OBJECTIVE: To investigate the influence of five different recording electrodes on the various parameters of sensory nerve action potentials (SNAPs). METHOD: Median sensory nerve conduction study was performed in 50 normal subjects using different five types of recording electrodes-disc electrode, ring electrode, bar electrode and two kinds of felt-tip bar electrodes (type 1 and 2). The interelectrode distances between active and reference electrodes were set at 4 cm for the disc and ring electrodes. The bar electrode, felt-tip electrodes type 1 and 2 were fixed at interelectrode distances of 3 cm, 3.7 cm and 2.3 cm, respectively. Onset and peak latency, onset to peak amplitude, peak to peak amplitude and duration of negative spike of SNAPs were measured. These parameters were compared using ANOVA test. RESULTS: Onset and peak latencies of SNAPs recorded from five different electrodes were not different (p>0.05). Onset to peak and peak to peak amplitudes of SNAPs recorded from felt-tip type 2 electrode were significantly reduced compared to other electrodes (p<0.05). Onset to peak amplitude of SNAPs was also reduced when the ring electrode was used (p<0.05). The negative spike durations of SNAPs recorded from felt-tip type 2 and bar electrodes were shorter than other electrodes recording (p<0.05). CONCLUSION: Onset and peak latencies of SNAPs were not affected by the types of electrodes used. Shortening of interelectrode distance may be a main cause of reduction of peak to peak amplitude and negative spike duration of SNAPs.
Action Potentials* ; Electrodes* ; Neural Conduction

OBJECTIVE: To establish the posterior cutaneous nerve of arm (PCNA) conduction technique and set up the reference values. METHOD: A PCNA conduction study was performed in 80 nerves of 40 neurologically healthy adult subjects with a mean age of 38 years (range, 20 to 56). Dantec Counterpoint MK2 machine was used. The recording bar electrodes were placed 10 cm distal to the axillary fold on a line connecting the posterior axillary fold and the olecranon. Supramaximal stimulation was applied to the axilla posterior to the brachial artery. Onset latency, baseline to peak amplitude and negative spike duration of sensory nerve action potentials were obtained. Skin temperature was measured in the posterior arm and maintained at 34 degrees C or above. RESULTS: Compound sensory action potential for the PCNA was recordable in all the subjects. The results were as follows: onset latency, 1.7+/-0.1 msec; baseline to peak amplitude, 4.6+/-1.4 microvolt; negative spike duration, 1.1+/-0.2 msec. CONCLUSION: PCNA response is readily obtainable. This study may help to assess the pain or paresthesia in the posterior aspect of the arm, although more studies are required for clinical application.
Action Potentials ; Adult* ; Arm* ; Axilla ; Brachial Artery ; Brachial Plexus ; Electrodes ; Humans ; Olecranon Process ; Paresthesia ; Proliferating Cell Nuclear Antigen ; Reference Values* ; Skin Temperature

OBJECTIVE: To assess overall quality of life (QOL) in lower limb amputees and identify the factors affecting their quality of life. METHOD: This study was designed as an interview survey using the questionnaire. The subjects were 78 lower limb amputees (male 76, female 2) and the age matched 39 healthy adult males consisted control group. Interview questionnaire included level of education, religion, marital status, occupation and income. Depression was measured by the Beck depression inventory (BDI). The QOL was measured by the MOS 36-item short-form health survey (SF-36). The SF-36 scores of amputee group were compared with that of control group, and were compared according to the various factors. RESULTS: The mean overall scores of QOL in amputee and control group were 50.2+/- 21.7, 73.6+/- 12.7 respectively (p<0.05). The mean scores were significantly reduced in amputee group as compared with the control group in entire dimension (p<0.05). Depression and numbers of combined diseases had a negative effect on multiple areas of QOL (p<0.05), however, occupation, income, amputation level, and time after amputation had no significant effect (p>0.05). CONCLUSION: The QOL assessed by SF-36 indicated relatively low functional and well-being status in amputees. Depression and combined diseases would be a most important factors on QOL.
Adult ; Amputation ; Amputees* ; Depression ; Education ; Female ; Health Surveys ; Humans ; Lower Extremity* ; Male ; Marital Status ; Occupations ; Quality of Life* ; Surveys and Questionnaires

