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Electromyography

 

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Electromyography



 
 
Electromyography (EMG) is a technique for evaluating and recording the activation signal of muscles. EMG is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cell
Cell (biology)

The cell is the structural and functional unit of all known Life organisms. It is the smallest unit of an organism that is classified as living, and is often called the building bricks of life....
s when these cells contract
Muscle contraction

Muscle fiber generates tension through the action of actin and myosin cross-bridge cycling. While under tension, the muscle may #Eccentric contraction, #Concentric contraction or #Isometric contraction....
, and also when the cells are at rest.

electrical source is the muscle membrane potential of about -70mV. Measured EMG potentials range between less than 50 µV and up to 20 to 30 mV, depending on the muscle under observation.

Typical repetition rate of muscle unit firing is about 7–20 Hz, depending on the size of the muscle (eye muscles versus seat (gluteal) muscles), previous axonal damage and other factors.






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Electromyography (EMG) is a technique for evaluating and recording the activation signal of muscles. EMG is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cell
Cell (biology)

The cell is the structural and functional unit of all known Life organisms. It is the smallest unit of an organism that is classified as living, and is often called the building bricks of life....
s when these cells contract
Muscle contraction

Muscle fiber generates tension through the action of actin and myosin cross-bridge cycling. While under tension, the muscle may #Eccentric contraction, #Concentric contraction or #Isometric contraction....
, and also when the cells are at rest.

Electrical characteristics

The electrical source is the muscle membrane potential of about -70mV. Measured EMG potentials range between less than 50 µV and up to 20 to 30 mV, depending on the muscle under observation.

Typical repetition rate of muscle unit firing is about 7–20 Hz, depending on the size of the muscle (eye muscles versus seat (gluteal) muscles), previous axonal damage and other factors. Damage to motor units can be expected at ranges between 450 and 780 mV.

History

The first documented experiments dealing with EMG started with Francesco Redi’s works in 1666. Redi discovered a highly specialized muscle of the electric ray fish (Electric Eel) generated electricity. By 1773, Walsh had been able to demonstrate that the Eel fish’s muscle tissue could generate a spark of electricity. In 1792, a publication entitled "De Viribus Electricitatis in Motu Musculari Commentarius" appeared, written by Luigi Galvani
Luigi Galvani

Luigi Galvani was an Italy physician and physicist who lived and died in Bologna. In 1771, he discovered that the muscles of dead frogs twitched when struck by a spark....
, in which the author demonstrated that electricity could initiate muscle contractions. Six decades later, in 1849, Dubios-Raymond discovered that it was also possible to record electrical activity during a voluntary muscle contraction. The first actual recording of this activity was made by Marey
Étienne-Jules Marey

?tienne-Jules Marey was a France scientist and Chronophotography, born in Beaune, France.His work was significant in the development of cardiology, physical instrumentation, aviation, cinematography and the science of labor photography....
 in 1890, who also introduced the term electromyography. In 1922, Gasser and Erlanger
Joseph Erlanger

Joseph Erlanger was an United States physiology.Erlanger was born on January 5, 1874, at San Francisco, California. He completed his B.S. in chemistry from the University of California, Berkeley and completed his M.D....
 used an oscilloscope
Oscilloscope

An oscilloscope is a type of electronic test instrument that allows signal voltages to be viewed, usually as a two-dimensional graph of one or more electrical potential differences plotted as a function of time or of some other voltage ....
 to show the electrical signals from muscles. Because of the stochastic nature of the myoelectric signal, only rough information could be obtained from its observation. The capability of detecting electromyographic signals improved steadily from the 1930s through the 1950s and researchers began to use improved electrodes more widely for the study of muscles. Clinical use of surface EMG (sEMG) for the treatment of more specific disorders began in the 1960s. Hardyck and his researchers were the first (1966) practitioners to use sEMG. In the early 1980s, Cram and Steger introduced a clinical method for scanning a variety of muscles using an EMG sensing device.

It is not until the middle of the 1980s that integration techniques in electrodes had sufficiently advanced to allow batch production of the required small and lightweight instrumentation and amplifiers. At present a number of suitable amplifiers are commercially available. In the early 1980s, cables became available which produce artifacts in the desired microvolt range. During the past 15 years, research has resulted in a better understanding of the properties of surface EMG recording. In recent years, surface electromyography is increasingly used for recording from superficial muscles in clinical protocols, where intramuscular electrodes are used for deep muscle only.

