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Dotan R, Woods S, Langille J, Falk B. Boys-men mean-power-frequency differences in progressive exercise to exhaustion, confounded by variability and adiposity. Eur J Appl Physiol 2024; 124:491-505. [PMID: 37553549 DOI: 10.1007/s00421-023-05292-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Only scant research has compared children's mean power frequency (MPF) to adults', with a clear overview still lacking. A significant obstacle has been MPF's high variability, which this study aimed to overcome by elucidating the MPF characteristics distinguishing boys from men in progressive exhaustive exercise. METHODS Electromyographic (EMG) data of 20 men (23.5 ± 2.5yrs) and 17 boys (10.2 ± 1.0 yrs), who performed progressively exhausting, intermittent isometric knee extensions, were subjected to secondary MPF analysis. Participants' vastus lateralis MPF data series were transformed to third-order polynomial regressions and expressed as percentages of the peak polynomial MPF values (%MPFpeak). The resulting curves were compared at 5-% time-to-exhaustion (TTE) intervals, using repeated-measures ANOVA. Raw MPFpeak values were adiposity corrected to 0% fat and used to convert the %MPFpeak data back to absolute MPF values (Hz) for estimating muscle-level MPF. RESULTS No overall interaction or group effects could be shown between the %MPFpeak plots, but pairwise comparisons revealed significantly higher men's values at 50-70%TTE and lower at 100%TTE, i.e. boys' shallower MPF rise and decline. The adiposity-corrected boys' and men's composite MPF values peaked at 125.7 ± 2.5 and 166.0 ± 2.4 Hz, respectively (110.7 ± 1.7 and 122.5 ± 2.1 Hz, uncorrected), with a significant group effect (p < 0.05) and pairwise differences at all %TTE points. CONCLUSIONS The boys were lower than the men in both the observed and, more so, in the adiposity-corrected MPF values that presumably estimate muscle-level MPF. The boys' shallower MPF rise and decline conform to children's claimed type-II motor-unit activation and/or compositional deficits and their related known advantage in muscular endurance.
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Affiliation(s)
- Raffy Dotan
- Kinesiology Department, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada.
| | - Stacey Woods
- Kinesiology Department, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| | - Jordan Langille
- Kinesiology Department, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| | - Bareket Falk
- Kinesiology Department, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
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Barron SM, Ordonez Diaz T, Pozzi F, Vasilopoulos T, Nichols JA. “Linear Relationship Between Electromyography and Shear Wave Elastography Measurements Persists in Deep Muscles of the Upper Extremity”. J Electromyogr Kinesiol 2022; 63:102645. [PMID: 35189570 PMCID: PMC9115669 DOI: 10.1016/j.jelekin.2022.102645] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/31/2022] [Accepted: 02/06/2022] [Indexed: 11/26/2022] Open
Abstract
Recent works have demonstrated a linear relationship between muscle activation and shear modulus in various superficial muscles. As such, it may be possible to overcome limitations of traditional electromyography (EMG) methods by assessing activation using shear wave elastography. However, the relationship has not been wholly validated in deep muscles. This study measured the association between squared shear wave velocity, which is related to shear modulus, and activation within superficial and deep muscles. This relationship was also compared between surface and intramuscular EMG electrodes. We simultaneously recorded EMG and shear wave velocity in one deep (brachialis) and one superficial (brachioradialis) muscle in ten healthy individuals during isometric elbow flexion across a wide range of contraction intensities. Muscle activation and squared shear wave velocity demonstrated good reliability (ICC > 0.75) and showed a linear relationship (P < 0.05) for all muscle/EMG electrode type combinations (study conditions) after down-sampling. Study condition was not a significant within-subject factor to the slope or intercept of the relationship (P > 0.05). This work demonstrates that activation of both superficial and deep muscles can be assessed noninvasively using ultrasound shear wave elastography and is a critical step toward demonstrating elastography's utility as an alternative to EMG.