OBJECTIVE: To investigate the clinical feature and quantitative electromyographic (QEMG) findings in the patients with post-polio syndrome (PPS). METHOD: Eleven patients who had clinical evidences of antecedent poliomyelitis were evaluated with standardized clinical history, physical examination and QEMG study. If a patient had fulfilled provisional criteria for PPS, he was regarded as PPS and six patients had fulfilled the criteria. Other patients were treated as control group with stable poliomyelitis. Manual muscle testing and needle EMG study including quantitative motor unit analysis was performed at the tibialis anterior and vastus medialis muscles. The existence of abnormal spontaneous activity and parameters of quantitative motor unit analysis, mean duration and amplitude of motor unit action potentials (MUAPs), were compared between PPS and control groups. The correlation between the muscle strength and parameters of QEMG was investigated. RESULTS: Abnormal spontaneous activities were noted in 4 out of 11 patients (36.4%) and three of these 4 patients were PPS. Mean duration and amplitude of MUAPs of tibialis anterior and vastus medialis muscles were not different significantly between the PPS and stable poliomyelitis group (p>0.05). The parameters of MUAPs were poorly correlated with muscle strength. CONCLUSION: Distribution of abnormal spontaneous activities and parameters of QEMG study were not different in PPS and stable poliomyelitis patients. QEMG study may not have additional benefit in differentiating PPS from stable poliomyelitis.
Action Potentials ; Humans ; Muscle Strength ; Muscles ; Needles ; Physical Examination ; Poliomyelitis ; Postpoliomyelitis Syndrome* ; Quadriceps Muscle

OBJECTIVE: To investigate the influence of electronic filter setting change on the parameters of motor and sensory nerve conduction studies. METHOD: Median motor and sensory nerve conduction studies were performed in 25 neurologically healthy adult subjects with a mean age of 29 years (range, 20~50). Compound muscle action potentials (CMAPs) and sensory nerve action potentials (SNAPs) were recorded after fixing the low frequency filter cutoff value of 1 Hz, 10 Hz, 100 Hz and 300 Hz and by changing high frequency filter cutoff level from 10 KHz to 0.5 KHz. Onset and peak latency, amplitude of CMAPs and SNAPs were measured and the area of CMAPs were also recorded. Dantec Counterpoint MK2 machine was used. Skin temperature was maintained at 34degrees C or above. RESULTS: As the high frequency filter was changed from 10 KHz to 0.5 KHz, the mean amplitude of SNAPs and CMAPs decreased by 33.5%, 3.3%, respectively. Onset and peak latency prolonged significantly below the high frequency filter level of 2 KHz (p<0.01). When the low frequency filter was varied form 1 Hz to 300 Hz, large differences were seen in amplitude (69.7%) and area (86.5%) of CMAPs and amplitude of SNAPs (36.6%) (p<0.01), but onset latency was not changed. Peak latency of CMAPs decreased by 20.8%, however, the peak latency of SNAPs reduced slightly (1.4%) (p>0.01). CONCLUSION: Significant alterations in parameters of CMAPs and SNAPs were produced by modification of filter setting. Optimum filter setting is recommended in nerve conduction study and filter parameters must remain constant when determining normal values and when performing serial studies on patients.
Action Potentials ; Adult ; Electrodiagnosis ; Humans ; Neural Conduction* ; Reference Values ; Skin Temperature

OBJECTIVE: To determine the effect of exercise in the early phase of reinnervation after sciatic nerve injuries in the rat. METHOD: Thirty six rats, Sprague-Dawley (weight, 200 to 220 g), were divided into the normal control and experimental groups. Using a haemostatic forceps, crushing injuries to the bilateral sciatic nerves were induced in the experimental group. The experimental group was further divided into exercise groups by the duration of daily swimming and initiation (duration since injury) of exercise after nerve injury (A, 2 hours/day and day 1; B, 30 minutes/day and day 1; C, 2 hours/day and week 2; D, 30 minutes/day and week 2) and non-exercise group (E). After completion of 5-week program the test results were evaluated by 1) sciatic nerve motor conduction study recorded at the gastro-soleus muscles, 2) measurement of soleus muscle tension, and 3) hematoxylin-eosin stain & alkaline ATPase stain (pH 9.4) of the soleus muscles. RESULTS: Nerve conduction study revealed significantly prolonged latency in group C and decreased amplitude in the group C, D. Peak twich tension decreased significantly in group C, D & E. Maximal tetanic tension was increased significantly in the group A compared to C. Both type I and II muscle fibers atrophied significantly in all the experimental groups compared to the normal control group with no changes of the composition of two muscle fibers. CONCLUSION: Swimming applied from the early phase after sciatic nerve injury may be beneficial in early recovery of muscle tension. Overexercise in the early stage of reinnervation, however, may hamper the functional return of the damaged muscle by nerve injury.
Adenosine Triphosphatases ; Animals ; Muscle Tonus ; Muscle, Skeletal* ; Muscles ; Neural Conduction ; Rats* ; Rats, Sprague-Dawley ; Sciatic Nerve* ; Surgical Instruments ; Swimming

