Pattern of maximum voluntary contraction in patients with temporomandibular disorder before and after speech therapy with and without use of elastic bandages / Padrão de contração voluntária máxima em pacientes com disfunção temporomandibular antes e após terapia fonoaudiológica com e sem uso de bandagem elástica

ABSTRACT Purpose: to verify if there is an electromyographic difference during maximal (maximum) voluntary contraction of the masseter and temporalis muscles in patients with temporomandibular disorders, before and after speech therapy intervention with and without the use of therapeutic elastic bandages. Methods: an analysis of secondary data from a clinical intervention study, carried out with 17 adult volunteers, diagnosed with temporomandibular muscle dysfunction with or without disc displacement with reduction. The Bandage Group received manual therapy associated with elastic bandages and the No Bandage Group received only manual therapy. Surface electromyography was performed to record the Maximum Voluntary Contraction before and after four weeks of speech therapy intervention. For exploratory analysis, the Mann Whitney and Wilcoxon paired tests were used, with P<0.05. Results: in the Bandage Group, there was a statistically significant decrease in electrical activity during Maximum Voluntary Contraction in the masseter and temporalis muscles on the left side at the post-therapeutic moment. Comparing the pre- and post-intervention between Bandage Group and No Bandage Group, a statistical difference was found in the electrical activity values of the Maximum Voluntary Contraction in the left temporal muscle. Conclusion: manual myofunctional speech therapy, associated or not with the use of therapeutic elastic bandages, impacts the muscle activity of the masseter and temporal muscles during Maximum Voluntary Contraction, whether the values demonstrate relaxation and/or equivalence of the electromyographic values of the masticatory muscles.

RESUMO Objetivo: verificar se há diferença eletromiográfica durante contração voluntária máxima dos músculos masseter e temporal de pacientes com disfunção temporomandibular, antes e após intervenção fonoaudiológica com e sem uso de bandagem elástica terapêutica. Métodos: foi realizada a análise de dados secundários de estudo do tipo intervenção clínica, com 17 voluntárias, adultas, com diagnóstico de disfunção temporomandibular muscular com ou sem deslocamento de disco com redução. O Grupo Bandagem recebeu terapia manual associada à bandagem elástica e o Grupo Sem Bandagem recebeu apenas terapia manual. Foi realizada eletromiografia de superfície para registro da contração voluntária máxima antes e após quatro semanas de intervenção fonoaudiológica. Para análise exploratória foram utilizados os testes: Mann Whitney e Wilcoxon Pareado, com p<0,05. Resultados: no Grupo Bandagem, houve diminuição estatisticamente significante da atividade elétrica durante a Contração Voluntária Máxima nos músculos masseter e temporal do lado esquerdo no momento pós-terapêutico. Na comparação do pré e pós-intervenção entre Grupo Bandagem e Grupo Sem Bandagem, constatou-se diferença estatística nos valores da atividade elétrica de Contração Voluntária Máxima no músculo temporal esquerdo. Conclusão: a terapia fonoaudiológica miofuncional manual, associada ou não ao uso da bandagem elástica terapêutica, impacta a atividade muscular dos músculos masseter e temporal durante a Contração Voluntária Máxima, sejam os valores demonstrando relaxamento e/ou equivalência dos valores eletromiográficos da musculatura mastigatória.

Perfil clínica y electromiográfico de las distrofias musculares en República Dominicana / Clinical and electromyographic profile of muscular dystrophies in the Dominican Republic

Introducción: Las distrofias musculares son trastornos miogénicos hereditarios caracterizados por una atrofia muscular progresiva y una debilidad de distribución y gravedad variable. La población de Republica Dominicana es fruto de una mezcla de etnias, haciéndola portadora de una herencia cromosómica y ADN diverso, siendo susceptibles a poder presentar cualquier desorden de carácter hereditario. Material y métodos: Con una muestra de 17 pacientes obtenidos entre septiembre 2019- marzo 2020, se realizó un estudio retrospectivo, descriptivo y transversal, en el cual se hizo una revisión de los expedientes de la clínica de miopatías en la consulta de neurología pediátrica del Hospital Infantil Doctor Robert Reid Cabral, para describir el perfil clínico de los pacientes con distrofia muscular y los hallazgos de electromiografía en los casos que la misma. Resultados: se encontró que la distribución de la edad correspondió a 5-9 años en un 53%, siendo el sexo masculino, el más frecuente. En el 70.59% presentaron antecedentes familiares de distrofia muscular. Los principales motivos de consulta fueron cansancio y caídas frecuentes. Conclusión: En los hallazgos de electromiografía, el porcentaje de pacientes que presentó esta prueba con alteraciones fue de 88.24% y sin alteraciones el 11.76%. Esto nos demuestra, la gran utilidad de dicho estudio en el diagnóstico de las distrofias musculares en países donde no se cuenta con estudio molecular, siendo una de las pruebas esenciales en el abordaje diagnóstico de los pacientes con sospecha clínica de dichas patologías.

Introduction: Muscular dystrophies are hereditary myogenic disorders characterized by progressive muscular atrophy and weakness of variable distribution and severity. The population of the Dominican Republic is the result of a mixture of ethnic groups, making it the bearer of a diverse chromosomal inheritance and DNA, being susceptible to presenting any hereditary disorder. Methods: With a sample of 17 patients obtained between September 2019-March 2020, a retrospective, descriptive and cross-sectional study, in which a review of the files of the myopathies clinic was made in the pediatric neurology consultation of the Children's Hospital Doctor Robert Reid Cabral, to describe the clinical profile of patients with muscular dystrophy and the electromyography findings in the cases with the same. Results: The age distribution corresponded to 5-9 years; 53%, being the masculines, the most frequent sex. In 70.59%, there was a family history of muscular dystrophy. The main reasons for consultation were fatigue and frequent falls. Conclusion: In the electromyography findings, the percentage of patients who presented this test with alterations was 88.24% and 11.76% without alterations. This result shows us the great utility of said study in the workup of muscular dystrophies in countries with no availabilities for molecular studies, being one of the essential tests in the diagnostic approach of patients with clinical suspicion of said pathologies.

