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The accuracy of needle electrode placement by trainees in selected forearm muscles using verification by neuromuscular ultrasound |
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| Institution: | 1. Regenerative Neurorehabilitation Laboratory, Shirley Ryan Ability Lab (Formerly the Rehabilitation Institute of Chicago), Chicago, IL, United States;2. Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States;3. Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States;1. Department of Radiology, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 64239, Israel;2. Department of Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 64239, Israel;1. University of Saskatchewan, College of Medicine, School of Rehabilitation Science, Saskatoon, Saskatchewan, Canada;2. University of Toronto, Department of Surgery, Division of Anatomy, Toronto, Ontario, Canada;3. University of Waterloo, Faculty of Applied Health Sciences, Department of Kinesiology, Digital Industrial Ergonomics and Shoulder Evaluation Laboratory (DIESEL), Waterloo, Ontario, Canada;1. Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark;2. Department of Clinical Medicine, Aarhus University, Denmark;3. Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Denmark;4. Department of Neurology, Aarhus University Hospital, Denmark;5. Spinal Cord Injury Center of Western Denmark, Department of Neurology, Regional Hospital of Viborg, Denmark |
| Abstract: | IntroductionAnatomic landmarks alone may not always be sufficient to accurately guide electromyography (EMG) electrode needle placement.MethodsSenior residents and fellows (n = 11) targeted 4 forearm muscles with anatomic landmarks alone versus with audiovisual EMG feedback. Accuracy of EMG needle placement was verified using neuromuscular ultrasound imaging.ResultsWhile relatively large and superficial FCR muscle was sampled at a rate of 100% with and without audiovisual EMG feedback, accuracy of deeper and/or smaller forearm muscles (FPL, EIP, and SUP) diminished significantly without audiovisual EMG feedback.DiscussionOur study suggests that in clinical scenarios in which an electrodiagnostician relies on anatomic landmarks alone to target small and deep muscles, the risk of misplacement of needle electrode is increased. Consideration for neuromuscular ultrasound to augment training and/or real time guidance in EMG practice may be appropriate. |
| Keywords: | Electromyography Ultrasound Forearm muscles Neuromuscular Quality improvement EMG"} {"#name":"keyword" "$":{"id":"k0035"} "$$":[{"#name":"text" "_":"electromyography FCR"} {"#name":"keyword" "$":{"id":"k0045"} "$$":[{"#name":"text" "_":"flexor carpi radialis FPL"} {"#name":"keyword" "$":{"id":"k0055"} "$$":[{"#name":"text" "_":"flexor pollicis longus EIP"} {"#name":"keyword" "$":{"id":"k0065"} "$$":[{"#name":"text" "_":"extensor indicis proprius SUP"} {"#name":"keyword" "$":{"id":"k0075"} "$$":[{"#name":"text" "_":"supinator CQI"} {"#name":"keyword" "$":{"id":"k0085"} "$$":[{"#name":"text" "_":"continuous quality improvement |
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