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Sec 4 emg

  1. ELECTROMYOGRAPHY (EMG) By: Mohammed Attia SBE-310 Medical Equipment I
  2. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 2
  3. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 3
  4. Definition ■ Electromyography (EMG) is an electro-diagnostic medicine technique for evaluating and recording the electrical activity produced by skeletal muscles. ■ EMG is performed using an instrument called an electromyograph to produce a record called an electromyogram. 4
  5. Definition (continue…) ■ An electromyograph detects the electric potential generated by muscle cells when these cells are electrically or neurologically activated. ■ The signals can be analyzed to detect medical abnormalities, activation level, or recruitment order, or to analyze the biomechanics of human or animal movement. 5
  6. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 6
  7. Physiological Background ■ A motor unit is defined as one motor neuron and all of the muscle fibers it innervates. ■ When a motor unit fires, the impulse (called an action potential) is carried down the motor neuron to the muscle. 7 ■ The area where the nerve contacts the muscle is called the neuromuscular junction, or the motor end plate.
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  9. Physiological Background(continue…) ■ After the action potential is transmitted across the neuromuscular junction, an action potential is elicited in all of the innervated muscle fibers of that particular motor unit. ■ The sum of all this electrical activity is known as a motor unit action potential (MUAP). ■ This electrophysiologic activity from multiple motor units is the signal typically evaluated during an EMG. ■ The composition of the motor unit, the number of muscle fibres per motor unit, the metabolic type of muscle fibres and many other factors affect the shape of the motor unit potentials in the myogram. 9
  10. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 10
  11. Block diagram 11
  12. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 12
  13. Medical uses ■ EMG testing has a variety of clinical and biomedical applications: – EMG is used as a diagnostics tool for identifying neuromuscular diseases, or – as a research tool for studying kinesiology, and disorders of motor control. 13 – EMG signals are sometimes used to guide botulinum toxin or phenol injections into muscles. – EMG signals are also used as a control signal for prosthetic devices such as prosthetic hands, arms, and lower limbs.
  14. Medical uses(continue…) ■ One basic function of EMG is to see how well a muscle can be activated. ■ The most common way that can be determined is by performing a maximal voluntary contraction (MVC) of the muscle that is being tested. ■ Muscle force, which is measured mechanically, typically correlates highly with measures of EMG activation of muscle. 14
  15. Medical uses(continue…) ■ EMG can also be used for indicating the amount of fatigue in a muscle. The following changes in the EMG signal can signify muscle fatigue: – an increase in the mean absolute value of the signal, increase in the amplitude and duration of the muscle action potential and an overall shift to lower frequencies. ■ Monitoring the changes of different frequency changes the most common way of using EMG to determine levels of fatigue. 15
  16. Medical uses(continue…) ■ EMG is usually performed with another electrodiagnostic medicine test that measures the conducting function of nerves. This is called a nerve conduction studies (NCS). ■ Needle EMG and NCSs are typically indicated when there is – pain in the limbs, – weakness from spinal nerve compression, or – concern about some other neurologic injury or disorder 16
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  18. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 18
  19. Two kinds of EMG ■ There are two kinds of EMG: – surface EMG and 19 – intramuscular EMG.
  20. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 20
  21. Surface EMG ■ Surface EMG assesses muscle function by recording muscle activity from the surface above the muscle on the skin. ■ Surface electrodes are able to provide only a limited assessment of the muscle activity. ■ Surface EMG can be recorded by a pair of electrodes or by a more complex array of multiple electrodes. ■ More than one electrode is needed because EMG recordings display the potential difference (voltage difference) between two separate electrodes. 21
  22. Surface EMG (continue…) ■ Limitations of this approach are the fact that surface electrode recordings – are restricted to superficial muscles, – are influenced by the depth of the subcutaneous tissue at the site of the recording which can be highly variable – depending of the weight of a patient, the more body fat an individual has, the weaker the EMG signal – and cannot reliably discriminate between the dischagres of adjacent muscles. 22
  23. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 23
  24. Intramuscular EMG ■ Intramuscular EMG can be performed using a variety of different types of recording electrodes. – The simplest approach is a monopolar needle electrode. ■ This can be a fine wire inserted into a muscle with a surface electrode as a reference; ■ or two fine wires inserted into muscle referenced to each other. ■ Most commonly fine wire recordings are for research or kinesiology studies. ■ Diagnostic monopolar EMG electrodes are typically insulated and stiff enough to penetrate skin, with only the tip exposed using a surface electrode for reference. 24
  25. Intramuscular EMG (continue…) ■ Needles for injecting therapeutic botulinum toxin or phenol are typically monopolar electrodes that use a surface reference. ■ In this case, it is used both to record signals and to inject. – Slightly more complex in design is the concentric needle electrode. 25
  26. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 26
  27. EMG machine types ■ Conventional EMG system – It is based on needle or surface electrodes – It could contain more than one EMG channel Used in hospitals and clinics 27
  28. EMG machine types (continue…) ■ Portable EMG system – It is used for out-door investigation and well as in clinical practice. – Some types use wireless gel electrodes applied to the skin of the user, – Then, electrodes amplify the signal received by the electromyogram. – The data is then transferred to the computer and analyzed in real-time. 28
  29. EMG machine types (continue…) ■ NOVII WIRELESS PATCH SYSTEM is a wearable device designed for high BMI (Body Mass Index) patients. ■ This small, wearable device enables accurate with no belts and cords, it improves patients' comfort and freedom during the birthing process. 29
  30. Outlines ■ Definition ■ Physiological Background ■ Block diagram ■ Medical uses ■ Two kinds of EMG ■ Surface EMG ■ Intramuscular EMG ■ EMG machine types ■ EMG artifacts 30
  31. EMG artifacts ■ Physiological Noise: – ECG, EOG, respiratory signals, etc. – Reduced by proper positioning of the sensors (location and orientation). ■ Ambient Noise: – Power line radiation (50, 60 Hz) – Removed by differential amplification 31
  32. EMG artifacts (continue…) ■ Baseline Noise: – Electro-chemical noise (skin-electrode interface) – Reduced by effective skin preparation ■ Movement Artifact noise – Movement of electrode with respect to the skin – Reduced by effective skin preparation, proper fixation of the sensor to the skin and filtering 32
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