There are many applications for the use of EMG. EMG is used clinically for the diagnosis of neurological and neuromuscular problems. It is used diagnostically by gait laboratories and by clinicians trained in the use of biofeedback or ergonomic assessment. EMG is also used in many types of research laboratories, including those involved in biomechanics, motor control, neuromuscular physiology, movement disorders, postural control, and physical therapy.

Procedure

There are two kinds of EMG in widespread use: surface EMG and needle (intramuscular) EMG. To perform intramuscular EMG, a needle electrode
Electrode

An electrode is an electrical conductor used to make contact with a nonmetallic part of a Electronic circuit . The word was coined by the scientist Michael Faraday from the Greek language words elektron and hodos, a way....
 is inserted through the skin
Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
 into the muscle tissue. A trained professional (most often a physiatrist, neurologist, physical therapist, or chiropractor) observes the electrical activity while inserting the electrode. The insertional activity provides valuable information about the state of the muscle and its innervating nerve. Normal muscles at rest make certain, normal electrical sounds when the needle is inserted into them. Then the electrical activity when the muscle is at rest is studied. Abnormal spontaneous activity might indicate some nerve and/or muscle damage. Then the patient is asked to contract the muscle smoothly. The shape, size and frequency of the resulting motor unit potentials is judged. Then the electrode is retracted a few millimeters, and again the activity is analyzed until at least 10-20 units have been collected. Each electrode track gives only a very local picture of the activity of the whole muscle. Because skeletal muscle
Skeletal muscle

They generally contract voluntarily , although they can contract involuntarily through Reflex action. The whole muscle is wrapped in a special type of connective tissue, epimysium....
s differ in the inner structure, the electrode has to be placed at various locations to obtain an accurate study.

Intramuscular EMG may be considered too invasive or unnecessary in some cases. Instead, a surface electrode
Electrode

An electrode is an electrical conductor used to make contact with a nonmetallic part of a Electronic circuit . The word was coined by the scientist Michael Faraday from the Greek language words elektron and hodos, a way....
 may be used to monitor the general picture of muscle
MUSCLE

MUSCLE is public domain, multiple sequence alignment software for protein and nucleotide sequences.MUSCLE is integrated into UGENE bioinformatics tool as a plugin....
 activation, as opposed to the activity of only a few fibres as observed using a needle. This technique is used in a number of settings; for example, in the physiotherapy clinic, muscle activation is monitored using surface EMG and patients have an auditory or visual stimulus to help them know when they are activating the muscle (biofeedback
Biofeedback

Biofeedback is a form of alternative medicine that involves measuring a subject's quantifiable bodily functions such as blood pressure, heart rate, body temperature, sweating, and muscle tension, conveying the information to the patient in real-time....
).

A motor unit
Motor unit

A motor unit is a single a-motor neuron and all of the corresponding muscle fiber it Innervate. When a motor unit is activated, all of its fibers contract....
 is defined as one motor neuron and all of the muscle fibers it innervates. When a motor unit fires, the impulse (called an action potential
Action potential

An action potential is a self-regenerating wave of electrochemical activity that allows nerve cells to carry a signal over a distance. It is the primary electrical signal generated by nerve cells, and arises from changes in the permeability of the nerve cell's axonal Cell membranes to specific ions....
) is carried down the motor neuron to the muscle. The area where the nerve contacts the muscle is called the neuromuscular junction, or the motor end plate. After the action potential is transmitted across the neuromuscular junction, an action potential is elicited in all of the innervated muscle fibers of that particular motor unit. The sum of all this electrical activity is known as a motor unit action potential (MUAP). This electrophysiologic activity from multiple motor units is the signal typically evaluated during an EMG. The composition of the motor unit, the number of muscle fibres per motor unit, the metabolic type of muscle fibres and many other factors affect the shape of the motor unit potentials in the myogram.

Nerve conduction testing
Nerve conduction study

A nerve conduction study is a test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor nerve and sensory nerves of the human body....
 is also often done at the same time as an EMG in order to diagnose neurological diseases.