OBJECTIVE: To analyze the relationship between painful hemiplegic shoulder (PHS) and ultrasonographic (US) findings according to the motor recovery stage of the stroke. METHOD: The medical records were reviewed retrospectively in 82 stroke patients from January 2005 to November 2009 who undertook US examination on hemiplegic shoulder. The clinical data collected were age, gender, stroke type, affected side, duration from stroke onset, manual function test (MFT) and the Brunnstrom stage of arm. The presence of spasticity, glenohumeral subluxation and sensory impairment were also investigated. The patients were classified into three groups according to the Brunnstrom recovery stage: the first, second and third recovery stages (RS1, RS2 and RS3). Furthermore, the correlations between US findings and the clinical characteristics according to the Brunnstrom recovery stage were analyzed. RESULTS: The presence of spasticity, glenohumeral subluxation, sensory impairment (proprioception) and MFT scores had statistically significant differences in each group. Among the 82 stroke patients, 62 patients (75.6%) had abnormal findings in US examination. The common abnormal structures were supraspinatus tendon (SST), biceps long head tendon (BLH), subacromial-subdeltoid bursa (SA-SD bursa). The frequencies of total US abnormality in each group were not significantly different (p=0.07). However, the SST abnormality was more frequent in the RS1, and the BLH and SA-SD bursa abnormality were more frequent in the RS3 (p<0.05). CONCLUSION: In this study, abnormal findings in US examination are frequent in PHS. The abnormal SST is related to the flaccidity, and the abnormal BLH and SA-SD bursa are related to the overuse.
Arm ; Head ; Humans ; Hydrogen-Ion Concentration ; Medical Records ; Muscle Spasticity ; Retrospective Studies ; Shoulder ; Shoulder Dislocation ; Stroke ; Tendons

PURPOSE: The lateralization of cognitive functions in crossed aphasia in dextrals (CAD) has been explored and compared mainly with cases of aphasia with left hemisphere damage. However, comparing the neuropsychological aspects of CAD and aphasia after right brain damage in left-handers (ARL) could potentially provide more insights into the effect of a shift in the laterality of handedness or language on other cognitive organization. Thus, this case study compared two cases of CAD and one case of ARL. MATERIALS AND METHODS: The following neuropsychological measures were obtained from three aphasic patients with right brain damage (two cases of CAD and one case of ARL); language, oral and limb praxis, and nonverbal cognitive functions (visuospatial neglect and visuospatial construction). RESULTS: All three patients showed impaired visuoconstructional abilities, whereas each patient showed a different level of performances for oral and limb praxis, and visuospatial neglect. CONCLUSION: Based on the analysis of these three aphasic patients' performances, we highlighted the lateralization of language, handedness, oral and limb praxis, visuospatial neglect and visuospatial constructive ability in aphasic patients with right brain damage.
Aged ; Aphasia/*etiology/*physiopathology ; Brain Injuries/*complications ; Cognition/*physiology ; Female ; Functional Laterality/*physiology ; Humans ; Male ; Middle Aged

This article summarizes the era from when Paul Broca had first introduced his aphasia case study and theory in 1861 to clinical-neuroanatomical approach which was widely known until early twentieth century. The article also comprises the cognitive-neuropsychological approach which appeared after the cognitive revolution in 1956. It investigated and compared the definition, classification method and the primary research object of aphasia in the perspectives of clinical-neuroanatomical approach and cognitive-neuropsychological approach. Each approach has its own advantages and disadvantages. Therefore, it is inappropriate to only support for a certain approach but better if two approaches are incorporated together and used effectively in certain situations. In order for the best research and treatment for the aphasic patients, clinical practitioners who prefer clinical-neuroanotomical approach and researchers who prefer cognitive-neuropsychological approach should participate together to incorporate the two approaches.