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Rosero-Salazar DH, Carvajal-Monroy PL, Wagener FADTG, Von den Hoff JW. Functional analysis of the rat soft palate by real-time wireless electromyography. Arch Oral Biol 2020; 122:105021. [PMID: 33348206 DOI: 10.1016/j.archoralbio.2020.105021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the function of the palatal muscles in vivo by real-time wireless electromyography in rats. The effects of palatal wounding were also analyzed. METHODS Microelectrodes were implanted six rats; in the masseter muscle (two-rats) for comparison, in the unwounded soft palate (two-rats) and the soft palate that received a surgical wound (two-rats). Two weeks after implantation, a wound was made in the soft palate using a 1 mm biopsy-punch. Electromyographic measurements and video-recordings were taken weekly to monitor train-duration and peak-amplitude during eating, grooming and drinking. RESULTS The train-duration of the masseter muscle during eating was 0.49 ± 0.11 s (rat-1) and 0.56 ± 0.09 s (rat-2), which was higher than during grooming. In the unwounded soft palate the train-duration during eating was 0.63 ± 0.12 s (rat-1) and 0.69 ± 0.069 s (rat-2), which was higher than during grooming and drinking. The peak-amplitude for eating in the normal soft palate before surgery was 0.31 ± 0.001 mV (rat-1) and 0.33 ± 0.02 mV (rat-2). This decreased to 0.23 ± 0.03 mV and 0.25 ± 0.11 mV respectively, after surgery. For drinking the peak-amplitude was 0.30 ± 0.01 mV (rat-1) and 0.39 ± 0.01 mV (rat-2) before surgery, which decreased to 0.23 ± 0.09 mV and 0.20 ± 0.14 mV respectively, after surgery. CONCLUSION The reduced peak-amplitude suggests impaired soft palate function after wounding. This is the first study into the in vivo function of the soft palate after surgical wounding. This model will contribute to develop strategies to improve soft palate function in patients.
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Affiliation(s)
- Doris H Rosero-Salazar
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Medical Basic Sciences, Faculty of Health, Universidad Icesi, Cali, Colombia
| | - Paola L Carvajal-Monroy
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Frank A D T G Wagener
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Johannes W Von den Hoff
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands.
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Cross JA, deVries J, Mocarski M, Ketchum NC, Compty E, Krimmer M, Fritz JM, Vetter CS. Electromyography of the Shoulder Musculature during Passive Rehabilitation Exercises. J Shoulder Elb Arthroplast 2020. [DOI: 10.1177/2471549220960044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Medical professionals remain conflicted about the best rehabilitation protocol a patient should perform after rotator cuff repair surgery. Exercises deemed passive may be activating the shoulder muscles to a moderate level, thus putting the surgical repair construct at risk for re-injury. The purpose of this study was to measure the activation of the rotator cuff and surrounding musculature during exercises used in physical therapy following rotator cuff repair surgery using electromyography (EMG). Methods Muscle activation was recorded in fourteen participants performing sixteen exercises. Four fine wire electrodes (supraspinatus, infraspinatus, subscapularis, teres minor) and six surface electrodes (upper and middle division of the trapezius, anterior, medial and posterior head of the deltoid, biceps brachii) were utilized. EMG activity values for each muscle were normalized to the maximum voluntary isometric contraction and activation levels were assessed. Results Twelve of the sixteen exercises tested were moderately active in the subscapularis muscle. The results show the subscapularis muscle was activated in all three planes of motion. Discussion Most exercises were found to have low activation levels for the supraspinatus, infraspinatus and teres minor muscles. While the exercises examined in this study appear to be safe for the more commonly repaired supraspinatus, caution should be used when administering exercises to individuals with repairs involving the subscapularis.