The squat exercise recruits core muscles as much as localized exercises / O exercício de agachamento recruta músculos do tronco tanto quanto exercícios localizados

Abstract Introduction In the context of resistance training, which encompasses both strengthening and rehabilitation, the incorporation of global range exercises demands intense activation of the trunk muscle groups, which play a primary role in body stabilization. The squat, notorious for its complexity and effectiveness in activating stabilizers during execution, raises a central question: whether this exercise recruits the muscles more significantly compared to localized exercises, such as push-ups and trunk exten-sions. Objective To identify the degree of activation of the trunk muscles during squats and compare it with localized exercises for the trunk muscles: lumbar and abdominal. Methods Using surface electromyography, the activation of the iliocostalis, multifidus, internal oblique, external oblique and rectus abdominis muscles was evaluated. The sample included 16 physically active volunteers of both sexes. A repeated measures t-test (α < 0.05) was used as an analysis method. Results The iliocostalis, multifidus and internal oblique muscles showed similar levels of activation both in the squat and in their respective isolated exercises, while the rectus abdominis and external oblique muscles showed greater activity during trunk flexion. Conclusion It is possible to infer that squats are an effective exercise for training the iliocostalis, multifidus and internal oblique muscles, while localized exercises are more suitable for strengthening the external oblique and rectus abdominis muscles. Such conclusion can contribute to optimizing the planning of exercise sessions by replacing isolated trunk exercises with squats.

Resumo Introdução No contexto do treinamento resistido, que engloba tanto o fortalecimento quanto a reabilitação, a incorporação de exercícios de alcance global demanda uma intensa ativação dos grupos musculares do tronco, os quais desempenham um papel primordial na estabilização corporal. O agachamento, notório por sua complexidade e eficácia na ativação dos estabilizadores durante a execução, suscita uma questão central: se o agachamento recruta de forma mais acentuada a musculatura do tronco comparativamente a exercícios localizados, tais como flexões e extensões do tronco. Objetivo Identificar o grau de ativação dos músculos do tronco durante o agachamento e confrontá-lo com exercícios localizados para a musculatura do tronco: lombar e abdominal. Métodos Através da aplicação da eletromiografia de superfície, avaliou-se a ativação dos músculos iliocostal, multífido, oblíquo interno, oblíquo externo e reto abdominal. A amostra englobou 16 voluntários de ambos os gêneros, fisicamente ativos. Empregou-se um teste t de medidas repetidas (α < 0,05) como método de análise. Resultados Os músculos iliocostal, multífido e oblíquo interno manifestaram níveis semelhantes de ativação tanto no agachamento quanto em seus respectivos exercícios isolados, enquanto os músculos reto abdominal e oblíquo externo apresentaram maior atividade durante a flexão do tronco. Conclusão É possível inferir que o agachamento se configura como um exercício eficaz para o treinamento do iliocostal, multífido e oblíquo interno, enquanto os exercícios localizados se revelam mais indicados para o fortalecimento do oblíquo externo e dos músculos reto abdominais. Tais conclusões podem contribuir para a otimização do planejamento de sessões de exercícios, mediante a substituição de exercícios isolados de tronco pelo agachamento.

Uso de Electromiografía de Alta Densidad en las Distrofias Musculares: una Mirada Actual / Use of high-density electromyography in muscular dystrophies: a current look

Introducción. Las distrofias musculares son trastornos genéticamente heredados que causan la degeneración progresiva de las fibras musculares. La electromiografía, especialmente la de alta densidad, se ha convertido en una herramienta valiosa para el diagnóstico y el estudio de la función muscular de trastornos neuromusculares. Objetivo. Describir y discutir el uso actual de esta técnica en las distrofias musculares. Métodos. Se realizó un Scoping Review sobre el uso de electromiografía de alta densidad en personas con distrofia muscular. Se buscó en PubMed, ScienceDirect, Scopus, Web of Science y Biblioteca Cochrane Plus, usando palabras clave en inglés y español. Se consideraron estudios desde 2015 a la fecha. Se identificaron tres artículos que cumplían con los criterios establecidos. Resultados. Los estudios se centraron en aplicaciones clínicas y de bioingeniería para personas con distrofia muscular de Duchenne y distrofia facioescapulohumeral. Los resultados sugieren que variables como la fatiga, la activación temporo-espacial y la dimensionalidad en gestos motores están determinados por la degeneración de las fibras musculares, el reemplazo por tejido fibrótico, los cambios adaptativos y la debilidad muscular progresiva característica de este grupo de condiciones. Se resalta la utilidad de la electromiografía de alta densidad en la evaluación y el manejo de la distrofia muscular. Conclusiones. El uso de esta técnica en estos trastornos neuromusculares sigue en aumento, pero se hace necesario explorar más aristas para ampliar su uso como herramienta en el estudio y en el desarrollo de intervenciones terapéuticas en esta condición por parte de profesionales de la salud.

Background. Muscular dystrophies are genetically inherited disorders that cause progressive degeneration of muscle fibers. Electromyography, especially high-density electromyography, has become a valuable tool for the diagnosis and study of muscle function in neuromuscular disorders, so the objective of this study is to describe and discuss the current use of this technique in muscular dystrophies. Methods. A Scoping Review was carried out on the use of high density electromyography in people with muscular dystrophy. PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane Plus Library were searched using keywords in English and Spanish. Studies from 2015 to date were considered. Three articles were identified that met the established criteria. Results. The studies focused on clinical and bioengineering applications for people with Duchenne muscular dystrophy and facioscapulohumeral dystrophy. The results suggest that variables such as fatigue, temporal-spatial activation and dimensionality in motor gestures are determined by the degeneration of muscle fibers, replacement by fibrotic tissue, adaptive changes and progressive muscle weakness characteristic of this group of conditions. The usefulness of high-density electromyography in the evaluation and management of muscular dystrophy is highlighted. Conclusions. The use of this technique in these neuromuscular disorders continues to increase, but it is necessary to explore more aspects to expand its use as a tool in the management of this condition.

