DOI QR코드

DOI QR Code

Comparison Study about Surface Mapping of Motor Points in Biceps Brachii Muscle Using Surface EMG and Electric Probe

표면 근전도와 전기 탐침기를 이용한 상완이두근의 운동점 표지 비교 연구

  • Received : 2017.11.07
  • Accepted : 2017.12.06
  • Published : 2018.01.31

Abstract

Objectives This study was performed to compare the electrical methods of motor points mapping using surface EMG and electric probe (Pointer Excel II). Methods 32 healthy adults (male 16, female 16) were selected. and classified into two groups; surface EMG group, electric probe (Pointer Excel II) group. In surface EMG group, motor points were searched by recoding the compound muscle potentials. In electric probe (Pointer Excel II) group, motor points were searched by scanning the skin with Pointer Excel II at low level stimulation. The locations of the motor points were expressed as X and Y values in relation to the reference line. The horizontal reference line was set as elbow crease and the vertical reference line was set as the line connecting coracoid process to the center of the horizontal reference line. The data was analyzed by 'Independent T-test' and 'equivalence test'. Results 1. The motor points of short head and long head of biceps brachii muscle were located at about 2/3 length of the vertical reference line from coracoid process and about 1/5~1/4 length of the half of the horizontal reference line from the vertical reference line in both group. 2. The motor points of the short head were located more distally and close to the vertical reference line (p<0.001). 3. In surface EMG group, the motor points of the long head were located more laterally in the female than male. And the motor points of the long head were located more distally in the left side than right side (p<0.05). In electric probe (Pointer Excel II) group, similar tendency was observed but there was no statistically significant difference (p>0.05). 4. As a result of the equivalence test between surface EMG group and electric probe (Pointer Excel II) group, the confidence intervals of the difference were within the equivalence limit. Therefore, the locations of the motor points searched by two ways are equa l (p>0.05, equivalence interval=3%). Conclusions The results indicate that electric probe (Pointer Excel II) can be used to search the motor points instead of surface EMG. This might improve the clinical efficiency when using the motor points to treat muscle dysfunction.