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Affiliation(s)
- Janelle A Cross
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John deVries
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Nicholas C Ketchum
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Eileen Compty
- Froedtert Sports Medicine Center, Froedtert & Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Matthew Krimmer
- Froedtert Sports Medicine Center, Froedtert & Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jessica M Fritz
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Carole S Vetter
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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Murray D, Keyser RE, Chin LMK, Bulea TC, Wutzke CJ, Guccione AA. EMG median frequency shifts without change in muscle oxygenation following novel locomotor training in individuals with incomplete spinal cord injury. Disabil Rehabil 2020; 44:52-58. [PMID: 32331508 PMCID: PMC10367183 DOI: 10.1080/09638288.2020.1755729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: To examine the effect of muscle fiber recruitment patterns on muscle oxygen utilization during treadmill walking in a group of individuals who have incomplete spinal cord injury.Methods: 5 participants with motor incomplete spinal cord injury (Age; 42.2 ± 18.8 years, Male; n = 4) completed an over ground locomotor training program. Muscle utilization/oxygenation and activation of the medial gastrocnemius were measured by near infrared spectroscopy and surface electromyography pre- and post-over ground locomotor training during two separate treadmill walking bouts at self-selected speeds. Outcomes were changes in deoxygenation hemoglobin/myoglobin concentrations, and the change in median power of the power spectrum of the electromyography after training.Results: A significant increase in median power of the power spectrum of the electromyography signal was observed during both bouts of treadmill walking, 6-minute walking bout and longer fatiguing bout (49% p = 0.047 and 48% p = 0.035, respectively) post-over ground locomotor training. There was no significant change in muscle utilization/oxygenation post-over ground locomotor training. There was no significant effect of median power of the power spectrum on deoxygenation hemoglobin/myoglobin during either of the walking bouts.Conclusions: The main finding of the current study was that median power of the power spectrum significantly increased following 12 weeks of over ground locomotor training, with no significant change in deoxygenation hemoglobin/myoglobin. The recruitment of more and/or larger motor units was seen in conjunction with no changes in muscle oxygen utilization for the same walking task.Implications for RehabilitationThe reduction of skeletal muscle innervation in Spinal Cord Injury may adversely affect the orderly recruitment of motor units, which could in turn blunt the oxidative metabolic response during physical activity.Over-ground locomotor could be a useful tool in the rehabilitative process following an incomplete spinal cord injury.
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Affiliation(s)
- Donal Murray
- Department of Kinesiology, Western Illinois University, Macomb, IL, USA
| | - Randall E Keyser
- Department of Rehabilitation Science, George Mason University, Fairfax, VA, USA
| | - Lisa M K Chin
- Rehabilitation Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD, USA
| | - Thomas C Bulea
- Rehabilitation Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD, USA
| | - Clinton J Wutzke
- Department of Rehabilitation Science, George Mason University, Fairfax, VA, USA
| | - Andrew A Guccione
- Department of Rehabilitation Science, George Mason University, Fairfax, VA, USA
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Sahara R, Hamada J, Yoshizaki K, Endo K, Segawa D, Yamaguchi M. Kinematic Differences between Two Types of Forward Elevations of the Shoulder Joint: Flexion and Reaching Elevation. Open Orthop J 2020. [DOI: 10.2174/1874325002014010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Background:
Extension of the elbow joint is maintained during shoulder flexion. In contrast, the arm starts from the flexed position of the elbow joint and the joint gradually extends during reaching elevation.
Objectives:
This study aimed to compare the kinematic elements and electromyographic (EMG) activities of the rotator cuff muscles between flexion and reaching elevation.
Methods:
The study included 10 healthy young men. (average age, 21.5 ± 3.4 years), and measurements were performed on their dominant arms. A three-dimensional motion analyzer was used to record the following elements during shoulder flexion and reaching elevation: the angles of glenohumeral joint elevation and scapular upward rotation, scapulohumeral rhythm, external rotation of the humerus, and glenohumeral plane shifting from the coronal plane. The EMG activities in the supraspinatus, infraspinatus, subscapularis, and teres minor were recorded simultaneously.
Results:
The plane of reaching elevation was retained at 60° from the coronal plane. The glenohumeral planes (P < 0 .01) and the external rotation angles of the humerus below 90° of elevation (P < 0.05) were significantly different between both the motions. The EMG activities in the supraspinatus (P < .01), infraspinatus (P < 0.05), and teres minor (P < 0.01) were significantly lower while reaching elevation than those during flexion.
Conclusion:
The motion plane at 60° from the coronal plane, movement of the humeral external rotation, and EMG activities of the rotator cuff muscles were different during reaching elevation and shoulder flexion.
