Are we on the right track in DBS surgery for dystonic head tremor? Polymyography is a promising answer.

The clinical benefit of Deep Brain Stimulation (DBS) is associated with electrode positioning accuracy. Intraoperative assessment of clinical effect is therefore key. Evaluating this clinical effect in patients with dystonic head tremor, as opposed to limb tremor, is challenging because the head is fixed in a stereotactic frame. To clinically assess head tremor during surgery, surface electromyography (EMG) electrodes were bilaterally applied to the sternocleidomastoid and cervical paraspinal muscles. This case shows that intraoperative polymyography is an easy and useful tool to assess the clinical effect of DBS electrode positioning.

An improved electrical impedance myography (EIM) tongue array for use in clinical trials.

OBJECTIVES: Electrical impedance myography (EIM) measurements of the tongue could provide valuable information about bulbar dysfunction in amyotrophic lateral sclerosis (ALS). A prototype tongue depressor EIM array produced gag reflexes. The objectives of this study were to determine the reliability, mean phase values, and tolerability of tongue EIM measurements using a smaller electrode array. METHODS: Tongue EIM measurements were performed in a total of 31 healthy individuals and four neuromuscular patients with lingual abnormalities. Reliability was assessed by calculating the intraclass correlation coefficient (ICC) and percent difference in addition to performing Bland-Altman analyses. Standard descriptive statistics, including results of a Mann-Whitney test, were also determined. RESULTS: At the 50 kHz frequency, the ICCs for intra- and inter-rater reliability were 0.76 with 5.17% difference and 0.78 with 5.34% difference respectively. The mean EIM phase values of healthy participants (11.61° ± 1.00°) and patients (9.87° ± 1.28°) were significantly different (p=0.0051). None of the participants experienced gag reflexes or discomfort. CONCLUSIONS: The small tongue array provided good inter- and intra-rater reliability, could preliminarily distinguish between healthy and diseased muscle, and was well-tolerated. SIGNIFICANCE: Biomarker information about tongue health could be more comfortably obtained with a smaller EIM array.

Ecografía del dolor muscular crónico: miositis calcificante / Ultrasound of chronic muscle pain: myositis ossificans

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Valoración de la capacidad funcional en el ámbito domiciliario y en la clínica. Nuevas posibilidades de aplicación de la acelerometría para la valoración de la marcha, equilibrio y potencia muscular en personas mayores / Functional capacity evaluation in a clinical and ambulatory setting: new challenges of accelerometry to assessment balance and muscle power in aging population

Dentro de cualquier población de individuos mayores de 65 años, una proporción sustancial (entre el 6% y el 25%) sufre diferentes síntomas del síndrome de fragilidad. A pesar de la complejidad del terminó fragilidad y de las imprecisiones en cuanto a su definición existe un consenso sobre sus síntomas y signos. Las personas que poseen este síndrome presentan pérdidas de fuerza muscular, fatiga, disminución de la actividad física, con un aumento del riesgo de padecer anorexia-pérdida de peso, delirium, hospitalización, declive funcional, deterioro cognitivo, mortalidad, ingreso en residencias, caídas e inestabilidad. Bajo este contexto, surge la necesidad de desarrollar tests que sean capaces de predecir de la forma más precoz posible la fragilidad y la discapacidad. La acelerometría es una herramienta adecuada para la monitorización de movimientos humanos de una forma objetiva y fiable, aplicable en la vida diaria de los sujetos sin implicar grandes costes. Los acelerómetros están siendo utilizados en la monitorización de diferentes movimientos. Se pueden obtener un amplio abanico de medidas como: clasificación de movimientos, valoración del nivel de actividad física, estimación del gasto de energía metabólica, medida del equilibrio, ritmo de marcha y control al levantarse-sentarse. Combinando la acelerometría con giróscopos y magnetómetros se podrá añadir información relacionada con la orientación y los cambios de posición. Esta revisión analiza las herramientas y tecnologías existentes que puedan llegar a detectar de manera precoz posibles signos y síntomas de la fragilidad y permitan a los individuos vivir autónomamente de forma más prolongada y en condiciones de mayor seguridad (AU)

If we consider a population of free-living individuals, who are 65 years old and even older, a substantial proportion (in the range of 6% to 25%) suffers from many of the elements of the syndrome of frailty. Although the syndrome is complex and still lacks a standard definition, there is a growing consensus about its signs and symptoms. Patients who are afflicted with frailty typically exhibit losses of muscle strength, fatigue easily, are physically inactive, with an increased risk (and fear) of falling, have undergone a recent, unintentional loss of weight, experience impaired cognition and depression, all of which is frequently complicated by a variety of coexistent illnesses. In this context, functional tests to predict disability and frailty are needed. Accelerometry offers a practical and low cost method of objectively monitoring human movements, and has particular applicability to the monitoring of disability in an aging population. Accelerometers have been used to monitor a range of different movements, including gait, sit to stand transfers and postural sway. This review focuses on methodological concepts in the evaluation of skeletal muscle function and monitoring systems (accelerometers and gyroscopes) in each of these areas. An integrated approach is described in which a combination of accelorometry and gyroscopy can be used to monitor a range of different parameters (muscle power, gait and balance) in an aging population in a clinical or out-patient setting (AU)