Keywords

Motor Point;Electric probe;Pointer Excel;Surface EMG;Biceps brachii

References

  1. Botter A, Operandi G, Lanfranco F, Allasia S, Maffiuletti NA, Minetto MA. Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning. Eur J Appl Physiol. 2011;111:2461-71. https://doi.org/10.1007/s00421-011-2093-y
  2. Gobbo M, Maffiuletti NA, Orizio C, Minetto MA. Muscle motor point identification is essential for optimizing neuromuscular electrical stimulation use. Journal of NeuroEngineering and Rehabilitation. 2014;11:17. https://doi.org/10.1186/1743-0003-11-17
  3. Kim MW, Kim JH, Yang YJ, Ko YJ. Anatomic Localization of Motor Points in Gastrocnemius and Soleus Muscles. Am. J. Phys. Med. Rehabil. 2005;84:680-3. https://doi.org/10.1097/01.phm.0000176341.85398.a9
  4. Chironna RL, Hecht JS, Subscapularis motor point block for the painful hemiplegic shoulder, Archives of Physical Medicine and Rehabilitation, 1990;71(6):428-9.
  5. Uchikawa K, Toikawa H, Liu M. Subscapularis motor point block for spastic shoulders in patients with cervical cord injury. Spinal Cord. 2009;47:249-51. https://doi.org/10.1038/sc.2008.122
  6. Hara Y, Ogawa S, Muraoka Y. Hybrid Power-Assisted Functional Electrical Stimulation to Improve Hemiparetic Upper-Extremity Function. Am J Phys Med Rehabil. 2006;85:977-85.
  7. Wang ZJ, Xing YL, Gao X, Hu XY, Zhang L, Li J, Guan Y, Robinson N. Motor entry point acupuncture compared with the standard acupuncture for treatment of shoulder abduction dysfunction after stroke: A randomized clinical trial. European Jorunal of Integrative Medicine. 2015;7S:26.
  8. Buchanan TS, Erickson JC. Selective block of the brachialis motor point, An Anatomic Investigation of Musculocutaneous Nerve Branching, Regional Anesthesia. 1996;21(2):89-92.
  9. Kim JS, Gwon JY, Kang SY, Park JW. Anatomical Locations of the motor Points of the Biceps and Brachialis Muscles. Annals of Rehabilitation Medicine. 2004;28(6):592-5.
  10. Park BK, Shin YB, Ko HY, Park JH, Baek SY. Anatomic Motor Point Localization of the Biceps Brachii and Brachialis Muscles. J Korean Med Sci. 2007;22:459-62. https://doi.org/10.3346/jkms.2007.22.3.459
  11. Lee JH, Kim HW, Im S, An X, Lee MS, Lee UY, Han SH. Localization of motor entry points and terminal intramuscular nerve endings of the musculocutaneous nerve to biceps and brachialis muscles. Surg Radiol Anat. 2010;32:213-20. https://doi.org/10.1007/s00276-009-0561-4
  12. Aquilonius SM, Askmark H, Gillberg PG, Nandedkar S, Olsson Y, Stalberg E. Topographical Localization of Motor Endplates in Cryosections of Whole Human Muscles. MUSCLE&NERVE. 1983;7:287-93.
  13. Amirali A, Mu L, Gracies JM, Simpson DM. Anatomical Localization of Motor Endplate Bands in the Human Biceps Brachii. Journal of Clinical Neuromuscular Disease. 2007;9(2):306-12. https://doi.org/10.1097/CND.0b013e31815c13a7
  14. Moon JY, Hwang TS, Sim SJ, Chun SI, Kim MY. Surface Mapping of Motor Points in Biceps Brachii Muscle. Ann Rehabil Med. 2012;36:187-96.
  15. Behringer M, Franz A, McCourt M, Mester J. Motor point map of upper body muscles. Eur J Appl Physiol. 2014;114:1605-17. https://doi.org/10.1007/s00421-014-2892-z
  16. Pointer Excel II Instruction manual, Lhasa OMS, Inc., Weymouth,MA.USA
  17. Lee JH. Electrotherapy. Seoul:Daehakseolim. 1995:176-7.
  18. Lee SW, Yun JM, Son JW, Kang BG, Park SM, Yun HJ, Kim DJ, Kim TJ, Lee I, Shin YI, Moon BS. The effect of electroacupuncture on upper-extremity spasticity of stroke patients. Korean J. Orient. Int. Med. 2007;28(3):492-501.
  19. McCrea PH, Eng JJ, Willms R. Phenol Reduces Hypertonia and Enhances Strength: A Longitudinal Case Study. Neurorehabil Neural Repair. 2004;18(2):112-6. https://doi.org/10.1177/08884390042265662
  20. Lee JH, Kim HW, Im S, An X, Lee MS, Lee UY, Han SH. Localization of motor entry points and terminal intramuscular nerve endings of the musculocutaneous nerve to biceps and brachialis muscles. Surg Radiol Anat. 2010;32:213-20. https://doi.org/10.1007/s00276-009-0561-4
  21. Shaari C, Sanders I. Quantifying how location and dose of botulinum toxin injections affect muscle paralysis. MUSCLE&NERVE. 1993;16:964-9.