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Gaudet S, Tremblay J, Dal Maso F. Evolution of muscular fatigue in periscapular and rotator cuff muscles during isokinetic shoulder rotations. J Sports Sci 2018; 36:2121-2128. [PMID: 29447092 DOI: 10.1080/02640414.2018.1440513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To this day, how shoulder muscles react to a strong fatigue stimulus during dynamic shoulder rotations remains unknown. The aims of this study were to assess the effect of repeated maximal internal-external isokinetic shoulder rotations on shoulder strength and muscle activity. Twenty-four individuals completed a 50-repetition fatiguing isokinetic protocol while electromyography was recorded on eleven muscles of the shoulder girdle. Time-frequency transformation and an ANOVA model using statistical parametric mapping methods were used to analyze shifts in instantaneous median frequency (MDF) between each 10-repetition Blocks. Peak torques decreased in both internal and external rotation (P < 0.01) by 24.8% on average which indicated the presence of fatigue. Significant decrease in MDF (P < 0.01) was observed for pectoralis, middle deltoid, upper, middle and lower trapezius, infraspinatus and subscapularis muscles. The observed fatigue to the periscapular and rotator cuff muscles suggests that shoulder stability could be compromised during repeated shoulder rotations, which could underlie the increased risk of scapular dyskinesis and shoulder impingement during fatiguing tasks. The present study provides a deeper understanding on the manifestations of fatigue within muscles of the shoulder girdle and the results could be applied toward improvements in athlete shoulder injury prevention and rehabilitation programs.
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Affiliation(s)
- Sylvain Gaudet
- a Département de Kinésiologie , Université de Montréal , Montréal , Canada
| | - Jonathan Tremblay
- a Département de Kinésiologie , Université de Montréal , Montréal , Canada
| | - Fabien Dal Maso
- a Département de Kinésiologie , Université de Montréal , Montréal , Canada
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Anatomic study and electromyographic analysis of the teres minor muscle. J Shoulder Elbow Surg 2017; 26:870-877. [PMID: 28087164 DOI: 10.1016/j.jse.2016.09.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/21/2016] [Accepted: 09/27/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND The teres minor muscle is a focused topic on the treatment of massive rotator cuff tears and reverse total shoulder arthroplasty. Its precise anatomy and function have not been completely investigated. The purposes of this study were to anatomically investigate the muscle and analyze electromyographic (EMG) activities during shoulder motion. METHODS This anatomic study used 20 shoulders from deceased donors (mean age, 75.0 years). EMG data were recorded from 10 healthy volunteers (mean age, 21.7 years) during flexion, abduction, and external rotations at 0° of abduction, at 90° of abduction, and at 90° of flexion in their dominant arms synchronized with a computerized 3-dimensional motion analysis system. RESULTS The muscle in all specimens consisted of 2 distinct muscular bundles: the upper and lower portions. The upper portion attached to the round area of the greater tuberosity, and the lower portion inserted into the linear shaped area. Both portions were independent in their origins, insertions, and innervation. The muscle engaged force during each shoulder motion. EMG activities of abduction and the 3 forms of external rotation were similar. Maximal voluntary contraction in the 3 forms of external rotation was 32% in maximum external rotation in the neutral position, 25% in flexion, and 40% in abduction. CONCLUSIONS The teres minor consists of independent upper and lower portions. The muscle engages force in all ranges of 5 shoulder motions, and maximum external rotation in abduction is a reliable method to evaluate potential activity of the muscle.
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Swanson BT, Holst B, Infante J, Poenitzsch J, Ortiz A. EMG activity of selected rotator cuff musculature during grade III distraction and posterior glide glenohumeral mobilization: results of a pilot trial comparing painful and non-painful shoulders. J Man Manip Ther 2016; 24:7-13. [PMID: 27252577 DOI: 10.1080/10669817.2015.1106819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES The objectives of this pilot study were to investigate rotator cuff activity that may be present during grade III distraction and posterior glide mobilization of the glenohumeral (GH) joint, as well as to examine any differences in response between painful and non-painful shoulders utilizing these techniques. METHODS EMG data were collected using Delsys EMGworks(®) software and Trigno(®) mini-wireless electrodes for the supraspinatus, infraspinatus and upper trapezius musculature during grade III GH distraction and posterior glide mobilization. A total of 20 shoulders (10 painful, 10 non-painful) were recruited from a sample of convenience. Submaximal voluntary dynamic contraction against gravity was used as reference for each of the three selected muscles. Participants underwent two trials of each mobilization, and the mean results for each group were assessed using descriptive statistics (mean, standard deviation) and effect size. RESULTS