Article

Electromyography (EMG) and musculoskeletal (MSK) ultrasound (US) are
core learning objectives during physical medicine and rehabilitation (PM&R)
training. However, there have been no prior studies using MSK US to assess the
acquisition of EMG procedural skills during residency training. This study aims
to demonstrate the differences in skillful needle placement between junior and
senior physiatry residents. The integration of both EMG and MSK US may have
tremendous potential for additional learning opportunities related to
electrodiagnostic education. OBJECTIVE: To determine the accuracy of anatomic
landmark-guided EMG needle electrode placement in commonly used muscles by PM&R
resident physicians. DESIGN: Cross-sectional study. SETTING: An academic PM&R
residency program. PARTICIPANTS: Twelve (5 postgraduate year [PGY] -3 and 7
PGY-4) PM&R resident physicians participating in a MSK US training course.
METHODS: Twelve PM&R residents in the eighth month of their third and fourth
years of postgraduate training performed anatomic landmark-guided needle
placement to the extensor indicis proprius (EIP), pronator teres (PT), peroneus
longus (PL), and soleus muscles of live subjects. Once the needle electrode was
satisfactorily placed, needle localization was verified with US. MAIN OUTCOME
MEASURES: Accuracy of EMG needle electrode placement. RESULTS: The overall
accuracy of needle electrode placement for all resident participants was 68.8%.
The mean accuracy of the 4 selected muscles was 50% by PGY-3 residents and 82.1%
for PGY-4 residents (P = .01). EIP was the most commonly missed muscle, with
correct placement performed by 20% of PGY-3 and 42.9% of PGY-4 residents. PGY-3
residents demonstrated 60% accuracy with localizing the PT, PL, and soleus
muscles. PGY-4 residents demonstrated 85.7% accuracy for PT, and 100% accuracy
for both PL and soleus muscles. CONCLUSIONS: Senior residents demonstrated
greater accuracy of landmark-guided needle placement than junior residents. EMG
procedural skills are important milestones in PM&R training, and MSK US may be a
useful tool to enhance resident learning.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS