Method for determining muscle dysfunction

• US 5,505,208 A
• Filed: 12/10/1993
• Issued: 04/09/1996
• Est. Priority Date: 12/10/1993
• Status: Expired due to Fees

• Current Assignee: Toomin Research Group
• Original Assignee: Toomin Research Group
• Inventors: Levendowski, Daniel, Toomim, Hershel, Appel, Gerald D., Kasten, John D.
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US08/166,347
• Time in Patent Office: 851 Days
• Field of Search: 128/733, 128/734, 128/774, 128/781, 128/782
• US Class Current: 600/546
• CPC Class Codes: A61B 5/389 Electromyography [EMG]

Abstract

A method for collecting back muscle dysfunction which comprises collecting electrical muscle activity measurements by applying a plurality of electrodes in a pattern across a patient'"'"'s back or test subject'"'"'s back, and measuring the electrical activity at each of these electrodes and storing these measurements at the same time. The database of these sets of measurements from the number of individuals is generated so that a normative sample for comparison is formed. A patient'"'"'s back muscle activity is quantified by collecting electrical muscle activity measurements for the patient and comparing the patient'"'"'s electrical muscle activity measurements ratios to the sample average ratios of the normative group.

Claims

1. A method for determining back muscle dysfunction of a patient, comprising the steps of:

(a) placing pairs of left and right electrodes in the areas adjacent pairs of upper, middle and lower back muscles, such as the cervical paraspinal muscles, the upper trapezius muscles, the middle trapezius muscles, the teres major muscles, the thoracic paraspinal muscles, the latissimus sorsi muscles, the obliquus externus muscles, and the lumbar paraspinal muscles, of the patient for measuring electrical muscle activities of the muscle areas thereof;

(b) choosing different patient positions that require different muscle activity that is normally bilaterally symmetric;

(c) choosing pairs of different patient positions that normally require different bilaterally reversed symmetric muscle activity;

(d) causing the patient to assume each of the patient positions for a fixed length of time;

(e) sampling the amplitudes of electrical activity of the patient multiple times with the electrodes during the time when the patient is in each of the plurality of patient positions, the electrical muscle activity simultaneously indicating the functionality and consequent compensating relationships of the muscles in the upper, middle and lower back of the patient;

(f) calculating ratio data by determining the logarithm ratio of selected and weighted measures of the electrical muscle activity to selected and weighted other measures of the electrical muscle activity for the patient;

(g) comparing the logarithmic ratios calculated for the patient to a database of average logarithmic ratios for a plurality of individuals having no symptomatic back dysfunction; and

(h) determining from the magnitude of differences in the logarithmic ratio comparison whether back muscle dysfunction exists in the patient for each muscle area of the patient at which an electrode was placed.

2. The method for determining back muscle dysfunction of a patient according to claim 1, wherein step (h) includes:

detecting abnormal patient ratio data to determine if the absolute magnitude of the difference between abnormal patient ratio data and ratio data is greater than or equal to an empirically determined value.

3. The method for determining back muscle dysfunction of a patient according to claim 2, wherein step (e) includes:

(e1) sampling respective electrical muscle area activity for a plurality of corresponding muscles, and wherein step (f) includes;

(f1) calculating a plurality of ratios for a first muscle area, each of said ratios respectively including the ratio of a measure of electrical muscle activity of the first muscle area to a measure of electrical muscle activity of a selected one of the other muscle areas.

4. The method for determining back muscle dysfunction of a patient according to claim 3, wherein step (h) includes:

(h1) determining a measure of back muscle dysfunction derived from the kinesiological relationship between corresponding patient areas for abnormal ratio data.

5. The method for determining back muscle dysfunction of a patient according to claim 1 wherein step (h) includes:

(h1) determining a measure of back muscle dysfunction for each muscle area corresponding to abnormal ratio data within a movement.

6. The method for determining back muscle dysfunction of a patient according to claim 5, wherein step (h) includes:

(h2) determining the severity of dysfunction of a muscle area derived from the number of movements for which there is a measure of back muscle dysfunction for the muscle area and combined magnitude of corresponding measures of back muscle dysfunction for the muscle area.

7. The method defined in claim 1 wherein step (d) includes:

(d1) causing the patient to assume each of the fixed patient positions for a fixed length of time multiple times, and wherein step (e) includes;

(e1) sampling the amplitudes of electrical activity of the patient a plurality of times with the electrodes during the times when the patient is in each of the plurality of fixed positions.

8. The method defined in claim 1 including the additional step of:

(i) determining the impedance of the patient from the electrodes to the muscle areas, and wherein step (g) includes;

(g1) adjusting the measured amplitude of electrical activity in accordance with the determined impedance of the patient.

9. The method defined in claim 8 wherein the determination of step (i) includes:

(i1) measuring the thickness of the adipose layer of the patient to determine the impedance.

10. The method defined in claim 8 wherein the determination of step (i) includes:

(i1) measuring the thickness of the adipose layer of the patient to determine the impedance.

11. The method defined in claim 1 wherein step (h) includes:

(h1) determining from the magnitude of deviation in the logarithmic ratios, at least two levels of muscle dysfunction that indicate treatment is advisable and to what muscle areas.

12. The method defined in claim 11 wherein step (h) includes:

(h1) weighting the patient'"'"'s logarithmic ratios for various muscle areas in accordance with the muscle areas kinesiological relationships so that the compensating relationships for the patient'"'"'s dysfunctional muscles can be determined.

13. The method defined in claim 12 including the additional step of:

(i) mapping the severity of the patient'"'"'s compensating relationships for each of the patient'"'"'s positions to graphically illustrate the muscle dysfunction and assist in selection of an appropriate course of therapy.

