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目的研究针极肌电图和神经传导检测用于评价趾短伸肌肌力的客观性和可靠性,为法医临床学建立肌力定量检测方法提供基础和依据。方法纳入44例正常人作为研究对象,足趾进行背屈时同步测量针极肌电图和神经传导检测指标,前者包括运动单位电位(motor unit potential,MUP)波幅、MUP计数、募集反应类型,后者包括复合肌肉动作电位(compound muscle action potential,CMAP)波幅、CMAP潜伏期和运动神经传导速度(motor nerve conduction velocity,MNCV)。所有受试者在配合条件下以及伪装功能障碍条件下进行试验。结果在配合条件下,不论同一操作者还是不同操作者间,MUP波幅、CMAP波幅、CMAP潜伏期和MNCV均具有良好的重测信度,而MUP计数和募集反应类型的重测信度一般,同一操作者之间的重复性略好于不同操作者间。在伪装条件下,MUP波幅、CMAP波幅、CMAP潜伏期和MNCV的重测信度较高,而MUP计数和募集反应类型的重测信度较低(ICC系数分别为0.52和0.57)。结论 MUP波幅、CMAP波幅、CMAP潜伏期和MNCV具有良好的重测信度,有利于不同操作者间和不同时期检测结果的比较;MUP计数和募集反应类型易受操作者和被检查者的主观性影响,可用于鉴别被测试者是否存在伪装。各项指标用于客观肌力的判断尚有待进一步研究。
Objective To investigate the objectivity and reliability of acupuncture-needle electromyography and nerve conduction test in the evaluation of muscular strength of toe-extensor extensor, and to provide a basis and foundation for forensic clinicians to establish a method for the quantitative determination of muscular strength. Methods Forty-four healthy subjects were enrolled in this study. Simultaneous measurement of the needle electromyography (EMG) and nerve conduction index (DRG) was performed in the dorsi of toes. The former included motor unit potential (MUP) amplitude, MUP count, The latter included compound muscle action potential (CMAP) amplitude, CMAP latency, and motor nerve conduction velocity (MNCV). All subjects under the conditions of cooperation and camouflage dysfunction under the conditions of the test. Results The MUP amplitude, CMAP amplitude, CMAP latency and MNCV both had good retest reliability under the conditions of the same operator and different operators, while the retest reliability of MUP count and the type of recruitment reaction were generally the same Repeatability between operators is slightly better than between different operators. MUP amplitude, CMAP amplitude, CMAP latency, and MNCV retest reliability were higher under mock conditions, whereas MUP counts and recruitment response types had lower retest reliability (ICC coefficients of 0.52 and 0.57, respectively). Conclusions MUP amplitude, CMAP amplitude, CMAP latency and MNCV have good retest reliability, which is in favor of the comparison of test results between different operators and in different periods. MUP counting and recruitment reaction types are sensitive to the subjectivity of the operator and the examinee Influence, can be used to identify the subject is disguised. The indicators for the determination of objective muscle strength remains to be further studied.