Computer aided electromyography and expert systems. In: Computer aided electromyography and expert systems, Elsevier, JE Desmedt

Merletti R, Farina D, Gazzoni M, Schieroni MP (2002) Effect of age on muscle functions investigated with surface electromyography. Muscle Nerve 25:65–76PubMedCrossRef

Merletti R, Farina D, Granata A (1999) Non-invasive assessment of motor unit properties with linear electrode arrays. Electroencephalogr Clin Neurophysiol Suppl 50:293–300PubMed

Merletti R, Knaflitz M, De Luca CJ (1990) Myoelectric manifestations of fatigue in voluntary and electrically elicited contractions. J Appl Physiol 69:1810–1820PubMed

Merletti R, Rainoldi A, Farina D (2001) Surface electromyography for noninvasive characterization of muscle. Exerc Sport Sci Rev 29:20–25PubMedCrossRef

Miller RG, Giannini D, Milner-Brown HS, Layzer RB, Koretsky AP, Hooper D, Weiner MW (1987) Effects of fatiguing exercise on high-energy phosphates, force, and EMG: evidence for three phases of recovery. Muscle Nerve 10:810–821PubMedCrossRef

Nishizono H, Saito Y, Miyashita M (1979) The estimation of conduction velocity in human skeletal muscle in situ with surface electrodes. Electroencephalogr Clin Neurophysiol 46:659–664PubMedCrossRef

O’Connor D, Marshall S, Massy-Westropp N (2003) Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome (Cochrane Review), The Cochrane Library, Issue 2

Rai-Chi C, Tsui-Fen Y, I-Wenn P, Tien-Yow C (1998) Compound muscle action potential amplitude and area changes in normal subjects and patients with carpal tunnel syndrome. Electromyogr Clin Neurophysiol 38:317–320

Rainoldi A, Galardi G, Maderna L, Comi G, Lo Conte L, Merletti R (1999) Repeatability of surface EMG variables during voluntary isometric contractions of the biceps brachii muscle. J Electromyogr Kinesiol 9:105–119PubMedCrossRef

Rainoldi A, Nazzaro M, Merletti R, Farina D, Caruso I, Gaudenti S (2000) Geometrical factors in surface EMG of the vastus medialis and lateralis muscles. J Electromyogr Kinesiol 10:327–336PubMedCrossRef

Ranney D (1997) Chronic musculoskeletal injuries in the workplace. WB Saunders Company, Philadelphia, USA

Roeleveld K, Blok JH, Stegeman DF, van Oosterom A (1997) Volume conduction models for surface EMG; confrontation with measurements. J Electromyogr Kinesiol 7:221–232PubMedCrossRef

Roeleveld K, Stegeman DF (2002) What do we learn from motor unit action potentials in surface electromyography? Muscle Nerve Suppl 11:S92–S97PubMedCrossRef

Ross MA, Kimura J (1995) AAEM case report #2: the carpal tunnel syndrome. Muscle Nerve 18:567–573PubMedCrossRef

Sadoyama T, Masuda M, Miyata H, Katsuta S (1988) Fibre conduction velocity and fibre composition in human vastus lateralis. EurJ Appl Physiol 57:767–771CrossRef

Schillings ML, Kalkman JS, van der Werf SP, van Engelen BG, Bleijenberg G, Zwarts MJ (2004) Diminished central activation during maximal voluntary contraction in chronic fatigue syndrome. Clin Neurophysiol 115:2518–2524PubMedCrossRef

Stashuk D (2001) EMG signal decomposition: how can it be accomplished and used? J Electromyogr Kinesiol 11:151–173PubMedCrossRef

Sunderland S (1978) Nervers and nerve injuries. Causative agents. Edimburgh, Churchill Livingstone

Tang X, Zhuang L, Lu Z (1999) Carpal tunnel syndrome: a retrospective analysis of 262 cases and a one to one matched case-control study of 61 women pairs in relationship between manual housework and carpal tunnel syndrome. Chin Med J (Engl) 112:44–48

Van der Hoeven JH, Zwarts MJ, Van Weerden TW (1993) Muscle fiber conduction velocity in amyotrophic lateral sclerosis and traumatic lesions of the plexus brachialis. Electroencephalogr Clin Neurophysiol 89:304–310PubMedCrossRef

Wee AS (2002) Needle electromyography in carpal tunnel syndrome. Electromyogr Clin Neurophysiol 42:253–256PubMed

Werner RA, Gell N, Franzblau A, Armstrong TJ (2001) Prolonged median sensory latency as a predictor of future carpal tunnel syndrome. Muscle Nerve 24:1462–1467PubMedCrossRef

Zwarts MJ, Stegeman DF (2003) Multichannel surface EMG: basic aspects and clinical utility. Muscle Nerve 28:1–17PubMedCrossRef

Title: Surface EMG signal alterations in Carpal Tunnel syndrome: a pilot study
Authors: A. Rainoldi
M. Gazzoni
R. Casale
Publication date: 01-05-2008
Publisher: Springer-Verlag
Published in: European Journal of Applied Physiology / Issue 2/2008
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-008-0694-x

At a glance: The STEP trials

Springer Medicine

Surface EMG signal alterations in Carpal Tunnel syndrome: a pilot study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2008

The effect of AMPD1 genotype on blood flow response to sprint exercise

Changes in power and force generation during coupled eccentric–concentric versus concentric muscle contraction with training and aging

Aerobic exercise affects C57BL/6 murine intestinal contractile function

Effects of short-term training using SmartCranks on cycle work distribution and power output during cycling

Health-related physical fitness of adolescents and young adults with myelomeningocele

The role of the slope of oxygen consumption and EMG activity on freely chosen pedal rate selection