Fecal incontinence—a review

Fecal incontinence (FI) is defined as the involuntary passage of fecal material through the anal canal. True incontinence must be differentiated from pseudo incontinence. FI is predominately a disease of the elderly or of institutional patients. Fecal incontinence in the nursing home population has been estimated at 47%. We provide a guide to appropriate clinical evaluation, diagnostic testing, and treatment of FI.     

A comparison of EMG output of four lower extremity muscles during selected yoga postures

The purpose of this study was to use surface electromyography (EMG) analysis to examine the muscle activation of the anterior tibialis (TA), gastrocnemius (GA), rectus femoris (RF) and biceps femoris (BF) muscles during several yoga poses: tree pose (Vrksashana), half moon pose (Ardha Chandrasana) and warrior III (Virabadrasana) when compared to a rest pose (mountain pose). Ten healthy females with more than 3 months of continuous yoga experience who practiced at least 1.5 h per week were recruited. EMG activity was recorded from the aforementioned muscles during mountain pose (“rest”) for 30 s, three times. Subjects then performed the following yoga poses in a randomized sequence while surface EMG activity was recorded: tree pose, half-moon, and warrior III. Each pose was held for 20s to 30 s and performed three times. EMG data were band pass filtered and the root mean square (RMS) was obtained. The peak RMS of each of the resting trials was obtained and averaged to produce an average peak resting RMS value. The study revealed significantly greater EMG activity in TA and GA in all three poses when compared to BF and RF. BF produced greater EMG activity than RF in warrior III. In conclusion, single limb yoga poses require increased use of the ankle musculature when compared to thigh musculature.     

Prolonged ambulant assessment of anorectal function in patients with prolapsing hemorrhoids

Six patients with prolapsing hemorrhoids and 12 control subjects had assessment of anorectal pressure and external sphincter electromyography performed over a prolonged period under ambulant conditions. Patients with prolapsing hemorrhoids demonstrated greater degrees of sampling responses, 12.9±1.9/hour,vs. 7.4±2.0/hour (mean ±SEM) in controls (P<.05). Ultraslow wave and giant ultraslow wave activity were seen frequently in the patient group occupying more than 30 percent of recording. The external sphincter demonstrated much greater electrical activity (spike potentials) in patients with hemorrhoids than in controls both by day, 24.9±11.0/10 minvs. 12.8±3.2/10 min (P<.02), and by night, 7.4±2.6 minvs. 1.6 ±1.3/10 min (P<.03). Sleep electrical activity in the presence of hemorrhoids did not differ significantly from that of controls during waking, 7.4±2.6/10 minvs. 12.8±3.2/10 min (P<.1). No difference in phasic and periodic rectal motor activity was noted between patient and control groups. This demonstrates the application of prolonged assessment of anorectal motility and external sphincter activity in a patient group. Abnormalities previously documented in patients with hemorrhoids using conventional manometric tests were confirmed. In addition, evidence of increased external sphincter function during waking and sleep may have implications in the pathophysiology of this disorder.     

Effect of thoracoabdominal configuration on the diaphragmatic contribution to rib cage motion

Owing to the diaphragm-rib cage interaction the diaphragm can reduce the load on the intercostal muscles. The extent of this load reduction was evaluated by analyzing the EMG activity of intercostal muscles as an index of the pressure generated by the intercostal muscles. Three trained subjects shifted their breathing configuration while the rib cage volume and flow were kept constant. Analysis of data thus obtained indicated that the diaphragmatic contribution to the rib cage motion improved with a thoracic shift of breathing. The significance of this effect was further evaluated by performing respiratory maneuvers at constant tidal volume and flow at normal and elevated functional residual capacity. At both lung volumes, a substantial saving of diaphragmatic activity attained by the thoracic shift of breathing was associated with a moderate increase or even a decrease in the intercostal EMG activity, suggesting an overall mechanical advantage of inspiratory muscles during thoracic breathing. Support by National Institute of Health Grant HL 25230 Preliminary results have been reported at the 66th annual FASEB meeting in New Orleans, 1982     

