Can the electrically stimulated manual muscle test differentiate upper from lower motor neuron injury in persons with acute SCI?

Title

Can the electrically stimulated manual muscle test differentiate upper from lower motor neuron injury in persons with acute SCI?

Creator

de Padua A; Renfro C; Grabnar M; Kilgore K; Bryden A; Roach MJ; Nemunaitis G

Publisher

Neurological Research

Date

2020
2020-09-24

Description

OBJECTIVE: To determine if the motor response on the stimulated manual muscle test (SMMT) in muscles with a grade 0 motor score on the manual muscle test (MMT) can differentiate lower motor neuron (LMN) from upper motor neuron (UMN) injury based on the presence of spontaneous activity (SA) with needle EMG. DESIGN: Prospective Study. PARTICIPANTS/METHODS: Twenty-one subjects with acute traumatic cervical SCI. METHODS: An upper extremity International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) evaluation was completed on all subjects. A needle EMG and an electrically stimulated manual muscle test (SMMT) were completed on all key upper extremity muscles with a MMT motor score of zero. RESULTS: The MMT, SMMT and Needle EMG were done on 77 muscles. The SMMT motor score was 0 on 10 muscles and >1 on 67 muscles. The needle EMG identified spontaneous activity (SA) in 55/77 muscles. Seventy percent (7/10) of the muscles with MMT and SMMT motor score of zero demonstrated SA on EMG. Seventy-two percent (48/67) of the muscles with MMT motor score = 0 and SMMT motor score ≥1 demonstrated SA on EMG. CONCLUSION: In our study, 70% of the muscles with a SMMT motor response of zero and 72% of the muscles with a SMMT motor response greater than or equal to one demonstrated SA on EMG. The use of the SMMT as a clinical measure to differentiate LMN from UMN integrity may be limited when applied.

Subject

spontaneous activity; EMG; lower motor neuron; SMMT; Spinal cord; upper motor neuron

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

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Pages

1-6

ISSN

1743-1328 0161-6412

Update Year & Number

Hospital List

Citation

de Padua A; Renfro C; Grabnar M; Kilgore K; Bryden A; Roach MJ; Nemunaitis G, “Can the electrically stimulated manual muscle test differentiate upper from lower motor neuron injury in persons with acute SCI?,” NEOMED Bibliography Database, accessed May 9, 2021, https://neomed.omeka.net/items/show/11445.

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