Modifica di Clinic Electromyography (sezione)

====Quantitative MUP Parameter Analysis====
Using the multiMUP analysis system, normative data has been collected from normal subjects. The examined muscles are the biceps brachii, deltoid, interosseous, vastus lateralis, and tibialis anterior.<ref name="Sacco" /> The parameters examined include amplitude, duration, area, thickness, size index, number of turns, and number of phases. The amplitude values for the biceps muscle were larger at 436 ± 115 μV compared to those reported by Buchtal (1962) at 175 ± 20 μV. These differences can be interpreted by the different modes of voluntary activation required in the two methods.

In an attempt to identify parameters that make the diagnostic value of EMG analysis significant and emphasize differences, the concept of "outlier" has been applied to MUP analysis, and its statistical significance has been established. For each MUP parameter, significance has been established for the upper and lower limits.<ref name="Henneman">Henneman E., Clamann HT, Gillus JD, Skinner RD.: Rank order of motor neurons within a pool: law of commination. J. Neurophysiol 1974; 37: 1338-49.</ref> The third lowest and third highest value of each parameter from the analysis of 20 consecutive MUPs were considered outliers for that subject, representing the 90th and 10th percentiles. Individual outlier values of each parameter were evaluated using regression analysis to study changes related to age.

Based on this definition, no more than two values above or below the limits were found in normal subjects. To assess the sensitivity of the outlier as a diagnostic tool, the system was applied to patients with neuropathies and myopathies (Figs. 3, 4).<gallery mode="slideshow">
File:Figure 3 ( Iani).jpg| '''Figure 3:''' Myopathic-type motor unit potentials (analyzed with the multiMUP method) show reduced amplitude and duration with an increase in the number of turns. 
File:Figure 4 (Iani).jpg| '''Figure 4:''' Neurogenic-type motor unit potentials show increased amplitude and duration with an increase in the number of phases. 
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