Electrophysiological evaluation of the neuromuscular junction: a brief review / Avaliação eletrofisiológica da junção neuromuscular: breve revisão

Abstract The nerve terminal and muscle membrane compose the neuromuscular junction. After opening the voltage-gated calcium channels, action potentials from the motor axons provoke a cascade for the acetylcholine release from synaptic vesicles to the synaptic cleft, where it binds to its receptor at the muscle membrane for depolarization. Low amplitude compound muscle action potential typically presents in presynaptic disorders, increasing by more than 100% after a 10-second effort in the Lambert-Eaton myasthenic syndrome and less in botulism. Needle electromyography may show myopathic motor unit action potentials and morphological instability ("jiggle") due to impulse blocking. Low-frequency repetitive nerve stimulation (RNS) is helpful in postsynaptic disorders, such as myasthenia gravis and most congenital myasthenic syndromes, where the number of functioning acetylcholine receptors is reduced. Low-frequency RNS with a decrement >10% is abnormal when comparing the 4th to the first compound muscle action potential amplitude. High-frequency RNS is helpful in presynaptic disorders like Lambert-Eaton myasthenic syndrome, botulism, and some rare congenital myasthenic syndromes. The high-frequency RNS releases more calcium, increasing the acetylcholine with a compound muscle action potential increment. Concentric needle records apparent single-fiber action potentials (spikes). A voluntary activation measures the jitter between spikes from two endplates. An electrical activation measures the jitter of one spike (one endplate). The jitter is the most sensitive test for detecting a neuromuscular junction dysfunction. Most neuromuscular junction disorders are responsive to treatment.

Resumo O nervo terminal e a membrana muscular compõem a junção neuromuscular. Após a abertura dos canais de cálcio dependentes de voltagem, os potenciais de ação do axônio motor provocam uma cascata de eventos que libera acetilcolina das vesículas para a fenda sináptica, ligando-se ao receptor na membrana muscular para despolarização. O potencial de ação muscular composto de baixa amplitude ocorre nas desordens pré-sinápticas, aumentando em mais de 100% após esforço de 10 segundos na síndrome miastênica de Lambert-Eaton e menos no botulismo. A eletromiografia pode mostrar potenciais de ação da unidade motora miopáticos e instabilidade morfológica ("jiggle") devido ao bloqueio do impulso. Estimulação nervosa repetitiva (ENR) de baixa frequência é útil nos distúrbios pós-sinápticos, como miastenia gravis e a maioria das síndromes miastênicas congênitas, quando há número reduzido de receptores de acetilcolina funcionantes. ENR de baixa frequência com decremento >10% é anormal comparando-se à amplitude do quarto com o primeiro potencial de ação muscular composto. ENR de alta frequência é útil nas doenças pré-sinápticas, como síndrome miastênica de Lambert-Eaton, botulismo e algumas síndromes miastênicas congênitas raras. ENR de alta frequência libera mais cálcio, aumenta acetilcolina, resultando em incremento do potencial de ação muscular composto. O eletrodo de agulha concêntrico registra potenciais de ação aparente de fibra única (PAAFU). Ativação voluntária mede jitter entre dois PAAFUs (duas junções neuromusculares). Ativação elétrica mede jitter de um PAAFU (uma junção neuromuscular). Jitter é o teste mais sensível para detectar disfunção de junção neuromuscular. A maioria dos distúrbios juncionais é responsiva ao tratamento.

A web-based survey to map the electromyography practice in Brazil / Uma enquete via internet para mapear a prática de eletromiografia no Brasil

Abstract Background Detailed information about the electromyography practice in Brazil is largely unavailable. Objective To evaluate where and how electromyography is performed in Brazil, as well as regional disparities and the professional and academic credentials of electromyographers. Methods We conducted an internet-based survey of active Brazilian electromyographers. The websites of health insurance companies, professional academies, medical cooperatives, online search engines, and social networks in each Brazilian state were screened and we evaluated the credentials of each electromyographer listed in the Brazilian Federal Medical Board (BFMB) registration website and their online curricula vitae in the Brazilian National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq, in Portuguese). We also evaluated the same parameters in a control group of non-electromyographer neurologists randomly matched by geographical distribution and gender. Results We found 469 electromyographers (384 neurologists and 85 non-neurologists), with a male predominance. In total, 81.9% were BFMB-certified neurologists, 49.9%, BFMB-certified clinical neurophysiologists, and 10.4%, BFMB-certified physiatrists. Among the non-neurologists, 48.2% were physiatrists. Most electromyographers practiced in states on the Southern and Southeastern regions of Brazil. When adjusted by population, the Federal District and the states of Mato Grosso do Sul and Goiás presented the highest of eletromyographers density. Electromyographers were not more likely to have current/past academic affiliations. Conclusion In Brazil, electromyography is performed predominantly by neurologists, and half of them are BFMB-certified clinical neurophysiologists. The present study highlights regional disparities and may guide government-based initiatives, for instance, to improve the diagnosis of leprosy and the management of neuromuscular disorders within the Brazilian territory.

Resumo Antecedentes Informações detalhadas sobre a prática de eletromiografia no Brasil são em grande parte indisponíveis. Objetivo Avaliar onde e como a eletromiografia é realizada no Brasil, as disparidades regionais, e as credenciais profissionais e acadêmicas dos eletromiografistas. Métodos Realizamos uma enquete via internet de eletromiografistas brasileiros ativos. Foram rastreados sites de operadoras de planos de saúde, academias profissionais médicas, cooperativas médicas, ferramentas de busca online e redes sociais em cada estado brasileiro. Em seguida, avaliamos as credenciais de cada eletromiografista listado no site de registro do Conselho Federal de Medicina (CFM) e seus curricula vitae online no Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Também avaliamos os mesmos parâmetros em um grupo controle de neurologistas não eletromiografistas pareados aleatoriamente por distribuição geográfica e gênero. Resultados Encontramos 469 eletromiografistas (384 neurologistas e 85 não neurologistas), com predominância do sexo masculino. Ao todo, 81,9% eram neurologistas com certificação confirmada pelo site do CFM, 49,9%, neurofisiologistas clínicos com certificação confirmada pelo site do CFM, e 10,4%, fisiatras com certificação confirmada pelo mesmo site. Entre os não neurologistas, 48,2% eram fisiatras. A maioria dos eletromiografistas atuava nos estados do Sul e do Sudeste. Quando ajustados pela população, o Distrito Federal e os estados de Mato Grosso do Sul e Goiás apresentaram a maior densidade de eletromiografistas. Os eletromiografistas não eram mais propensos a ter vínculos acadêmicos atuais/passados. Conclusão No Brasil, a eletromiografia é realizada predominantemente por neurologistas, e metade deles são neurofisiologistas clínicos com certificação confirmada pelo site do CFM. Este estudo destacou as disparidades regionais, e pode orientar ações governamentais para, por exemplo, melhorar o diagnóstico da hanseníase e o manejo das doenças neuromusculares no território brasileiro.