Both the painful and non-painful groups exhibited considerable levels of rotator cuff activity during each test parameter, with the painful group consistently generating higher supraspinatus and infraspinatus RMS and peak force activity. Analysis of the peak combined rotator cuff activity during distraction (d = 0.58) and posterior glides (d = 0.64) suggests moderate-to-high practical significance of the results. DISCUSSION GH distraction and posterior glide mobilizations have traditionally been thought of as passive treatment procedures. The results of this pilot study indicate that the supraspinatus and infraspinatus are significantly active during these techniques. Findings suggest that during these techniques, the total infra/supraspinatus EMG activity approaches the level produced while raising the arm against gravity. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Brian T Swanson
- School of Physical Therapy, Texas Woman's University, Houston, TX, USA; Department of Physical Therapy, University of New England, 716 Stevens Ave., Portland, ME, USA
| | - Brian Holst
- School of Physical Therapy, Texas Woman's University, Houston, TX, USA
| | - John Infante
- School of Physical Therapy, Texas Woman's University, Houston, TX, USA
| | - James Poenitzsch
- School of Physical Therapy, Texas Woman's University, Houston, TX, USA
| | - Alexis Ortiz
- School of Physical Therapy, Texas Woman's University, Houston, TX, USA
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Shoulder Electromyography Measurements During Activities of Daily Living and Routine Rehabilitation Exercises. J Orthop Sports Phys Ther 2016; 46:375-83. [PMID: 27049599 DOI: 10.2519/jospt.2016.6090] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Controlled laboratory study. Background The activity of the rotator cuff muscles has not previously been measured with indwelling electromyography (EMG) comparing ambulation and other movements. Knowledge of the relative contribution of these muscles during various tasks may help to guide rehabilitation progression. Objective To measure activity of the rotator cuff muscles and other shoulder muscles during normal ambulation, shirt and sling donning and doffing, and rehabilitation tasks commonly performed after rotator cuff surgery. Methods In 28 volunteers (15 men, 13 women; mean age, 32.2 years), indwelling EMG activity was measured in the supraspinatus, infraspinatus, teres minor, and subscapularis muscles during various tasks; and surface EMG activity was measured in the middle deltoid, biceps, and upper trapezius muscles. Results Using median EMG activity, in general, donning and doffing a shirt or sling recruited the rotator cuff muscles more than the other 7 tasks tested. Self-ranging motion using pulleys, especially in the scapular plane, was also consistently associated with greater recruitment of the shoulder muscles. Pendulum exercises, passive range of motion by a physical therapist, and self-ranging motion with a dowel recruited the shoulder muscles to a lesser extent. Conclusion Our results demonstrate that rehabilitation tasks such as pendulum exercises, passive range of motion by a physical therapist, and self-ranging motion with a dowel show low EMG activity, whereas pulleys in the sagittal plane and scapular plane show greater activity. Scapular plane activity was consistently higher than sagittal plane activity. Of all the tasks assessed, ambulation without a sling and donning and doffing a sling and a shirt consistently showed the highest activity. J Orthop Sports Phys Ther 2016;46(5):375-383. Epub 6 Apr 2016. doi:10.2519/jospt.2016.6090.
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A deadly complication of superficial muscular needle electromyography: bilateral pneumothoraces. Case Rep Med 2013; 2013:861787. [PMID: 24391671 PMCID: PMC3872379 DOI: 10.1155/2013/861787] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/08/2013] [Indexed: 12/20/2022] Open
Abstract
Needle electromyography (EMG) is an expression of the physiological or pathophysiological state of muscles. Selection of the type of electrode used during these measurements is based upon several factors, including the location of the muscle of interest, the need for specificity, and the requirement of minimization of cross-talk between adjacent muscles. Pneumothorax is a serious complication of needle EMG. Here, we present a 19-year-old patient who suffered bilateral pneumothoraces as a complication of needle EMG. She has a history of weakness and limitation of abduction on her right shoulder for three years. EMG was ordered by orthopedic surgeon to determine whether a dorsal scapular or long thoracic nerve paralysis caused these symptoms. She was brought to our emergency department (ED) with the complaints of diaphoresis and dyspnea which began after needle EMG was performed two hours ago. A chest X-ray revealed bilateral small pneumothoraces and was confirmed by computed thoracic tomography scan. Patient was admitted to observation unit in ED. Thoracic ultrasonography was preferred to follow up the patient. After five days, pneumothoraces were dissolved on bilaterally and the patient was discharged to home. Iatrogenic pneumothorax is a complication observed at various clinical fields. Emergency physician must consider this possibility in patients admitted with dyspnea after needle EMG.
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