Patients can occasionally find the procedure somewhat painful while others experience only a small amount of discomfort when the needle is inserted. The muscle or muscles being tested may be slightly sore for a day or two after the procedure.

Normal results

Muscle tissue at rest is normally electrically inactive. After the electrical activity caused by the irritation of needle insertion subsides, the electromyograph should detect no abnormal spontaneous activity (i.e. a muscle at rest should be electrically silent, with the exception of the area of the neuromuscular junction
Neuromuscular junction

A neuromuscular junction is the synapse or junction of the axon terminal of a motoneuron with the motor end plate, the highly-excitable region of muscle plasma membrane responsible for initiation of action potentials across the muscle's surface, ultimately causing the muscle to contract....
, which is normally electrically very spontaneously active). When the muscle is voluntarily contracted, action potentials begin to appear. As the strength of the muscle contraction is increased, more and more muscle fibers produce action potentials. When the muscle is fully contracted, there should appear a disorderly group of action potentials of varying rates and amplitudes (a complete recruitment and interference pattern).

Abnormal results

EMG is used to diagnose two general categories of disease: neuropathies and myopathies.

Neuropathic disease has the following defining EMG characteristics:
  • An action potential
    Action potential

    An action potential is a self-regenerating wave of electrochemical activity that allows nerve cells to carry a signal over a distance. It is the primary electrical signal generated by nerve cells, and arises from changes in the permeability of the nerve cell's axonal Cell membranes to specific ions....
     amplitude
    Amplitude

    Amplitude is the magnitude of change in the oscillating variable, with each oscillation, within an oscillating system. For instance, sound waves are oscillations in atmospheric pressure and their amplitudes are proportional to the change in pressure during one oscillation....
     that is twice normal due to the increased number of fibres per motor unit because of reinnervation
    Reinnervation

    In living tissues, reinnervation describes the process by which motor nerves grow new axons in order to take over the functionality of nearby dead or otherwise dysfunctional nerves....
     of denervated fibres.
  • An increase in duration
    Duration

    A tone may be sustained for varying lengths of time. Duration is a property of tone that becomes one of the bases rhythm or an quantity of time or a particular time Interval ....
     of the action potential
  • A decrease in the number of motor unit
    Motor unit

    A motor unit is a single a-motor neuron and all of the corresponding muscle fiber it Innervate. When a motor unit is activated, all of its fibers contract....
    s in the muscle (as found using motor unit number estimation
    Motor unit number estimation

    Motor Unit Number Estimation is a technique that uses electromyography to estimate the number of motor units in a muscle....
     techniques)


Myopathic disease has these defining EMG characteristics:
  • A decrease in duration of the action potential
  • A reduction in the area
    Area

    Area is a quantity expressing the two-dimensional size of a defined part of a surface, typically a region bounded by a closed curve. The term surface area refers to the total area of the exposed surface of a 3-dimensional solid, such as the sum of the areas of the exposed sides of a polyhedron....
     to amplitude
    Amplitude

    Amplitude is the magnitude of change in the oscillating variable, with each oscillation, within an oscillating system. For instance, sound waves are oscillations in atmospheric pressure and their amplitudes are proportional to the change in pressure during one oscillation....
     ratio of the action potential
  • A decrease in the number of motor units in the muscle (in extremely severe cases only)


Because of the individuality of each patient and disease, some of these characteristics may not appear in every case.

Abnormal results may be caused by the following medical conditions (please note this is nowhere near an exhaustive list of conditions that can result in abnormal EMG studies):
  • Alcoholic neuropathy
  • Axillary nerve dysfunction
    Axillary nerve dysfunction

    Axillary nerve dysfunction is a general term that refers to any type of dysfunction of the axillary nerve. The axillary nerve is a branch of the brachial plexus that innervates the Deltoid muscle and teres minor muscles....
  • Becker's muscular dystrophy
    Becker's muscular dystrophy

    Becker's muscular dystrophy is an X-linked recessive inherited disorder characterized by slowly progressive muscle weakness of the legs and pelvis....
  • Brachial plexopathy
  • Carpal tunnel syndrome
    Carpal tunnel syndrome