14. The method defined in claim 12 wherein step (g) includes:

(g1) generating the database of average logarithmic ratios for a plurality of individuals having no symptomatic back dysfunction by for each of the plurality of individuals;

placing pairs of left and right electrodes thereon in the areas adjacent pairs of upper, middle and lower back muscles, that are to be used in patient testing;

causing the individual to assume each of the patient positions for the fixed length of time;

sampling the amplitudes of electrical activity of the individual multiple times with the electrodes during the time when the individual is in each of the plurality of patient positions;

calculating ratio data by determining the logarithm ratio of selected and weighted measures of the electrical muscle activity to selected and weighted other measures of the electrical muscle activity for the individual; and

averaging the logarithmic ratios calculated for the individual into the database of average logarithmic ratios for a plurality of individuals having no symptomatic back dysfunction.

15. A method for determining back muscle dysfunction of a patient, comprising the steps of:

(a) placing pairs of left and right electrodes in the areas adjacent pairs of upper, middle and lower back muscles of the patient for measuring electrical muscle activities of the muscle areas thereof;

(b) choosing different patient positions that require different muscle activities that are normally bilaterally symmetric;

(c) choosing pairs of different patient positions that normally require different bilaterally reversed symmetric muscle activities;

(d) causing the patient to assume each of the patient positions for a fixed length of time;

(e) sampling the amplitudes of electrical activity of the patient multiple times with the electrodes during the time when the patient is in each of the plurality of patient positions, the electrical muscle activity simultaneously indicating the functionality and consequent compensating relationships of the muscles in the upper, middle and lower back of the patient;

(f) calculating ratio data by determining a function ratio of selected and weighted measures of the electrical muscle activity to selected and weighted other measures of the electrical muscle activity for the patient, the function emphasizing low electrical muscle activity with respect to high electrical muscle activity;

(g) comparing the function ratios calculated for the patient to a database of average function ratios for a plurality of individuals having no symptomatic back dysfunction; and

(h) determining from the magnitude of differences in the function ratio comparison whether back muscle dysfunction exists in the patient for each muscle area of the patient at which an electrode was placed.

16. The method defined in claim 15 wherein step (d) includes:

(d1) causing the patient to assume each of the fixed patient positions for a fixed length of time multiple times, and wherein step (e) includes;

(e1) sampling the amplitudes of electrical activity of the patient a plurality of times with the electrodes during the times when the patient is in each of the plurality of fixed positions.

17. The method defined in claim 15 including the additional step of:

(i) determining the impedance of the patient from the electrodes to the muscle areas, and wherein step (g) includes;

(g1) adjusting the measured amplitude of electrical activity in accordance with the determined impedance of the patient.

18. The method defined in claim 15 wherein step (h) includes:

(h1) determining from the magnitude of deviation in the function ratios, at least two levels of muscle dysfunction that indicate treatment is advisable and to what muscle areas treatment should affect.

19. The method defined in claim 18 wherein step (h) includes:

(h1) weighting the patient'"'"'s function ratios for various muscle areas in accordance with the muscle areas kinesiological relationships so that the compensating relationships for the patient'"'"'s dysfunctional muscles can be determined.

20. The method defined in claim 19 including the additional step of:

(i) mapping the severity of the patient'"'"'s compensating relationships for each of the patient'"'"'s positions to graphically illustrate the muscle dysfunction and assist in selection of an appropriate course of therapy.

21. A method for determining back muscle dysfunction of a patient, comprising the steps of:

(a) placing pairs of left and right electrodes in the areas adjacent pairs of upper, middle and lower back muscles of the patient for measuring electrical muscle activities of the muscle areas thereof;

(b) choosing different patient positions that require different muscle activities to maintain such positions that are bilaterally symmetric in individuals without back muscle dysfunction;

(c) choosing pairs of different patient positions that require different bilaterally reversed symmetric muscle activities to maintain such positions in individuals without back muscle dysfunction;

(d) causing the patient to assume each of the patient positions for a fixed length of time;

(e) sampling and storing the amplitudes of electrical activity of the patient multiple times with the electrodes during the time when the patient is in each of the plurality of patient positions, the electrical muscle activity simultaneously indicating the functionality and consequent compensating relationships of the muscles in the upper, middle and lower back of the patient;

(f) calculating ratio data by determining a function ratio of selected and weighted measures of the electrical muscle activities to selected and weighted other measures of the electrical muscle activity for the patient, the function emphasizing low electrical muscle activity with respect to high electrical muscle activity;

(g) comparing the function ratios calculated for the patient to a database of average function ratios for a plurality of individuals having no symptomatic back dysfunction;

(h) determining from the magnitude of differences in the function ratio comparison whether abnormal back muscle activity exists in the patient for each muscle area of the patient at which an electrode was placed;

(i) if in step (h) abnormal back muscle activity is determined, then multiply the function ratio by a kinesiological weighting factor which corresponds to the kinesiological relationship between the muscle areas in the function ratio;

(j) determine if the determined abnormal back muscle activity is consistent with different patient positions; and

(k) display consistently determined abnormal back muscle activity.

22. The method defined in claim 21 wherein step (e) includes:

(e1) determining the impedance of the patient from the electrodes to the muscle areas; and

(e2) adjusting the stored amplitude of electrical activity in accordance with the determined impedance of the patient.

23. The method defined in claim 21 wherein step (k) includes:

(k1) displaying consistently determined hyperactive dysfunctional back muscle area activity;

(k2) displaying consistently determined hypoactive dysfunctional back muscle area activity;

(k3) displaying consistently determined compensating hyperactive back muscle area activity; and

(k4) displaying consistently determined symptomatic hypoactive back muscle area activity.