Repouso eletromiográfico dos músculos mastigatórios de pacientes com disfunção temporomandibular antes e após intervenção fonoaudiológica com e sem bandagem elástica / Electromyographic rest of the masticatory muscles of patients with temporomandibular disorders before and after speech therapy with and without elastic bandage / Resto electromiográfico de los músculos masticatorios de pacientes con trastornos temporomandibulares antes y después de logopedia con y sin venda elástica

Objetivo: A pesquisa tem por objetivo verificar os limiares de repouso eletromiográfico dos músculos masseter e temporal em pacientes com disfunção temporomandibular (DTM) antes e após intervenção fonoaudiológica com e sem a utilização de bandagem elástica terapêutica. Métodos: A coleta contou com 14 participantes do sexo feminino, com idade entre 18 e 40 anos, com diagnóstico de DTM muscular ou mista. As pacientes foram divididas entre dois grupos classificados em: pacientes com bandagem associada à terapia tradicional (CB) e grupo de terapia tradicional (SB). As pacientes inicialmente foram avaliadas pelo exame de eletromiografia de superfície nas situações de contração voluntária máxima e repouso, e após quatro semanas de intervenção, foi realizada nova avaliação com os mesmos instrumentos. A análise dos dados ocorreu de forma quantitativa e qualitativa. Resultados:No grupo SB o músculo masseter direito apresentou aumento dos valores de repouso com significância, foi observado que o mesmo ocorreu para todos os músculos deste grupo, influenciando no equilíbrio da musculatura ipsilateral e contralateral, no entanto sem evidência estatística. O grupo CB não demonstrou valores estatísticos significativos, porém qualitativamente os valores de repouso muscular diminuíram e equilibraram-se de forma contralateral. Conclusão: Não foram observadas mudanças estatisticamente significantes nos limiares eletromiográficos durante repouso dos músculos masseter e temporal em ambos os grupos. Qualitativamente houve aumento dos valores eletromiográficos após terapia manual tradicional em todos os músculos do grupo SB. Com relação ao grupo CB, houve diminuição dos valores do repouso eletromiográfico após terapia, embora sem evidências estatísticas. (AU)

Purpose: Objective: The research aims to verify the electromyographic rest thresholds of the masseter and temporal muscles in patients with temporomandibular disorders (TMD) before and after speech therapy intervention with and without the use of therapeutic elastic bandage. Methods: The collection included 14 female participants, aged between 18 and 40 years, who had a diagnosis of muscular or mixed TMD. The patients were divided into two groups: with traditional therapy (CB) bandage and traditional therapy (SB) only group. The patients underwent initial evaluation, as well as surface electromyography in situations of maximum voluntary contraction and rest and at the end of the four weeks of intervention, a new evaluation was performed with the same instruments. Data analysis occurred quantitatively and qualitatively. Results: In the SB group, the right masseter muscle showed a significant increase in resting values. It was observed that the same occurred for all muscles in this group, influencing the balance of the ipsilateral and contralateral muscles, although without statistical evidence. The CB group did not show statistically significant values, but qualitatively the muscle rest values decreased and balanced in a contralateral way. Conclusion: No statistically significant changes were observed in the resting electromyographic thresholds of the masseter and temporalis muscles in both groups. Qualitatively, there was an increase in electromyographic values after traditional manual therapy in all muscles in the SB group. Regarding the CB group, there was a decrease in electromyographic resting values after therapy, although without statistical evidence. (AU)

Objetivo: La investigación tiene como objetivo verificar los umbrales electromiográficos de reposo de los músculos masetero y temporal en pacientes con trastornos temporomandibulares (TMD) antes y después de la terapia del habla con y sin el uso de venda elástica terapéutica. Métodos: La colección incluyó a 14 participantes mujeres, con edades entre 18 y 40 años, diagnosticadas con TTM muscular o mixta. Los pacientes fueron divididos en dos grupos clasificados en: pacientes con vendaje asociado a terapia tradicional (CB) y grupo de terapia tradicional (SB). Los pacientes fueron inicialmente evaluados mediante electromiografía de superficie en situaciones de máxima contracción voluntaria y reposo, luego de cuatro semanas de intervención se realizó una nueva evaluación con los mismos instrumentos. El análisis de datos se llevó a cabo cuantitativa y cualitativamente. Resultados: En el grupo SB, el músculo masetero derecho presentó un aumento significativo en los valores de reposo, se observó que lo mismo ocurrió para todos los músculos de este grupo, influyendo en el equilibrio de los músculos ipsilaterales y contralaterales, sin embargo, sin evidencia estadística. El grupo CB no mostró valores estadísticamente significativos, pero cualitativamente los valores de descanso muscular disminuyeron y se equilibraron contralateralmente. Conclusión: No se observaron cambios estadísticamente significativos en los umbrales electromiográficos en reposo de los músculos masetero y temporal en ambos grupos. Cualitativamente, hubo un aumento de los valores electromiográficos después de la terapia manual tradicional en todos los músculos del grupo SB. En cuanto al grupo CB, hubo una disminución de los valores electromiográficos de reposo después de la terapia, aunque sin evidencia estadística. (AU)

Assessment of diaphragmatic function through surface electromyography in healthy individuais. A cross-section observational study

Introduction: Diaphragmatic surface electromyography is a procedure designed to assess the diaphragm. The physiological values of the electrical activity may have potential use in rehabilitation, sports training, ventilatory support withdrawal in critical care units and follow-up of respiratory disease. Objective: To assess and describe the diaphragmatic function through surface electromyography in a population of individuals during spontaneous and forced breathing. Methods: Observational, exploratory cross-sectional study including subjects with no comorbidities. Diaphragmatic surface EMG was performed measuring the mean quadratic root during tidal volume and vital capacity breathing. The body composition of the participants was also assessed. Results: 28 males and 22 females were included in the study. The mean quadratic root of the tidal volume for two minutes was 13.94 nV for females and 13.31 nV for males. The vital capacity was 23.24 nV for males and 22.4 nV for females. A correlation was identified between the mean quadratic root, weight, and body surface. Conclusions: Mean quadratic root values of tidal volume in two minutes in healthy females and males have been documented. The mean quadratic root values are correlated with the physiological and functional characteristics of the participants.