    Carpal tunnel syndrome , or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist, leading to paresthesias, numbness and muscle weakness in the hand....
  • Centronuclear myopathy
  • Cervical spondylosis
  • Charcot-Marie-Tooth disease
    Charcot-Marie-Tooth disease

    Charcot-Marie-Tooth disease , known also as Hereditary Motor and Sensory Neuropathy , Hereditary Sensorimotor Neuropathy , or Peroneal Muscular Atrophy, is a heterogeneous inherited disorder of nerves that is characterized by loss of muscle tissue and touch sensation, predominantly in the feet and legs but also in the hands...
  • Common peroneal nerve dysfunction
  • Denervation (reduced nervous stimulation)
  • Dermatomyositis
    Dermatomyositis

    Dermatomyositis is a connective-tissue disease related to Polymyositis that is characterized by inflammation of the muscles and the skin....
  • Distal median nerve dysfunction
  • Duchenne muscular dystrophy
    Duchenne muscular dystrophy

    Duchenne muscular dystrophy is a severe recessive Sex linkage form of muscular dystrophy characterized by rapid progression of muscle degeneration, eventually leading to loss in ambulation and death....
  • Facioscapulohumeral muscular dystrophy
    Facioscapulohumeral muscular dystrophy

    Facioscapulohumeral muscular dystrophy , which is also known as Landouzy-Dejerine, is an autosomal dominant form of muscular dystrophy that initially affects the skeletal muscles of the face , scapula and upper arms ....
     (Landouzy-Dejerine)
  • Familial periodic paralysis
  • Femoral nerve dysfunction
  • Fields condition
  • Friedreich's ataxia
    Friedreich's ataxia

    Friedreich's ataxia is an inherited disease that causes Progressive illness to the nervous system resulting in symptoms ranging from gait disturbance and speech problems to heart disease....
  • Guillain-Barre
  • Lambert-Eaton Syndrome
  • Mononeuritis multiplex
    Mononeuritis multiplex

    Mononeuritis multiplex is the clinical picture that arises from problems with multiple individual nerves serially or almost simultaneously....
  • Mononeuropathy
    Mononeuropathy

    Mononeuropathy is a type of neuropathy that only affects a single nerve. It is diagnostically useful to distinguish them from peripheral neuropathy and autonomic neuropathy because the limitation in scope makes it more likely that the cause is a localized trauma or infection....
  • Motor neurone disease
    Motor neurone disease

    The motor neurone diseases are a group of progressive neurological disorders that destroy motor neuron, the cells that control voluntary muscle activity including speaking, walking, breathing, swallowing and general movement of the body....
  • Multiple system atrophy
    Multiple system atrophy

    Multiple system atrophy is a rare disease, degenerative neurological disorder. MSA is associated with the degeneration of nerve cells in specific areas of the brain....
  • Myasthenia gravis
    Myasthenia gravis

    Myasthenia gravis is a neuromuscular disease leading to fluctuating muscle weakness and fatigue . It is an autoimmunity, in which weakness is caused by circulating antibody that block acetylcholine receptors at the post-synaptic neuromuscular junction, inhibiting the stimulative effect of the neurotransmitter acetylcholine....
  • Myopathy
    Myopathy

    In medicine, a myopathy is a muscular disease in which the muscle fibers do not function for any one of many reasons, resulting in muscular weakness....
     (muscle degeneration, which may be caused by a number of disorders, including muscular dystrophy)
  • Myotubular myopathy
  • Neuromyotonia
    Neuromyotonia

    Neuromyotonia, also known as Isaacs' Syndrome, is spontaneous muscle activity resulting from repetitive motor unit action potentials of peripheral origin....
  • Peripheral neuropathy
    Peripheral neuropathy

    Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerve or from the Adverse effect of systemic illness....
  • Poliomyelitis
    Poliomyelitis

    Poliomyelitis, often called polio or infantile paralysis, is an acute virus infectious disease spread from person to person, primarily via the fecal-oral route....
  • Polymyositis
    Polymyositis

