**From the Editor**

Utilization of electrodiagnosis; namely electromyography (EMG), nerve conduction studies, late responses, repetitive nerve stimulation techniques, quantitative EMG and evoked po‐ tentials, has long been discussed in many text books as basic principles. However the usage of electroneuromyography is rather new in some aspects when compared with tasks of daily practise. This book, we believe, will cover and enlighten those aspects where electrodiagno‐ sis has begun to play important roles nowadays.

that an investigation of muscle activity during exercise in water provides beneficial informa‐

Assistive Robots are one of the rising trends of our age and Gopura et al inform us about the recent trends in EMG-based control methods for assistive robots. I believe that our readers will find this chapter extremely interesting especially for the future directions that the au‐

A very distinguished chapter about biorobotics follows the above chapter. Garcia G. et al, present us a 3D graphical simulator they devised which mimics the behaviour of the Osaka Hand. The results are very exciting: Three sound-limbed subjects and a subject with double upper-limb amputation at wrist level were able to control the finger angle naturally and ac‐

The last chapter which is written by Lorenzo-Gomez MF et al, describe an interesting task performed with EMG. Their chapter is about electromyographic treatment in women with chronic inflammatory disorders of the urinary tract. I believe that this chapter will provide a

This book may of course have errors despite our obsessive reviews and efforts. But all in all, I think that it provides the reader with interesting up-to-date data while summarizing some

As a last remark, I want to thank all the authors of this book for their amazing works, to our publishing process manager Ms Marija Radja, without whom I would not be able to edit this book and finally to my dear mentor and teacher Prof. Dr. Gulseren Akyuz who has written a

I dedicate this book to all the people from whom I have learned a lot of things in this life. To my teachers, my patients, my students, my residents, my parents and mostly to my beloved husband Dr. Cuneyt Turker. I know I could not manage life and my career without him.

I wish and hope that this book will be useful for anyone who wants to read about new per‐ spectives in electrodiagnosis. I also hope that it will arouse a new and great inspiration for

**Assoc. Prof. Dr. Hande Turker MD, MS**

Department of Neurology

Samsun, Turkey

Preface IX

Lecturer, Neurologist and Clinical Neurophysiologist Ondokuz Mayıs University School of Medicine

tion for a broad range of participants, coaches and researchers.

new perspective for both urologists and electromyographers.

preface for the book during her very busy schedule.

curately by using this rehabilation system.

basic electrodiagnostic knowledge.

researchers working on this field.

thors propose.

The book begins with an overview of the application of EMG in neurological disorders, a chapter by Faranak et al, where the role of EMG in neurological practise is explained thor‐ oughly.The chapters by Suzuki et al, and Partanen J. describe late responses in cerebrovas‐ cular diseases and spontaneous activation in EMG respectively.

After these three basic chapters, there comes an interesting chapter on spinal cord neuro‐ physiology by Kohn et al. The chapter, as stressed in its introduction part, provides concep‐ tual and methodological background for researchers and clinicians who use EMG to study human spinal cord neurophysiology.

The chapter "Clinical Quantitative Electromyography" by Stashuk and Adel aims to provide an overview of different electromyographic techniques stressing quantitative EMG. A re‐ view and comparison of applications of EMG techniques for clinical decision concludes the chapter.

The next chapter by Cardozo et al summarizes a very important, yet mostly underestimated subject: Age related neuromuscular adjustments assessed by EMG. The chapter serves its aim and provides a global understanding of EMG parameters used to identify the age relat‐ ed neuromuscular fatigability alterations.

The seventh chapter by Layne C. et al, introduces a novel analysis technique "Synergos" to provide a quantitative index of multiple muscle activation, using surface electromyography from multiple muscles as the input variables. This new technique is important because it may have the potential to be used as a clinical tool to assess abnormalities in the neuromus‐ cular system and monitor the effectiveness of treatments for these disorders.

How deep should you squat to maximise a holistic training response? This striking ques‐ tion's answer is investigated in a research by Gladys et al. Their chapter provides electro‐ myographic, energetic, cardiovascular, hypertrophic and mechanical evidence for its well written findings.

The ninth chapter by Sozen H. and me, focuses on the use of surface electromyography in sports and exercise and gives information about studies concerning the comparison of mus‐ cle activation during elliptical trainer, treadmill and bike exercise by using surface EMG as a comparative test.

"Evoked EMG makes measurement of muscle tone possible by analysis of the H/M ratio", say Satoru K and Nakabyaski K. They describe a quite new perspective by using known electrodiagnostic procedures.

I believe that the chapter which follows is interesting, not only for electromyographers, but also for people who deal with underwater sports. This chapter by Kaneda et al, concludes that an investigation of muscle activity during exercise in water provides beneficial informa‐ tion for a broad range of participants, coaches and researchers.

**From the Editor**

VIII Preface

chapter.

written findings.

comparative test.

electrodiagnostic procedures.

sis has begun to play important roles nowadays.

human spinal cord neurophysiology.

ed neuromuscular fatigability alterations.

cular diseases and spontaneous activation in EMG respectively.