  22. Campenhout AV, Molenaers G. Localization of the motor endplate zone in human skeletal muscles of the lower limb: anatomical guidelines for injection with botulinum toxin. Developemental Medicine and Child Neurology. 2011;53(2):108-18. https://doi.org/10.1111/j.1469-8749.2010.03816.x
  23. Gracies JM, Lugassy M, Weisz DJ, Vecchio M, Flanagan S, Simpson DM. Botulinum Toxin Dilution and Endplate Targeting in Spasticity:A Double-Blind Controlled Study. Arch Phys Med Rehabil. 2009;90:9-16.
  24. Ko ES, Lee JH, Song YK. A study of manipulative treatments for musculoskeletal problems applying proprioceptive spinal reflex. The Journal of Korea CHUNA Manual Medicine for Spine&Nerves. 2006;1(2):81-92.
  25. Binder MD, Hirokawa N, Windhorst U. Encyclopedia of Neuroscience. Springer. 2008:3865.
  26. Bear MF, Connors BW, Paradiso MA. Neruroscience Exploring the brain. 2nd edition. London:Lippincott Williams&Wilkins. 2001:437-63.
  27. Martini FH. Fundamentals of Anatomy and Physiology. 4th edition. NewJersey:Prentice Hall. 1998:416-43.
  28. Wadell I, Johansson H, Sjolander P, Sojka P, Djupsjobacka M, Niechaj A. Fusimotor reflexes influencing secondary muscle spindle afferents from flexor and extensor muscles in the hind limb of the cat. Journal de Physiologie. 1991;85(4):223-34.
  29. Sjolander P, Johansson H, Djupsjobackab M. Spinal and supraspinal effects of activity in ligament afferents. Journal of Electromyography and Kinesiology. 2002; 12(3):162-76.
  30. Johansson H, Djupsjobackab M, Sjolander P. Influences on the ${\gamma}$-muscle spindle system from muscle afferents stimulated by KCl and lactic acid. Neuroscience Research. 1993;16:49-57. https://doi.org/10.1016/0168-0102(93)90008-E
  31. Djupsjobackab M, Johansson H, Bergenheim M. Influences on the ${\gamma}$-muscle spindle system from muscle afferents stimulated by increased intramuscular concentrations of arachidonic acid. Brain Research 663. 1994:293-302. https://doi.org/10.1016/0006-8993(94)91276-9
  32. DA Canapp. Select modalities. Clin Tech Small Anim Pract. 2007;22(4):160-5. https://doi.org/10.1053/j.ctsap.2007.09.004
  33. Martin L, Cometti G, Pousson M, Morlon B. Effect of elctrical stimulation training on the contractile charracteristics of the triceps surae muscle. Eur J Appl Physio. 1993;67:457-61. https://doi.org/10.1007/BF00376463
  34. Girold S, Jalab C, Bernard O, Carette P, Kemoun G, Dugue B. Dry-Land Strength Training vs. Electrical Stimulation in Sprint Swi mming Performance. J Strength Cond Res. 2012;26(2):497-505. https://doi.org/10.1519/JSC.0b013e318220e6e4
  35. Colson S, Martin A, Van Hoecke J. Re-Excmination of Training Effects by Electrostimulation in the Human Elbow Musculoskeletal System. Int J Sports Med. 2000;21:281-8. https://doi.org/10.1055/s-2000-8882
  36. Zhao JG, Cao CH, Liu CZ, Han BJ, Zhang J, Li ZG, Yu Tao, Wang XH, Zhao H, Xu ZH. Effect of acupuncture treatment on spastic states of stroke patients. Journal of the Neurological Sciences. 2009;276:143-7. https://doi.org/10.1016/j.jns.2008.09.018
  37. Mukherjee M, McPeak LK, Redford JB, Sun C, Liu W. The Effetc of Elctro-Acupuncture on Spasticity of the Wrist Joint in Chronic Stroke Survivors. Arch Phys Med Rehabil. 2007;88:159-66. https://doi.org/10.1016/j.apmr.2006.10.034
  38. Sim WJ, Moon SH, Ryu HJ, Jung SH, Kim SS, Lee JS. The effects of the muscles a long meridians release therapy to spastic patients after stroke. The Journal of Korean rehabilitation. 2004;14(1):63-75.
  39. Noh JH, Park JA, Cho SW, Youn HM, Jang KJ, Sone CH, Ahn CB, Kim CH. Effect of Bee-venom acupuncture on upper limb spasticity of stroke patients. The Journal of Korean acupuncture&moxibustion society. 2010;27(4):115-25.
  40. Noh JH, Park JA, Youn HM, Jang KJ, Song CH, Ahn CB, Kim CH. The effect of hominis placenta pahrmacopuncture on leg spasticity of stroke patients. The Journal of Korean pharmacopunture institute. 2009;12(4):97-110.
  41. Ryu SH, Lee KS, Kim TK, Choi YS, Yun SP, Jang JC, Moon SK, Ko CN, Cho KH, Kim YS, Bae HS. Effects of electroacupuncture on the hemiplegic upper extremity after stroke. J Korean Oriental Med. 2002;23(2):180-9.
  42. Alexander DN, Cen S, Sullivan KJ, Bhavnani G, Ma X, Azen SP. Effects of Acupuncture Treatment on Poststroke Motor Recovery and Physical Function: A Pilot Study. Neurorehabil Neural Repair. 2004;18:259-67. https://doi.org/10.1177/1545968304271568