    Polymyositis is a type of chronic inflammatory myopathy, related to dermatomyositis and inclusion body myositis. Polymyositis means 'many muscle inflammation'....
  • Radial nerve dysfunction
  • Sciatic nerve dysfunction
  • Sensorimotor polyneuropathy
  • Sleep bruxism
  • Spinal stenosis
    Spinal stenosis

    Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves. This is usually due to the natural process of spinal degeneration that occurs with aging....
  • Thyrotoxic periodic paralysis
  • Tibial nerve dysfunction
  • Ulnar nerve dysfunction


EMG signal decomposition


EMG signals are essentially made up of superimposed motor unit action potentials (MUAPs) from several motor units. For a thorough analysis, the measured EMG signals can be decomposed into their constituent MUAPs. MUAPs from different motor units tend to have different characteristic shapes, while MUAPs recorded by the same electrode from the same motor unit are typically similar. Notably MUAP size and shape depend on where the electrode is located with respect to the fibers and so can appear to be different if the electrode moves position. EMG decomposition is non-trivial, although many methods have been proposed.

Applications of EMG

EMG signals are used in many clinical and biomedical applications. EMG is used as a diagnostics tool for identifying neuromuscular diseases, assessing low back pain, kinesiology
Kinesiology

Kinesiology, also known as Human Kinetics, is the science of human movement. It focuses on how the body functions and moves. A kinesiological approach applies scientific based medical principles towards the analysis, preservation and enhancement of human movement in all settings and populations....
 and disorders of motor control. EMG signals are also used as a control signal for prosthetic devices such as prosthetic hands, arms, and lower limbs.

EMG can be used to sense isometric
Isometric

The term isometric comes from the Greek for "having equal measurement".isometric may mean:* Isometric projection , a method for the visual representation of three-dimensional objects in two dimensions; a form of orthographic projection, or more specifically, an axonometric projection....
 muscular activity where no movement is produced. This enables definition of a class of subtle motionless gestures to control interfaces without being noticed and without disrupting the surrounding environment. These signals can be used to control a prosthesis or as a control signal for an electronic device such as a mobile phone or PDA.

EMG signals have been targeted as control for flight systems. The Human Senses Group at the NASA Ames Research Center
NASA Ames Research Center

NASA Ames Research Center is a NASA facility located at Moffett Federal Airfield, which covers at the borders of the cities of Mountain View, California and Sunnyvale, California in California....
 at Moffett Field, CA seeks to advance man-machine interfaces by directly connecting a person to a computer. In this project, an EMG signal is used to substitute for mechanical joysticks and keyboards. EMG has also been used in research towards a "wearable cockpit" which employs EMG-based gestures to manipulate switches and control sticks necessary for flight in conjunction with a goggle-based display.

Unvoiced speech recognition recognizes speech by observing the EMG activity of muscles associated with speech. It is targeted for use in noisy environments, and may be helpful for people without vocal cords and people with aphasia
Aphasia

Aphasia , also known as rhymnasia, is a loss of the ability to produce and/or comprehend language, due to injury to brain areas specialized for these functions, such as Broca's area, which governs language production, or Wernicke's area, which governs the interpretation of language....
.

EMG has also been used as a control signal for computers and other devices. An interface device based on EMG could be used to control moving objects, such as mobile robots or an electric wheelchair. This may be helpful for individuals who cannot operate a joystick-controlled wheelchair. Surface EMG recordings may also be a suitable control signal for some interactive video games.

An EMG sensor switch was developed in 2008 called the Libertas EMG Sensor(). This sensor picks up minute EMG signals typically from ALS
Amyotrophic lateral sclerosis

Amyotrophic Lateral Sclerosis is a progressive, usually fatal, neurodegenerative disease caused by the degeneration of motor neurons, the nerve cells in the central nervous system that control voluntary muscle movement....
 victims with little remaining muscular activity. The Libertas transmits the EMG signal through Bluetooth
Bluetooth

Bluetooth is a wireless protocol for exchanging data over short distances from fixed and mobile devices, creating personal area networks . It was originally conceived as a wireless alternative to RS232 data cables....
 to a computer. When volitional muscle contration is detected, virtual switch closure is then passed to specialized augmentative communication software that allows users to control the computer with any remaining muscles under volitional control. The technique effectively replaces the keyboard and mouse inputs with EMG control.