Introducción: La electromiografía de superficie diafragmática es un procedimiento para la evaluación diafragmática. Los valores fisiológicos de la actividad eléctrica tendrían aplicaciones potenciales en rehabilitación, entrenamiento deportivo, en el retiro ventilatorio en unidades de cuidado crítico y en el seguimiento a patologías respiratorias. Objetivo: Evaluar y describir la función diafragmática a través de electromiografía de superficie diafragmática en una población de sujetos durante la respiración espontánea y la respiración forzada. Métodos: Estudio observacional exploratorio de corte transversal en el que se incluyeron sujetos sin comorbilidades. Se realizó electromiografía de superficie diafragmática midiendo la raíz cuadrática media durante respiraciones de volumen corriente y capacidad vital. Adicionalmente, se valoró la composición corporal de los participantes. Resultados: Se incluyeron 28 hombres y 22 mujeres. La raíz cuadrática media de volumen corriente por dos minutos fue de 13,94 µV para mujeres y 13,31 µV para hombres, mientras que la capacidad vital fue 23,24 µV para hombres y 22,4 µV para mujeres. Se encontró una correlación entre la raíz cuadrática media, el peso y la superficie corporal. Conclusiones: Se han documentado los valores de la raíz cuadrática media de volumen corriente por dos minutos en mujeres y hombres sanos. Los valores de la raíz cuadrática media se correlacionan con características fisiológicas y funcionales de los participantes.

Assessment of electromyography in evaluating masseter muscle activity in oral submucous fibrosis with different treatment modalities: a systematic review

Electromyography (EMG) is used for the measurement of muscle activity to characterize the nature of muscle contraction in Oral submucous fibrosis (OSMF). Aim: To assess the efficacy of EMG in evaluating masseter muscle activity in the management of OSMF. This review identified 73 records from standard databases which were rigorously screened with eligibility criteria and 3 clinical studies were identified based on our inclusion criteria. The quality of included studies was assessed by the PEDro scale and data was synthesized with detailed characterization. The Risk of Bias assessment among studies was done using the ROBINS-I tool and a meta-analysis could not be done due to high clinical heterogeneity. Our result recommends that EMG be used as an objective prognosis assessment tool by quantifying the management of OSMF irrespective of the intervention applied. However, it is not to be considered the gold standard as of now with limited data pooled and needs to be further assessed with clinical trials. EMG can be advocated as a reliable adjunct assessment for measuring the interventional outcome of OSMF irrespective of treatment modalities.

La electromiografía se ha utilizado para medir la actividad muscular y caracterizar la naturaleza de la contracción muscular. Nuestra revisión sistemática tuvo como objetivo evaluar la eficacia de EMG en la evaluación de la actividad del músculo masetero en el manejo de OSMF. Esta revisión identificó 73 registros de bases de datos estándar que se revisaron rigurosamente con criterios de elegibilidad y se identificaron 3 estudios clínicos según nuestros criterios de inclusión. La calidad de los estudios incluidos se evaluó mediante la implementación de la escala PEDro y los datos se sintetizaron con una caracterización detallada. La evaluación del riesgo de sesgo entre los estudios se realizó mediante la herramienta ROBINS-I y no se pudo realizar un metanálisis debido a la alta heterogeneidad clínica. Nuestro resultado recomienda que la EMG podría utilizarse como una herramienta objetiva de evaluación del pronóstico mediante la cuantificación en el manejo de OSMF independientemente de la intervención aplicada. Sin embargo, no debe considerarse el estándar de oro a partir de ahora con datos agrupados limitados, y debe volver a evaluarse en el futuro después de la disponibilidad de ensayos clínicos extensos. A partir de ahora, la EMG se puede recomendar como un equipo de evaluación complementario confiable para medir el resultado de la intervención de la fibrosis submucosa oral, independientemente de las modalidades de tratamiento.

Confiabilidade teste-reteste de um protocolo de coleta do sinal eletromiográfico do músculo masseter em indivíduos com disfunção temporomandibular / Test-retest reliability of a protocol for recording the electromyographic signal from the masseter muscle on patients with temporomandibular disorders

Introdução: A eletromiografia (EMG) tem sido utilizada para avaliar alterações no sistema mastigatório proporcionada pela disfunção temporomandibular (DTM). Objetivos: Verificar a confiabilidade teste-reteste de um protocolo de coleta do sinal EMG do músculo masseter em indivíduos com DTM. Métodos: Estudo transversal composto por 20 indivíduos com DTM. Os testes foram realizados em duas sessões com 7 dias de intervalo. O sinal EMG foi avaliado pelas variáveis integral (iEMG) e a raiz quadrada da média do sinal (RMS). Resultados: Na análise intradia a confiabilidade para o RMS (ICC2,k: 0.85 a 0.96 ) e iEMG ICC2,k: 0.85 a 0.95) foi excelente, enquanto que a confiabilidade teste/reteste foi pobre para ambas as variáveis RMS (ICC2,1: 0.03 a 0.29) e iEMG (ICC2,1: 0.08 a 0.39). Conclusões: O protocolo de coleta do sinal EMG do músculo masseter em indivíduos com DTM demonstrou que os dados são reprodutíveis somente na mesma sessão de coletas enquanto que, para coletas em dias alternados a confiabilidade foi pobre.

Introduction: Electromyography (EMG) has been used to assess alterations in the masticatory system caused by temporomandybular disorders (TMD). Objectives: The aim of this study was to verify the test-retest reliability of a protocol for recording the EMG signal from masseter muscle in TMD patients. Methods: This is a cross-sectional study comprising 20 individuals with TMD. Tests were performed in two sessions 7 days apart. The EMG signal was evaluated by the variables integral (iEMG) and the root mean square of the signal (RMS). Results: In the intraday analysis the reliability for the RMS (ICC2,k: 0.85 to 0.96) and iEMG (ICC2,k: 0.85 to 0.95) was excellent, while the test/retest reliability was poor for both RMS (ICC2,1: 0.03 to 0.29) and iEMG (ICC2,1: 0.08 to 0.39) variables. Conclusions: The protocol for collecting the EMG signal from the masseter muscle in an individual with TMD demonstrated that the data are reproducible only in the same recording session, whereas for c recording on alternate days, the reliability was poor.

