Extensor digitorum brevis bulk and associations with fibular motor nerve conduction amplitude.
Journal
PM & R : the journal of injury, function, and rehabilitation
ISSN: 1934-1563
Titre abrégé: PM R
Pays: United States
ID NLM: 101491319
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
revised:
07
04
2021
received:
26
10
2020
accepted:
09
04
2021
pubmed:
21
4
2021
medline:
9
4
2022
entrez:
20
4
2021
Statut:
ppublish
Résumé
Prior work demonstrates that fibular compound motor action potential (CMAP) amplitude <4.0 mV predicts impairment of ankle proprioceptive precision and increased fall risk. Extensor digitorum brevis (EDB) inspection may present a simple clinical surrogate for CMAP amplitude. (1) To estimate the inter-rater reliability of assessment of EDB bulk. (2) To determine whether inspection of EDB bulk is associated with fibular CMAP amplitude. Prospective inter-rater reliability study. Academic center outpatient Physical Medicine & Rehabilitation electromyography (EMG) clinics. Fifty-two adult participants (102 feet). (1) Inter-rater reliability of assessment of EDB bulk. (2) Mean fibular CMAP amplitude. (3) A binary measure of fibular CMAP amplitude at/above or below a 4.0 mV threshold. Inter-rater reliability of EDB bulk grading was moderate (kappa: 0.65 [95% confidence interval (CI) 0.48-0.82]). The mean CMAP value was 5.9 ± 2.2 mV when bulk was normal, 3.4 ± 2.1 mV when diminished, and 0.6 ± 0.9 mV when atrophied. A multivariable analysis demonstrated that EDB bulk, distal symmetric polyneuropathy (DSP), and lumbar radiculopathy were all associated with CMAP amplitude. The sensitivity and specificity of grading muscle bulk as normal versus abnormal in detecting CMAP amplitude above or below 4.0 mV were 0.86 (95% CI 0.78-0.94) and 0.71 (95% CI 0.54-0.88), respectively. An atrophied EDB was a highly specific indicator that CMAP amplitude was abnormal (<4.0 mV) in 100% of cases (8/8). EDB bulk was associated with fibular CMAP amplitude. Atrophy was a highly specific indicator for CMAP amplitude below 4.0 mV. Evaluation of EDB bulk may represent a quick and easy clinical surrogate marker for CMAP amplitude and distal neuromuscular impairment.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
428-433Informations de copyright
© 2021 American Academy of Physical Medicine and Rehabilitation.
Références
Bergen G, Stevens MR, Burns ER. Falls and fall injuries among adults aged ≥65 years - United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(37):993-998. https://doi.org/10.15585/mmwr.mm6537a2.
Lohman MC, Sonnega AJ, Nicklett EJ, Estenson L, Leggett AN. Comparing estimates of fall-related mortality incidence among older adults in the United States. J Gerontol A Biol Sci Med Sci. 2019;74(9):1468-1474. https://doi.org/10.1093/gerona/gly250.
Richardson JK, Hurvitz EA. Peripheral neuropathy: a true risk factor for falls. J Gerontol A Biol Sci Med Sci. 1995;50(4):M211-M215. https://doi.org/10.1093/gerona/50a.4.m211.
Callaghan B, Kerber K, Langa KM, et al. Longitudinal patient-oriented outcomes in neuropathy: importance of early detection and falls. Neurology. 2015;85(1):71-79. https://doi.org/10.1212/WNL.0000000000001714.
Schwartz AV, Vittinghoff E, Sellmeyer DE, et al. Diabetes-related complications, glycemic control, and falls in older adults. Diabetes Care. 2008;31(3):391-396. https://doi.org/10.2337/dc07-1152.
Strotmeyer ES, de Rekeneire N, Schwartz AV, et al. The relationship of reduced peripheral nerve function and diabetes with physical performance in older white and black adults: the health, aging, and body composition (health ABC) study. Diabetes Care. 2008;31(9):1767-1772. https://doi.org/10.2337/dc08-0433.
Ward RE, Boudreau RM, Caserotti P, et al. Sensory and motor peripheral nerve function and incident mobility disability. J Am Geriatr Soc. 2014;62(12):2273-2279. https://doi.org/10.1111/jgs.13152.
Richardson JK, Allet L, Kim H, Ashton-Miller JA. Fibular motor nerve conduction studies and ankle sensorimotor capacities. Muscle Nerve. 2013;47(4):497-503. https://doi.org/10.1002/mus.23618.
Son J, Ashton-Miller JA, Richardson JK. Frontal plane ankle proprioceptive thresholds and unipedal balance. Muscle Nerve. 2009;39(2):150-157. https://doi.org/10.1002/mus.21194.
Richardson JK, Demott T, Allet L, Kim H, Ashton-Miller JA. Hip strength: ankle proprioceptive threshold ratio predicts falls and injury in diabetic neuropathy. Muscle Nerve. 2014;50(3):437-442. https://doi.org/10.1002/mus.24134.
McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22(3):276-282.
Allet L, Kim H, Ashton-Miller J, De Mott T, Richardson JK. Frontal plane hip and ankle sensorimotor function, not age, predicts unipedal stance time. Muscle Nerve. 2012;45(4):578-585. https://doi.org/10.1002/mus.22325.
Donaghy A, DeMott T, Allet L, Kim H, Ashton-Miller J, Richardson JK. Accuracy of clinical techniques for evaluating lower limb sensorimotor functions associated with increased fall risk. PM R. 2016;8(4):331-339. https://doi.org/10.1016/j.pmrj.2015.08.017.
Linden D, Glocker FX, Berlit P. Variable innervation of the intrinsic foot muscles. An electrophysiological study. Electromyogr Clin Neurophysiol. 1996;36(7):399-403.
Swerdloff MA, Stewart DF. Anomalous innervation to the extensor digitorum brevis. J Brachial Plex Peripher Nerve Inj. 2019;14(1):e14-e15. https://doi.org/10.1055/s-0039-1685531.