The aim of this research is to determine whether HDsEMG could be used as a reliable alternative to a current clinical procedure of lower arm muscle innervation zone localization.
ID
Source
Brief title
Condition
- Central nervous system vascular disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
If the innervation zone can indeed be reliably located using HDsEMG:
the distance [mm] between this location and the location as estimated using the
bony landmark method.
Secondary outcome
Variability in innervation zone location as a function of test condition, i.e.
of elbow and wrist joint angles, level of isometric contraction and stimulation
method (i.e. voluntary contraction on various levels of force, reflex induction
by an external stretching force, or electrical stimulation).
Background summary
Botulinum toxin A injections are increasingly applied to reduce abnormally high
muscle tone in specific neurological disorders. Effective treatment requires
application close to the muscle*s in-nervation zone. No standard procedure of
innervation zone localization currently exists. Moreover, there is evidence for
clinically relevant variation in innervation zone location, both between
indi-viduals and as a function of muscle activation level but not of joint
angle. High-density surface electromyography (HDsEMG) potentially offers a
suitable method of innervation zone localization under various conditions.
The primary research question is whether it is possible to reliably localize
the flexor carpi ulnaris muscle*s innervation zone using HDsEMG under various
experimental conditions.
Study objective
The aim of this research is to determine whether HDsEMG could be used as a
reliable alternative to a current clinical procedure of lower arm muscle
innervation zone localization.
Study design
The methodology will be developed and evaluated on a cohort of 10 healthy
adults. In both arms, the innervation zone of the flexor carpi ulnaris muscle
will be determined using HDsEMG. Motor unit potentials will be measured during
three types of muscle activation: voluntary contraction, mechanically induced
stretch reflex and electrical stimulation of the ulnar nerve. Innervation zone
location will be compared to a method based on bony landmarks. Reliability will
be assessed by repeated measures. Innervation zone location dependency on
muscle activation level, joint angle and method of muscle stimulation will be
assessed.
Study burden and risks
Electromyography is performed using a galvanically separated system that poses
no threat to the subject at all. The wrist movements imposes on the subject are
of minor amplitude and could theoretically result in some lower arm muscle
pain. Electrical stimulation of the ulnar nerve may result in a momentary
unpleasant or even slightly painful sensation.
This research could contribute to more effective ways of botulin toxin
application to lower arm muscles that cause less inconvenience to the patient.
Subjects participating in this research are not at risk of anything but minor
inconvenience and time investment.
Postbus 9600
2300 RC Leiden
NL
Postbus 9600
2300 RC Leiden
NL
Listed location countries
Age
Inclusion criteria
healthy adult volunteers, matched to the group of patients regularly seen at the LUMC Rehabilitation Department*s outpatient botulinum toxin injection treatment
Exclusion criteria
conditions that may influence voluntary control or mechanical properties of one or both flexor carpi ulnaris muscles, e.g.:
central neurological pathology;
peripheral neurological pathology affecting one or both upper extremities;
past fracture of lower arm, wrist or carpals;
active lower arm tendinopathy.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL31848.058.10 |