The potential applicability of facial nerve monitoring as a navigation tool in parotid gland surgery

Abstract Objectives: The aim of this study was to assess the relationship between the stimulation amplitude and the distance to the facial nerve. Methods: This study was designed as a prospective clinical study. A total of 20 patients (12 males, 8 females) were included. Partial superficial parotidectomy was performed in all patients with intraoperative facial monitoring. Measurements were made on the main trunk and major branches. Stimulation was started at 1 mA and incrementally increased to 2 and 3mA's. The shortest distance creating a robust response (>100mV) was recorded. Results: At 1 mA, 2 mA and 3 mA stimulation intensity, the average distance between the tip of the stimulation probe and the main trunk was 2.20±0.76 mm (range 1-3 mm), 3.80±0.95 mm (range 2-5 mm), 4.80±1.05 mm (range 3-7 mm) respectively. The stimulus intensity was inversely proportional in respect to the distance between the nerve and the tip of the stimulus probe (P < .00). The same relation was present in the facial nerve major branch measurements (P < .00). Conclusion: The proportional stimulation amplitude and distance to the facial nerve is thought to be a reliable auxillary method to assist the surgeon by facilitating the estimation of the distance to the facial nerve during extracapsular dissection and minimally invasive cases where the facial nerve isn't routinely dissected. Level of evidence: Level 3.

Diagnostic Contradictions in Carpal Tunnel Syndrome / Contradições diagnósticas na síndrome do túnel do carpo

Abstract Objective Given the divergence of opinions on the need for complementary tests such as ultrasonography (US) and electroneuromyography (ENMG) for the diagnosis of carpal tunnel syndrome (CTS), we aimed to elucidate which of them presents greater accuracy for the confirmation of the presence or not of this condition. Methods A total of 175 patients from a hand surgery outpatient clinic were clinically evaluated, and the results of clinical trials (Tinel, Phalen and Durkan), US (normal or altered), and ENMG (normal, mild, moderate and severe) were noted, crossed, and submitted to a statistical analysis to verify the agreement between them. Results with the sample had a mean age of 53 years, with a prevalence of female patients (159 cases). Of the patients with positive clinical test, 43.7% had normal US and 41.7% had no alterations on the ENMG. Negative results were found on the Tinel in 46.9%, on the Phalen in 47.4%, and on the Durkan in 39.7%. In the crossing between the results of the ENMG and those of the other diagnostic methods, there was little statistical agreement between them. Conclusion There was no agreement between the results of the clinical examinations, the US and the ENMG in the diagnosis of CTS, and there is no clinical or complementary examination for CTS that accurately determines the therapeutic approach. Level of Evidence IV, Case Series.

Resumo Objetivo Diante da divergência sobre a necessidade de exames complementares, como ultrassonografia (US) e eletroneuromiografia (ENMG) para o diagnóstico da síndrome do túnel do carpo (STC), objetivamos elucidar qual deles apresenta maior precisão na confirmação da presença ou não desta afecção. Métodos Um total de 175 pacientes de um ambulatório de cirurgia da mão foram avaliados clinicamente, e os resultados dos testes clínicos (Tinel, Phalen e Durkan), da US (normal ou alterada) e da ENMG (normal, leve, moderada e grave) foram anotados, cruzados, e submetidos a análise estatística para verificar a concordância entre eles. Resultados A idade média da amostra era de 53 anos, sendo prevalente o sexo feminino (159 casos). Dos pacientes com teste clínico positivo, 43,7% apresentavam US normal, e 41,7%, ENMG sem alterações. Foram encontrados resultados negativos no Tinel em 46,9% no Phalen em 47,4%, e no Durkan em 39,7%. No cruzamento entre a ENMG e os demais métodos diagnósticos, houve pouca concordância estatística. Conclusão Não houve concordância entre os resultados dos exames clínicos, da US e da ENMG no diagnóstico da STC, e não há exame clínico ou complementar para STC que determine a conduta terapêutica com precisão. Nível de Evidência IV, Série de Casos.

Characteristics of Motoneurons Controlling Single Finger Movement in Different Individuals / 医用生物力学

Objective To analyze characteristics of motoneurons controlling the extension of a single finger in different individuals, and obtain the similarity and difference of micro-motoneurons characteristics in different individuals. Methods The motoneurons were decomposed by blind source separation algorithm. The two dimensional (2D) features of the neurons were quantified, and the fingers were classified by the features of the neurons decomposed by different individuals. In addition, the proportion of shared motor neurons was used to study characteristics of motoneurons innervating the coordinated movement of different fingers between individuals. Results There were significant differences in spatial distribution of motoneurons between the index finger and the middle finger for different individuals, but the activation area was similar. Using data from different people as training sets and testing sets, the average accuracy of finger classification was 86. 99% , and it was significantly improved to 90. 07% after using transfer component analysis (TCA) calibration. Through analysis on the proportion of shared neurons in different individuals, it was found that the proportion of shared neurons between index finger and other three fingers (middle finger, ring finger and little finger) was relatively low, while that between ring finger and little finger was high. Conclusions The spatial discharge characteristics of motoneurons controlling different fingers in different individuals are similar and have small individual differences. This study reveals the internal neural mechanism of different individuals during finger movement, and provides references for clinical neural mechanism analysis of patients with finger movement disorders and the related engineering applications

Continuous Motion Estimation of Elbow Joint Based on Multi-Modal Information Fusion / 医用生物力学

Objective Aiming at the problems of lacking initiative in upper limb rehabilitation training equipment, single training mode, and low active participation of patients, an upper limb continuous motion estimation algorithm model based on multi-modal information fusion was proposed, so to realize accurate estimation of elbow joint torque. Methods Firstly, the surface electromyography (sEMG) signal and posture signal of participants were collected at four angular velocities, and the time domain characteristics of the signal were extracted. The principal component analysis was adopted to multi-feature fusion. The back propagation neural network (BPNN) was optimized through the additional momentum and the adaptive learning rate method. The particle swarm optimization (PSO) algorithm was used to optimize the neural network and a continuous motion estimation model based on PSO-BPNN was constructed. Finally, the joint torque calculated by the second type of Lagrangian equation was used as the accurate value to train the model. The performance of the model was compared with the traditional BP neural network model. Results The root mean square error (RMSE) of the traditional BP neural network model was 558.9 N·m, and the R2 coefficient was 77.19%, Whereas the RMSE and the R2 coefficient of the optimized model were 113.6 mN·m and 99.12%, respectively.Thereby, the accuracy of torque estimation was improved apparently. Conclusions The method for continuous motion estimation of the elbow joint proposed in this study can estimate the motion intention accurately, and provide a practical scheme for the active control of upper exoskeleton rehabilitation robot.

