Han Nami, Yabroudi Mohammad A, Stearns-Reider Kristen, Helkowski Wendy, Sicari Brian M, Rubin J Peter, Badylak Stephen F, Boninger Michael L, Ambrosio Fabrisia
N. Han, MD, PhD, Department of Physical Medicine and Rehabilitation, University of Pittsburgh, and Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Busan, Republic of Korea.
M.A. Yabroudi, PT, MS, Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania.
Phys Ther. 2016 Apr;96(4):540-9. doi: 10.2522/ptj.20150133. Epub 2015 Nov 12.
Electrodiagnosis can reveal the nerve and muscle changes following surgical placement of an extracellular matrix (ECM) bioscaffold for treatment of volumetric muscle loss (VML).
The purpose of this study was to characterize nerve conduction study (NCS) and electromyography (EMG) changes following ECM bioscaffold placement in individuals with VML. The ability of presurgical NCS and EMG to be used as a tool to help identify candidates who are likely to display improvements postsurgically also was explored.
A longitudinal case series design was used.
The study was conducted at the McGowan Institute for Regenerative Medicine at the University of Pittsburgh. Eight individuals with a history of chronic VML participated. The intervention was surgical placement of an ECM bioscaffold at the site of VML. The strength of the affected region was measured using a handheld dynamometer, and electrophysiologic evaluation was conducted on the affected limb with standard method of NCS and EMG. All measurements were obtained the day before surgery and repeated 6 months after surgery.
Seven of the 8 participants had a preoperative electrodiagnosis of incomplete mononeuropathy within the site of VML. After ECM treatment, 5 of the 8 participants showed improvements in NCS amplitude or needle EMG parameters. The presence of electrical activity within the scaffold remodeling site was concomitant with clinical improvement in muscle strength.
This study had a small sample size, and participants served as their own controls. The electromyographers and physical therapists performing the evaluation were not blinded.
Electrodiagnostic data provide objective evidence of physiological improvements in muscle function following ECM placement at sites of VML. Future studies are warranted to further investigate the potential of needle EMG as a predictor of successful outcomes following ECM treatment for VML.
电诊断可揭示在外科手术植入细胞外基质（ECM）生物支架以治疗容积性肌肉损失（VML）后神经和肌肉的变化。
本研究的目的是描述在VML患者中植入ECM生物支架后神经传导研究（NCS）和肌电图（EMG）的变化。还探讨了术前NCS和EMG作为一种工具帮助识别术后可能显示改善的候选者的能力。
采用纵向病例系列设计。
该研究在匹兹堡大学麦高恩再生医学研究所进行。8名有慢性VML病史的个体参与。干预措施是在VML部位手术植入ECM生物支架。使用手持测力计测量患区的力量，并采用标准NCS和EMG方法对患肢进行电生理评估。所有测量均在手术前一天获得，并在术后6个月重复进行。
8名参与者中有7名术前电诊断显示VML部位存在不完全单神经病。ECM治疗后，8名参与者中有5名的NCS波幅或针极EMG参数有所改善。支架重塑部位的电活动与肌肉力量的临床改善同时出现。
本研究样本量小，参与者为自身对照。进行评估的肌电图医生和物理治疗师未设盲。
电诊断数据为在VML部位植入ECM后肌肉功能的生理改善提供了客观证据。未来有必要进一步研究针极EMG作为VML患者ECM治疗成功结果预测指标的潜力。
