Faculty Bibliography

OBJECTIVE: An apparatus and procedure are described to determine position specific normalization coefficients for surface EMG of upper extremity musculature. STUDY DESIGN: Thirty-nine subjects were tested three times. Repeatability of EMG measurements across test sessions was determined by computing intraclass correlation coefficients. Two-way analysis of variance was used to test upper extremity position dependent differences in EMG measurements. BACKGROUND: EMG measurements are susceptible to error from skin movement and muscle length changes, both of which may occur when upper extremity positions vary. Normalization of the EMG signal without consideration for such positional influences may lead to erroneous conclusions regarding muscle activation during functional tasks. METHOD: An apparatus was designed that allowed subjects to perform three repetitions of maximum elbow flexion, forearm pronation, wrist extension, and wrist flexion with the forearm in neutral and pronated positions. Surface EMG was sampled from eight muscles. Mean EMG on maximum voluntary contraction was computed, and resting EMG was subtracted to obtain EMG normalization coefficients. RESULTS: Upper extremity position affected the EMG normalization coefficient for biceps brachii, which was lower in the pronated position, and extensor carpi radialis, which was higher in the pronated position (P<0.00625). CONCLUSIONS: The apparatus accommodates various combined positions of the elbow, forearm and wrist. The normalization procedure is efficient for testing subjects who are being observed during functional tasks. Only two muscles were affected by upper extremity position, but group trends were not always consistent with individual behavior. This method would ensure the use of appropriate EMG normalization coefficients regardless of individual variation. RELEVANCE: This method is effective for normalizing EMG signals using task specific upper extremity positions. It may be used to test isometric exertions of distal upper extremity musculature for clinical and research purposes

The measurement of the avidity of cytomegalovirus (CMV) immunoglobulin G (IgG) antibodies has been shown by several investigators to be useful in identifying and excluding primary CMV infections in pregnant women. In this work, we examined the diagnostic utility of reflex testing of CMV IgM-positive specimens from pregnant women by using a CMV IgG avidity assay. The utility of this approach was directly dependent on the sensitivity of the CMV IgM assay employed during the initial screen. The higher initial reactivity rate of the AxSYM CMV IgM assay was necessary in order to detect CMV IgM in specimens containing low-avidity CMV IgG antibodies, indicative of a primary CMV infection, which other CMV IgM assays (Behring, Vidas, Captia, and Eurogenetics) fail to detect in some cases. The use of the AxSYM CMV IgM assay, followed by an avidity test, should result in more accurate diagnosis of CMV infection in pregnant women

This paper describes a structural sequential process aimed to enhance the quality of life of a 29 year old man through the application of assistive technology (AT). The client had life-long severe multiple disabilities, showed increasing fragility and decreasing functional abilities that resulted, among other problems, in a problem with toileting. The process involved a thorough assessment and evaluation of the client, his physical, cognitive and perceptual skills involved in the performance of the task, requirements of the task, the technology, and the task environment. A clinical reasoning model for the provision of AT was applied during the process to identify the functional deficits of the client with respect to the problematic task. The approach enabled a multidisciplinary team of university-affiliated professionals including physical and occupational therapists, an ergonomist, a rehabilitation engineer and care providers in an institution for developmentally disabled people to determine the primary attributes of a technological intervention. The process resulted in the selection of an appropriate piece of AT followed by its modification and adaptation in order to address the specific needs of the client. The client's toilet use was improved in a manner that ultimately contributed to enhancing the quality of his life. Projections for further improvements of the quality of life of the client in this institution were also discussed

A study is summarized analyzing the levels of serum antibodies against vaccination antigens in 43 children treated for acute lymphoblastic leukemia. Two different therapeutical regimens were used. All children had been immunized against measles and rubella before being diagnosed with leukemia. Eight of the 24 children treated 1986-1991 lacked protective levels of antibodies against measles; four of the 24 children lacked antibodies against rubella. In the second cohort of children (n = 16) treated from 1992 and onwards, nine lacked protective levels of antibodies against measles, eight lacked antibodies against rubella

The purpose of this project was to develop a streamlined upper extremity examination to be used in a company-based upper extremity CTD management program. Thirty-six symptomatic employees were examined by an occupational health nurse and categorized into those requiring further medical evaluation or those appropriate for conservative management. Backward logistic regression showed that the Appearance and Symmetry (AS) and the Neurological and Special Tests (NST) sections of the examination together explained 86.1 % (p = 0.002) of the nurses categorical decisions. Based on these preliminary development data, a short screening examination was proposed