成人型脊髓性肌萎缩症46例临床分析

目的 总结成人型脊髓性肌萎缩症(SMA_4)的临床、肌电图和病理特征。方法 收集48例经肌肉活检确诊的SMA_4病人的临床、肌电图和病理资料,对其进行回顾性分析和研究。结果 SMA_4病人平均发病年龄38.23岁,起病隐袭,肌无力和肌萎缩以四肢近端为主,进展缓慢,预后相对较好。肌电图主要表现为插入电位异常,常见纤颤波和束颤波,部分可见正相尖波,平均波幅和平均时限均显著增加,大都有多相电位增多,大力收缩都不能达到干扰相。肌活检主要表现为小群性肌萎缩,并可见同型肌君化及肌纤维代偿性肥大。结论 根据临床特征,结合肌电图和肌活检结果,可以确诊成人型脊髓性肌萎缩症。     

Associations Between Muscle Synergies and Treatment Outcomes in Cerebral Palsy Are Robust Across Clinical Centers

Objective

To determine whether patient-specific differences in motor control quantified using muscle synergy analysis were associated with changes in gait after treatment of cerebral palsy (CP) across 2 clinical centers with different treatments and clinical protocols.

先天性肌性斜颈患儿胸锁乳突肌表面肌电信号特征研究

目的 探讨先天性肌性斜颈(CMT)双侧胸锁乳突肌的表面肌电信号特征.方法 选择60例CMT患儿作为CMT组,并根据病变部位分为左CMT组和右CMT组,另以15例健康儿童作为对照组,检测各组研究对象在5个体位(仰卧中立位、颈部左右旋转和左右侧屈)下双侧胸锁乳突肌的肌电信号,进行时域均方根值(RMS)分析.结果 仰卧中立位时,CMT组患侧胸锁乳突肌的RMS值为8.7±4.4,低于健侧的16.3 ±6.4(t=11.118,P＜0.01).颈部旋转和侧屈时,CMT组患侧胸锁乳突肌的RMS值低于健侧(P＜0.05);CMT组双侧胸锁乳突肌RMS值均明显增加,但患侧增加的RMS值明显低于健侧(t=6.239,P＜0.01).仰卧中立位时,对照组左侧胸锁乳突肌的RMS值为13.1 ±7.1,右侧为12.7±6.8,双侧差异无统计学意义(P＞0.05);颈部旋转和侧屈时,对照组双侧胸锁乳突肌RMS值差异无统计学意义(P＞0.05);双侧胸锁乳突肌RMS值也均增加,但两侧增加的RMS值差异无统计学意义(P＞0.05).结论 表面肌电信号检测显示CMT患侧肌肉运动单位激活、募集和参与活动的数量较少,肌肉兴奋性差.左CMT和右CMT患儿的胸锁乳突肌表面肌电信号特征表现一致.     

肌电图辅助激痛点定位神经阻滞治疗肥胖病人肩颈痛探讨

目的探索了一种新的肌电图激痛点定位神经阻滞疗法以提高镇痛疗效,避免并发症。方法将肌电图记录电极用导线与一次性注射器的针头相连,通过肌电图上的单位动作电位确定注射针头准确进入肌筋膜的激痛点后,进行神经阻滞注射。结果通过肌电图上的单位动作电位变化能帮助判断穿刺深度、判断肌筋膜的准确激痛点并避免穿刺针进入脂肪组织和血管组织、防止气胸等并发生,并可显著提高镇痛效果。结论肌电图辅助激痛点定位神经阻滞技术可操作性强,效果可靠,值得推广。     

肢体动作时表面肌电信号的复杂度特征分析

目的：利用C0复杂度分析手指动作时前臂肌肉表面肌电信号的特征。方法：记录指浅屈肌（FDS）、指伸肌（ED）的肌电信号及食指或中指在4N、6N和8N力量水平下相对应的电压。截取第3通道得到的食指或中指力量平稳段并找到对应的肌电信号段,采用改进的C0复杂度算法,对FDS和ED上记录的肌电信号均截取力量稳定时的2000个点计算其C0复杂度。结果：对于4N、6N及8N3个力量等级,食指动作时FDS、ED两块肌肉的C0平均值均大于中指的C0平均值。结论：食指、中指产生相同的力量时,其相应的表面肌电信号C0复杂度存在差异,表明C0复杂度可用于描述手指活动时前臂肌肉的活动状态。