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Test Performed: Lumbar DynaROM Surface EMG Exam

Instrument Utilized: MYOVISION 3G Wirefree™ DYNAROM SEMG

Electrode Attachments: Lumbar Paraspinals: Approximately L1 and L5, bilaterally.

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Date of Loss:Click here to enter a date.

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Interpretation By (Name): Click here to enter text.

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MyoVision 3G DynaROM Surface Electromyography Interpretation: Lumbar Exam: Overview
For patient graphs, please see print-outs of patient line graphed data generated using MyoVision 3G Wirefree™ System. The system combines Dynamic Surface EMG and Range of Motion by measuring muscle guarding and bracing while simultaneously measuring Range of Motion. The system is featured in the AMA Publication “The Practical Guide to Range of Motion Assessment”.

The system generates color graphs showing muscle activity and range of motion data for each range of motion. Refer to the print out from the MyoVision System when evaluating the interpretation of the data from each exam. Each test typically requires that the patient performs between 2 and 3 trials of each range of motion.

Electrodes are attached bilaterally at approximately L1 and L5 with a ground attached above the bony prominence of the scapula.

The ranges of motion evaluated in this interpretation include:

  • Lumbar Flexion
  • Left Lateral Flexion
  • Right Lateral Flexion
  • Left Rotation
  • Right Rotation

Range of motion is the measure of how far an individual can bend. Recent studies indicate that combining Range of Motion with Dynamic Surface EMG increases sensitivity and specificity of the device for evaluating injury.

OVERVIEW OF TESTING METHODOLOGY

FLEXION / RE-EXTENSION:

This is a study of the muscle activity of the lumbar paraspinal region as the patient performs a series of three consecutive flexions. Muscles of the lumbar paraspinals “relax” when the body is placed in a fully flexed position. Readings should be relatively low (relax) in flexion (markers 1, 3, 5). Research studies have established this as expected in normal individuals, with muscles firing in a “bracing” manner (higher readings in flexion) as injury leads to muscular bracing and compensation.

Symmetry & Irritability:Muscles typically fire in a relatively smooth, symmetrical fashion when comparing left and right sides. With injury, it is common to see asymmetries and irritability which is clear when line graphs demonstrate significant variability, and are not smooth during motion.

LATERAL FLEXION (Left Right) and ROTATION (Left Right)

Level of Activity of Opposite Side (Co-Contraction): There should be little or no muscle activity from the lumbar paraspinals on the opposite side during the motion. For example, in a left lateral flexion, there should be considerable firing of muscles on the left side with muscle activity on the right side remaining low and relatively relaxed.

Abnormal Contraction: When opposing muscle fires and the one tested remains low (exact opposite of how the muscles should perform).

Irritability: Muscles fire in a smooth fashion in normal individuals with little irritability or fasciculation. Soft tissue injuries create a state of abnormal motor functioning which appears as jitter or increased variability in the sEMG signal as the patient moves. This is done as the patient braces in response to pain or joint restriction. An individual who is experiencing pain or joint restriction typically demonstrates greater amounts of muscle fasciculation (seen as variability or jitter) in response to these conditions.

Consistency: A person in good health will show a greater consistency in muscle patterns than those injured. Whereas injured patients’ test results show a greater increase in variability. In general, there will be less consistency with injuries.

Abnormal Consistency: When muscles fire opposite of how they should perform consistently.

Abnormal Muscle Firing Pattern: When muscles fire opposite of how they should perform. This can be a sign of muscle guarding.

Interpretation of Patient Test Results

Lumbar Flexion DynaROM Dynamic Surface EMG

  1. Flexion Relaxation:Choose an item.
  2. Irritability: Choose an item.
  3. Symmetry: Choose an item.
  4. Consistency:Choose an item.
  5. How quickly muscles relax upon return to neutral: Choose an item.
  6. Range of Motion in Degrees Qualitative: Choose an item.

Lumbar Left Lateral Flexion

  1. Level of Activity of Opposite Side (Bracing Guarding/ Co-Contraction):Choose an item.
  2. Irritability:Choose an item.
  3. Consistency:Choose an item.
  4. Symmetry in comparison to opposite side motion:Choose an item.

Lumbar Right Lateral Flexion

  1. Level of Activity of Opposite Side (Bracing Guarding/ Co-Contraction):Choose an item.
  2. Irritability:Choose an item.
  3. Consistency:Choose an item.
  4. Symmetry in comparison to opposite side motion:Choose an item.

Lumbar Left Rotation

  1. Level of Activity of Opposite Side (Bracing Guarding/ Co-Contraction):Choose an item.
  2. Irritability:Choose an item.
  3. Consistency:Choose an item.
  4. Symmetry in comparison to opposite side motion:Choose an item.

Lumbar Right Rotation

  1. Level of Activity of Opposite Side (Bracing Guarding/ Co-Contraction): Choose an item.
  2. Irritability:Choose an item.
  3. Consistency:Choose an item.
  4. Symmetry in comparison to opposite side motion:Choose an item.

CONCLUSION:

(must conclude based upon test data above): The patient

Important Information Regarding the Test Results

The information gathered from the sEMG is one of the many pieces of data used in determining a clinical profile and should not be used alone in the determination of injury or disability. Muscles often compensate for problems of the spine and do so in a manner that does not always directly reflect the exact location or even the general direction of the source. As an example, cervical problems often appear as abnormal muscle activity of the upper

thoracic region. It is important to note that no single test can be used to determine injury.

The Dynamic Surface EMG and Range of Motion exam provides one piece of evidence used to develop a clinical profile.

PROGNOSIS:

Optional: May delete if not applicable.

TREATMENT RECOMMENDATIONS:

Optional: May delete if not applicable.

Signed,

Dr. FIRST NAME LAST NAME

INCLUDE CONTACT INFO.

Performed with MyoVision 3G Wirefree™ Physiomonitoring Equipment.Page 1