Correlation between Elbow Flexor Muscle Strength and Needle Electromyography Parameters after Musculocutaneous Nerve Injury

doi:10.12116/j.issn.1004-5619.2022.221104

Abstract

Abstract:

Objective To explore the changes of elbow flexor muscle strength after musculocutaneous nerve injury and its correlation with needle electromyography （nEMG） parameters. Methods Thirty cases of elbow flexor weakness caused by unilateral brachial plexus injury （involving musculocutaneous nerve） were collected. The elbow flexor muscle strength was evaluated by manual muscle test （MMT） based on Lovett Scale. All subjects were divided into Group A （grade 1 and grade 2, 16 cases） and Group B （grade 3 and grade 4, 14 cases） according to their elbow flexor muscle strength of injured side. The biceps brachii of the injured side and the healthy side were examined by nEMG. The latency and amplitude of the compound muscle action potential （CMAP） were recorded. The type of recruitment response, the mean number of turns and the mean amplitude of recruitment potential were recorded when the subjects performed maximal voluntary contraction. The quantitative elbow flexor muscle strength was measured by portable microFET 2 Manual Muscle Tester. The percentage of residual elbow flexor muscle strength （the ratio of quantitative muscle strength of the injured side to the healthy side） was calculated. The differences of nEMG parameters, quantitative muscle strength and residual elbow flexor muscle strength between the two groups and between the injured side and the healthy side were compared. The correlation between elbow flexor manual muscle strength classification, quantitative muscle strength and nEMG parameters was analyzed. Results After musculocutaneous nerve injury, the percentage of residual elbow flexor muscle strength in Group B was 23.43% and that in Group A was 4.13%. Elbow flexor manual muscle strength classification was significantly correlated with the type of recruitment response, and the correlation coefficient was 0.886 （P<0.05）. The quantitative elbow flexor muscle strength was correlated with the latency and amplitude of CMAP, the mean number of turns and the mean amplitude of recruitment potential, and the correlation coefficients were -0.528, 0.588, 0.465 and 0.426 （P<0.05）, respectively. Conclusion The percentage of residual elbow flexor muscle strength can be used as the basis of muscle strength classification, and the comprehensive application of nEMG parameters can be used to infer quantitative elbow flexor muscle strength.

Key words: forensic medicine, muscle strength, needle electromyography, maximal voluntary contraction, recruitment potential, compound muscle action potential, musculocutaneous nerve injury, biceps brachii

CLC Number:

DF795.1

Dong GAO, Pei-pei ZHUO, Dong TIAN, Dan RAN, Qing XIA, Wen-tao XIA. Correlation between Elbow Flexor Muscle Strength and Needle Electromyography Parameters after Musculocutaneous Nerve Injury[J]. Journal of Forensic Medicine, 2023, 39(2): 137-143.

Figures/Tables 4

References 19

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组别	CMAP潜伏期/ms		CMAP波幅/μV
组别	健侧	伤侧	健侧	伤侧
A组（n=16）	4.59±0.21	9.49±2.28^1）	13.53±4.13	1.66±1.97^1）
B组（n=14）	4.42±0.27	6.54±2.15^1）2）	14.94±4.22	4.76±2.76^1）2）

组别	CMAP潜伏期/ms		CMAP波幅/μV
组别	健侧	伤侧	健侧	伤侧
A组（n=16）	4.59±0.21	9.49±2.28^1）	13.53±4.13	1.66±1.97^1）
B组（n=14）	4.42±0.27	6.54±2.15^1）2）	14.94±4.22	4.76±2.76^1）2）

募集反应类型	A组（N=16）	B组（N=14）
单纯混合相	0	4（28.6）
单纯相	4（25.0）	10（71.4）
少量MUP	10（62.5）	0
偶见MUP	2（12.5）	0

募集反应类型	A组（N=16）	B组（N=14）
单纯混合相	0	4（28.6）
单纯相	4（25.0）	10（71.4）
少量MUP	10（62.5）	0
偶见MUP	2（12.5）	0

组别	定量肌力/kgf		平均转折数/（T·s^-1）		平均波幅/μV
组别	健侧	伤侧	健侧	伤侧	健侧	伤侧
A组（n=16）	18.15±5.16	0.66±0.40^1）	563.63±202.03	141.20±124.46^1）	1294.75±485.80	353.00±288.73^1）
B组（n=14）	17.88±4.43	3.81±1.97^1）	517.64±126.26	344.29±130.25^1）	1054.14±384.64	654.14±267.443^1）