Gao Dong, Xia Qing, Ran Dan, Tian Dong, Zhu Guang-You, Fan Li-Hua
Fa Yi Xue Za Zhi. 2013 Dec;29(6):409-13.
To study the objectivity and reliability of needle electromyography and nerve conduction for detection of musculus extensor digitorum brevis strength, which may provide a basis for establishing a quantitative detection of muscle strength in forensic clinical study.
Forty-four healthy people were enrolled as the subjects, and during toe dorsiflexion, the following items including needle electromyography indexes, motor unit potential (MUP) amplitude, MUP count, recruitment reaction type, and nerve conduction detection indexes, compound muscle action potential (CMAP) amplitude, CMAP latent period and motor nerve conduction velocity (MNCV), were simultaneously detected under the cooperation and disguise condition.
Under the cooperation condition, regardless of the same operator or different operators, there were good test-retest reliabilities in MUP amplitude, CMAP amplitude, CMAP latent period and MNCV, while there were normal test-retest reliabilities in MUP count and recruitment reaction type and the repeatability of the same operator was slightly better than the repeatability between different operators. Under the disguise condition, test-retest reliabilities of MUP amplitude, CMAP amplitude, CMAP latent period and MNCV were relatively high, while test-retest reliabilities of MUP count and recruitment reaction type were relatively low.
There are good test-retest reliabilities in MUP amplitude, CMAP amplitude, CMAP latent period and MNCV, which can be conducive to comparison between different operators and results at various times; MUP count and recruitment reaction type, which can be easily affected by subjectivity of operators and examinees, can be used to differentiate whether an examinee disguises or not. The indexes used to objectively judge muscle strength remain to be further investigated.
研究针极肌电图和神经传导检测趾短伸肌肌力的客观性和可靠性,为法医学临床研究中建立肌力定量检测方法提供依据。
选取44名健康人作为研究对象,在足背屈过程中,于合作及伪装条件下同步检测针极肌电图指标、运动单位电位(MUP)波幅、MUP数量、募集反应类型等肌电图指标,以及复合肌肉动作电位(CMAP)波幅、CMAP潜伏期和运动神经传导速度(MNCV)等神经传导检测指标。
在合作条件下,无论同一操作者还是不同操作者,MUP波幅、CMAP波幅、CMAP潜伏期和MNCV的重测信度良好,而MUP数量和募集反应类型的重测信度正常,且同一操作者的重复性略优于不同操作者之间的重复性。在伪装条件下,MUP波幅、CMAP波幅、CMAP潜伏期和MNCV的重测信度较高,而MUP数量和募集反应类型的重测信度较低。
MUP波幅、CMAP波幅、CMAP潜伏期和MNCV具有良好的重测信度,有利于不同操作者之间及不同时间结果的比较;MUP数量和募集反应类型易受操作者和受检者主观因素影响,可用于鉴别受检者是否伪装。客观判断肌力的指标仍有待进一步研究。