Kinematic and Dynamic Study on Traditional Chinese Cervical Manipulation / 医用生物力学

Objective To simultaneously collect and analyze the kinematic and dynamic parameters for two techniques of traditional Chinese cervical manipulation ( TCCM), and quantitatively describe its biomechanical characteristics. Methods A senior practitioner completed the TCCM (positioning and directional rotation pulling, lateral flexion, respectively) on 10 healthy subjects, and the fluorescent marker balls were pasted on the operator to capture manipulation movements. The dynamic parameters and the surface electromyography ( sEMG) signals were collected by pressure-sensitive gloves and wireless sEMG acquisition system. Results The upper arm muscle was the main force muscle during TCCM, and biceps brachii had the highest contribution rate. The range of motion (ROM), speed, pulling force, and time during cervical spine positioning and directional rotation pulling were all greater than those during cervical spine lateral flexion. The integrate electromyography ( iEMG) and root mean square (RMS) for each muscle of the operator during cervical spine positioning and directional rotation pulling were higher than those during cervical spine lateral flexion. Conclusions The overall ROM, three-dimensional (3D) motion angle, load intensity and time during CCTM have the characteristics of high speed, low amplitude and strong force, reflecting the biomechanical characteristics of ‘ cunjin ’ ( one-inch punch ) in traditional Chinese medicine. This study provides references for further standardizing manual teaching and training and improving clinical safety.

Evaluation of ankle joint protection effect of parachute ankle brace on paratrooper landing / 中华劳动卫生职业病杂志

Objective: To study the protective effect of parachute ankle brace on ankle joint during simulated parachuting landing. Methods: In August 2021, 30 male paratroopers were selected as the test subjects by simple random sampling method. They jumped from the 1.5 m and 2.0 m height platforms respectively with and without parachute ankle brace, and landed on the sandy ground in a semi-squat parachute landing position. The experiment was divided into 1.5 m experimental group and control group and 2.0 m experimental group and control group. Angle sensor and surface electromyograph were used to measure and analyze the coronal tilt range of the ankle joint and the percentage of maximal voluntary contraction (MVE%) of the muscles around the ankle joint, respectively, to evaluate the protective effect of the parachute ankle brace. Results: At the same height, the tilt range of coronal plane of ankle in experimental group was significantly reduced compared with control group, and the difference was statistically significant (P<0.05). Under the same protection state, the tilt range of the coronal plane of the ankle in the 1.5 m group was significantly reduced compared with that in the 2.0 m group, and the difference was statistically significant (P<0.05). The coronal plane inclination range of the ankle in 2 m experimental group was significantly lower than that in 1.5 m control group, and the difference was statistically significant (P<0.05). Compared with 1.5 m control group, MVE% of right tibialis anterior muscle and bilateral lateral gastrocnemius decreased in 1.5 m experimental group, while MVE% of bilateral peroneus longus increased, with statistical significance (P<0.05). Compared with 2.0 m control group, the MVE% of bilateral tibialis anterior muscle and right lateral gastrocnemius decreased in 2.0 m experimental group, while the MVE% of bilateral peroneus longus increased, with statistical significance (P<0.05). The MVE% of bilateral tibialis anterior muscle, bilateral lateral gastrocnemius muscle and right peroneus longus muscle in 1.5 m experimental group decreased compared with 2.0 m experimental group, and the differences were statistically significant (P<0.05). Compared with 2.0 m control group, the MVE% of bilateral tibialis anterior muscle, right lateral gastrocnemius muscle and right peroneus longus muscle in 1.5 m control group decreased, and the differences were statistically significant (P<0.05) . Conclusion: Wearing parachute ankle brace can effectively limit the coronal plane inclination range of ankle joint, improve the stability of ankle joint and reduce the load on the muscles around ankle joint by landing. Reducing the height of the jumping platform can reduce the coronal plane incline range of the ankle and the muscle load around the ankle during landing.

Local muscle load and fatigue of simulated high-voltage cable climbing task of operation inspection personnel by surface electromyography / 环境与职业医学

Background Climbing pylons during high-voltage cable maintenance is not only a labor-intensive task, but also a challenge bringing about heat stress and mental pressure from working at height, which may lead to accumulation of muscle fatigue and work-related musculoskeletal disorders. Objective To record the local muscle fatigue during a simulated climbing task by high-voltage cable electricians based on surface electromyography (sEMG) signals, explore the characteristic changes in sEMG signals and their relationship with subjective fatigue evaluation of the task, and provide data support for developing task specific objective assessment tools for local muscle fatigue and prevention of work-related musculoskeletal disorders. Methods Ten male college students were recruited to conduct a test of a simulated pylon climbing task. The climbing distance was 60 m, and a task segment was set for every 20 m (about 100 s), recorded as T1, T2, and T3, respectively. After completing each task segment, the subjects were required to rate their subjective fatigue using the Borg's RPE Scale. Fatigue was defined by rating of perceived exertion (RPE) score ≥ 14 in this study. The sEMG signals of trapezius, erector spinae, rectus femoris, and gastrocnemius muscles were recorded wirelessly. The standardized maximal voluntary electrical activation (MVE) obtained by standardizing the root mean square (RMS) of the time domain index and the median frequency (MF) of the frequency domain index were estimated for the recorded sEMG signals, and joint amplitude and spectrum analysis (JASA) was used to evaluate local muscle fatigue of target muscles involving in the climbing task. Results The RPE scores of T1, T2, and T3 were 11.9, 15.3, and 17.4, respectively. Subjective fatigue was found in T2 and T3 but not in T1. With the extension of climbing time, the MVE values of left and right erector spinae muscles, left and right rectus femoris, and right gastrocnemius muscle increased gradually, while the MVE values of left and right trapezius muscles and left gastrocnemius muscle increased first and then decreased. The MF values of left and right rectus femoris increased at first, then remained unchanged, while the MF values of the other muscles remained basically unchanged. In T1, three muscles, including left trapezius muscle and both side of erector spinae muscles, showed fatigue; in T2, five muscles, including both sides of erector spina muscles, right trapezius muscle, and both sides of gastrocnemius muscle appeared fatigue; in T3 , except for left rectus femoris, the other seven muscles were fatigue. Conclusion The characteristic changes of electromyography signals in the simulated climbing task are not completely consistent with the typical amplitude increase and left shift of the frequency spectrum of sEMG signals in static tasks, indicating that the application of time-domain and frequency-domain analysis methods in the evaluation of muscle fatigue in climbing tasks needs further discussion. Trapezius muscles and erector spinae muscles are the first to show fatigue in the simulation, and may be the sensitive muscle groups of muscle fatigue associated with climbing movement. Compared with subjective evaluation, surface electromyography is more sensitive in the assessment of body fatigue. Fatigue is reported about 100 s of climbing (the climbing length is about 20 m).

