Erfassung des Muskelfunktionszustandes durch Bestimmung der Muskelfaserleitgeschwindigkeit

Zusammenfassung

Die Leitgeschwindigkeit der Erregung entlang von Muskelfasern (CV) wurde an 20 gesunden Versuchspersonen (10 Männer und 10 Frauen) im Alter zwischen 24 und 45 Jahren im Musculus biceps brachii unter Verwendung von niveaugetriggerter Mittelung im Interferenz-EMG bei Ableitung mit verzweigten und monopolaren Oberflächenelektroden gemessen. Die CV von Kindern wurde an 90 gesunden Kleinkindern im Alter von bis zu fünf Jahren untersucht. 43 Neugeborene mit Lähmungen des brachialen Plexus (BPP) (mäßig bis schwer), wurden ebenfalls untersucht. Die gemessene CV war bei unschiedlicher, willkürlicher Muskelanspannung (10, 25, 50 und 75 % der maximalen willkürlichen Anspannung MVC) unter Ableitung mit monopolaren gegenüber verzweigten Elektroden bei allen untersuchten gesunden Probanden gleich. Bei 50 und 75 % MVC war die CV signifikant höher als bei 10 und 25 % MVC. Bei verzweigten, gemittelten Potenzialen (AvPs) war die positive Endphase unterdrückt. Die monopolaren AvPs glichen in ihrem Kurvenverlauf den Aktionspotenzialen motorischer Einheiten. Die Parameter der verschiedenen Potenzialphasen (unter Einschluss der positiven Endphase) könnten Zusatzinformationen über den Funktionsstatus von Muskeln liefern. Die CV der gesunden Kinder nahm langsam mit dem Alter zu (von 1,56 ± 0,22 m/s auf 3,26 ± 0,30 m/s). Der Leitgeschwindigkeitswert korrelierte signifikant mit dem Alter. Bei Neugeborenen mit BPP war die Leitgeschwindigkeit im paretischen Arm höher und blieb bei der schweren Form von BPP während der Rekonvaleszenzphase eines Jahres signifikant erhöht. Diese Befunde können durch Erholung, vor allem von schnellen und großen motorischen Einheiten erklärt werden, die eine höhere CV besitzen. Zusammenfassend zeigt sich die niveaugetriggerte Mittelung des Interferenz-EMGs durch Ableitung mit verzweigten Elektroden als adäquate, nicht invasive Methode, um die Fortleitungsgeschwindigkeit der Erregung entlang der Muskelfasern zu messen und einen veränderten Funktionszustand der Muskeln zu erfassen.

Abstract

In 20 healthy subjects (10 males and 10 females) aged between 24 and 45 years, the conduction velocity of excitation along muscle fibers (CV) was measured in biceps brachii muscle using level averaging of interference EMG recorded by branched and monopolar surface electrodes. The CV in children was investigated in 90 healthy infants aged up to 5 years. 43 newborns with brachial plexus palsy (BPP) (moderate and severe) was investigated, too. The measured CV, recorded with both monopolar and branched electrodes were significant equal (p > 0.05) at all different muscle tension (10, 25, 50 and 75 % of MVC) and for all investigated healthy subjects. The CV was significant higher (p < 0.05) at 50 and 75 % compared to 10 and 25 % of MVC. In branched averaged potentials (AvPs) the terminal positive phase was suppressed. The monoplar AvPs were with waveform similar to those of motor units potentials and the parameters of the different potential's phases (including the terminal positive one) may give additional information for functional state of muscles. CV of healthy infants increased gradually with their age (from 1.56 ± 0.22 m/s to 3.26 ± 0.30 m/s). The value of CV depended significantly on the age. In newborns BPP the CV was higher in paretic arm and remains significantly higher (sever BPP) during the recovering period of one year. These findings may be explained with recovering predominantly of fast and large MUs, which have a higher CV. In conclusion, the level-triggered averaging of the interference EMG recorded from the skin surface by branched electrodes is an adequate noninvasive method for the measurement of the propagation velocity of excitation along the muscle fibers and for evaluation of changed muscle functional state.

Key words

Muscle physiology - surface EMG - muscle fiber conduction velocity - plexus paresis - interference EMG - multiple electrodes - experimental neurophysiology

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