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Lab study in physical medicine and rehabilitation

Lab study in physical medicine and rehabilitation. 台北榮總復健醫學部 R4 程遠揚. Important Lab studies in physical medicine and rehabilitation. Nerve conduction study and electromyography Urodynamic study Cardiopulmonary exercise testing. Nerve Conduction study.

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Lab study in physical medicine and rehabilitation

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  1. Lab study in physical medicine and rehabilitation 台北榮總復健醫學部 R4 程遠揚

  2. Important Lab studies in physical medicine and rehabilitation • Nerve conduction study and electromyography • Urodynamic study • Cardiopulmonary exercise testing

  3. Nerve Conduction study • Tools: Stimulator, grounding electrode, reference electrode, recording electrode • Note the amplitude, duration, area, distal latency, and conduction velocity in each study

  4. Nerve conduction study • Amplitude: direct correlate to the axon fiber remained. Other reasons of amplitude drop includes: myopathy, neuromuscular junction disease, conduction block, or disuse atrophy • Conduction velocity: correlate to the integrity of nerve myelin. CMAP velocity is calculated by both distal and proximal stimulation. SNAP velocity is calculated directly by distal stimulation.

  5. Electromyography • Resting: observe if spontaneous activity including positive sharp wave or fibrillation presents • Minimal contraction: Observe each MUAP’s morphology, amplitude, and duration. • Assess the recruitment pattern

  6. Purpose for NCS/EMG • Determine the type of neuromuscular disease • Determine the lesion level • Determine the timing of the lesion • Determine the severity of the lesion

  7. Urodynamic study • Cystometry • Sphincter electromyography • Uroflometry • Urethral pressure profile

  8. Urodynamic study

  9. Purpose for urodynamic study • Evaluation the type of neurogenic bladder after CNS injuryUninhibited bladderSpastic bladderFlaccid bladder • Determine the severity of stress urinary incontinence • Determine the presence and severity of benign prostate hyperplasia

  10. Cardiopulmonary exercise testing • Evaluate the change of blood pressure, heart rate, and ventilation during graded exercise testing with increasing intensity • Determine the anaerobic threshold by plotting of exercise testing • Observe the peak exercise response. Determine the maximum oxygen consumption of the patient.

  11. V-slope method for anaerobic threshold

  12. Purposes for cardiopulmonary exercise testing • For reference of exercise program prescription • To evaluate the severity of cardiovascular disease and make suggestion for the intensity of activity of daily life or the necessity for medication modification or operation • To evaluate responses to cardiopulmonary rehabilitation program

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