Correlation between Elbow Flexor Muscle Strength and Needle Electromyography Parameters after Musculocutaneous Nerve Injury / 法医学杂志

OBJECTIVES@#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.@*CONCLUSIONS@#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.

Effect of neuroelectrophysiological changes on the clinical manifestations and surgical outcomes of lumbar degenerative diseases / 中国骨伤

OBJECTIVE@#To evaluate the effects of electromyography on the clinical manifestations and prognosis after posterior lumbar interbody fusion(PLIF) of degenerative lumbar diseases.@*METHODS@#A retrospective analysis was performed on 68 patients with degenerative lumbar diseases, including 29 males and 39 females, aged 21 to 84 years old, who underwent electromyogram (EMG) from January 2018 to October 2019. The patients were divided into negative and positive groups according to whether theresults of EMG was normal or abnormal, PLIF surgery was performed in both groups. The preoperative duration of illness, postoperative recovery time, operative time, intraoperative blood loss, postoperative ambulation time and length of postoperative hospital stay were recorded. The clinical efficacy was evaluated by visual analogue scale(VAS) of low back and lower limb, the Japanese Orthopedic Association(JOA) score before and after operation.@*RESULTS@#All patients were follow-up from 26 to 39 months. The subjective symptoms, clinical signs, daily activities and JOA total scores after operation in two groups were significantly higher than those before preoperation(P<0.05);the clinical signs score and total JOA score in the negative group at 3 months after operation were higher than those in the positive group(P<0.05). The VAS score of leg pain in the negative group after 1 and 3 months was less than that in the positive group(P<0.05). Patients 's illness time, postoperative recovery time, hospitalization time and implantation time in the negative group were shorter than those in the positive group(P<0.05). At other time points, there was no significant difference in low pain VAS, leg pain VAS, JOA scores in the two groups(P>0.05). There was no significant difference in the operation time and intraoperative bleeding volume between the two groups(P>0.05).@*CONCLUSION@#Patients with normal electromyography had shorter disease duration than ones with abnormal electromyography in lumbar degenerative disease;after PLIF, patients with normal electromyography recovered faster than ones with abnormal electromyography, but the results of electromyography had no effect on the final prognosis of PLIF surgery.

Diagnostic value of F wave changes in patients with Charcot-Marie-Tooth1A and chronic inflammatory demyelinating polyneuropathy / 北京大学学报(医学版)

OBJECTIVE@#To analyze and compare the characteristics and causes of F wave changes in patients with Charcot-Marie-Tooth1A (CMT1A) and chronic inflammatory demyelinating polyneuropathy (CIDP).@*METHODS@#Thirty patients with CMT1A and 30 patients with CIDP were enrolled in Peking University Third Hospital from January 2012 to December 2018. Their clinical data, electrophysiological data(nerve conduction velocity, F wave and H reflex) and neurological function scores were recorded. Some patients underwent magnetic resonance imaging of brachial plexus and lumbar plexus, and the results were analyzed and compared.@*RESULTS@#The average motor conduction velocity (MCV) of median nerve was (21.10±10.60) m/s in CMT1A and (31.52±12.46) m/s in CIDP. There was a significant difference between the two groups (t=-6.75, P < 0.001). About 43.3% (13/30) of the patients with CMT1A did not elicit F wave in ulnar nerve, which was significantly higher than that of the patients with CIDP (4/30, 13.3%), χ2=6.65, P=0.010. Among the patients who could elicit F wave, the latency of F wave in CMT1A group was (52.40±17.56) ms and that in CIDP group was (42.20±12.73) ms. There was a significant difference between the two groups (t=2.96, P=0.006). The occurrence rate of F wave in CMT1A group was 34.6%±39%, and that in CIDP group was 70.7%±15.2%. There was a significant difference between the two groups (t=-5.13, P < 0.001). The MCV of median nerve in a patient with anti neurofascin 155 (NF155) was 23.22 m/s, the latency of F wave was 62.9-70.7 ms, and the occurrence rate was 85%-95%. The proportion of brachial plexus and lumbar plexus thickening in CMT1A was 83.3% (5/6) and 85.7% (6/7), respectively. The proportion of brachial plexus and lumbar plexus thickening in the CIDP patients was only 25.0% (1/4, 2/8). The nerve roots of brachial plexus and lumbar plexus were significantly thickened in a patient with anti NF155 antibody.@*CONCLUSION@#The prolonged latency of F wave in patients with CMT1A reflects the homogenous changes in both proximal and distal peripheral nerves, which can be used as a method to differentiate the CIDP patients characterized by focal demyelinating pathology. Moreover, attention should be paid to differentiate it from the peripheral neuropathy caused by anti NF155 CIDP. Although F wave is often used as an indicator of proximal nerve injury, motor neuron excitability, anterior horn cells, and motor nerve myelin sheath lesions can affect its latency and occurrence rate. F wave abnormalities need to be comprehensively analyzed in combination with the etiology, other electrophysiological results, and MRI imaging.