Utilization of electrodiagnosis; namely electromyography (EMG), nerve conduction studies, late responses, repetitive nerve stimulation techniques, quantitative EMG and evoked po‐ tentials, has long been discussed in many text books as basic principles. However the usage of electroneuromyography is rather new in some aspects when compared with tasks of daily practise. This book, we believe, will cover and enlighten those aspects where electrodiagno‐

The book begins with an overview of the application of EMG in neurological disorders, a chapter by Faranak et al, where the role of EMG in neurological practise is explained thor‐ oughly.The chapters by Suzuki et al, and Partanen J. describe late responses in cerebrovas‐

After these three basic chapters, there comes an interesting chapter on spinal cord neuro‐ physiology by Kohn et al. The chapter, as stressed in its introduction part, provides concep‐ tual and methodological background for researchers and clinicians who use EMG to study

The chapter "Clinical Quantitative Electromyography" by Stashuk and Adel aims to provide an overview of different electromyographic techniques stressing quantitative EMG. A re‐ view and comparison of applications of EMG techniques for clinical decision concludes the

The next chapter by Cardozo et al summarizes a very important, yet mostly underestimated subject: Age related neuromuscular adjustments assessed by EMG. The chapter serves its aim and provides a global understanding of EMG parameters used to identify the age relat‐

The seventh chapter by Layne C. et al, introduces a novel analysis technique "Synergos" to provide a quantitative index of multiple muscle activation, using surface electromyography from multiple muscles as the input variables. This new technique is important because it may have the potential to be used as a clinical tool to assess abnormalities in the neuromus‐

How deep should you squat to maximise a holistic training response? This striking ques‐ tion's answer is investigated in a research by Gladys et al. Their chapter provides electro‐ myographic, energetic, cardiovascular, hypertrophic and mechanical evidence for its well

The ninth chapter by Sozen H. and me, focuses on the use of surface electromyography in sports and exercise and gives information about studies concerning the comparison of mus‐ cle activation during elliptical trainer, treadmill and bike exercise by using surface EMG as a

"Evoked EMG makes measurement of muscle tone possible by analysis of the H/M ratio", say Satoru K and Nakabyaski K. They describe a quite new perspective by using known

I believe that the chapter which follows is interesting, not only for electromyographers, but also for people who deal with underwater sports. This chapter by Kaneda et al, concludes

cular system and monitor the effectiveness of treatments for these disorders.

Assistive Robots are one of the rising trends of our age and Gopura et al inform us about the recent trends in EMG-based control methods for assistive robots. I believe that our readers will find this chapter extremely interesting especially for the future directions that the au‐ thors propose.

A very distinguished chapter about biorobotics follows the above chapter. Garcia G. et al, present us a 3D graphical simulator they devised which mimics the behaviour of the Osaka Hand. The results are very exciting: Three sound-limbed subjects and a subject with double upper-limb amputation at wrist level were able to control the finger angle naturally and ac‐ curately by using this rehabilation system.

The last chapter which is written by Lorenzo-Gomez MF et al, describe an interesting task performed with EMG. Their chapter is about electromyographic treatment in women with chronic inflammatory disorders of the urinary tract. I believe that this chapter will provide a new perspective for both urologists and electromyographers.

This book may of course have errors despite our obsessive reviews and efforts. But all in all, I think that it provides the reader with interesting up-to-date data while summarizing some basic electrodiagnostic knowledge.

As a last remark, I want to thank all the authors of this book for their amazing works, to our publishing process manager Ms Marija Radja, without whom I would not be able to edit this book and finally to my dear mentor and teacher Prof. Dr. Gulseren Akyuz who has written a preface for the book during her very busy schedule.

I dedicate this book to all the people from whom I have learned a lot of things in this life. To my teachers, my patients, my students, my residents, my parents and mostly to my beloved husband Dr. Cuneyt Turker. I know I could not manage life and my career without him.

I wish and hope that this book will be useful for anyone who wants to read about new per‐ spectives in electrodiagnosis. I also hope that it will arouse a new and great inspiration for researchers working on this field.

**Assoc. Prof. Dr. Hande Turker MD, MS**

Lecturer, Neurologist and Clinical Neurophysiologist Ondokuz Mayıs University School of Medicine Department of Neurology Samsun, Turkey

**Chapter 1**

**Overview of the Application of EMG Recording in**

Yunfen Wu, María Ángeles Martínez Martínez and

Additional information is available at the end of the chapter

evaluate the effectiveness of treatment strategies.

permit examining the integrity of the corticospinal tract.

neurological damage during diverse surgical procedures.

Pedro Orizaola Balaguer

http://dx.doi.org/10.5772/56030

**1. Introduction**

**the Diagnosis and Approach of Neurological Disorders**

The Electromyography (EMG) is a neurophysiological technique for examining the electrical activity of skeletal muscles. The source of electrical signal in EMG is the muscle membrane potential. The muscle fibers innervated by the axonal branches of a motor neuron form a motor unit (MU). The muscle fibers of each motor unit are intermingled with fibers of other MUs [1]. The summation of action potentials of MUs is called motor unit action potential (MUAP) [2]. The biosignal recorded from a muscle or its fibers reflects the anatomical and physiological properties of the motor system. As such, EMG recording and analysis are powerful neuro‐ physiological techniques that can be employed to: a) identify the health status of the motor system; b) localize and typify peripheral and central abnormalities and lesions; c) determine the temporal course and the severity of motor system abnormalities, and d) determine and

Muscle activity can be detected during resting state or during voluntary movement. In addition, induction of compound action potential (CMAP) and motor evoked potential (MEP) can be obtained by means of peripheral nerve stimulation (PNS) and cortical stimulation, respectively. While PNS provides measurement of integrity of the peripheral motor system, cortical stimulation through techniques such as Transcranial Magnetic Stimulation (TMS),

Furthermore, the value of EMG recording as an Intraoperative neuromonitoring method has been described since the late 1970´s [3]. To date, EMG recording is a useful technique to prevent

> © 2013 Wu et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

© 2013 Wu et al.; licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

distribution, and reproduction in any medium, provided the original work is properly cited.
