A literature review of the methodology of EMG recordings of the diaphragm
Received 28 July 2008; received in revised form 24 February 2009; accepted 26 February 2009. published online 08 May 2009.
Abstract
Introduction
EMG measurements of the diaphragm (rEMG) provide insight in to ventilatory muscle activity. Applicability of these measurements has improved, but literature of the different rEMG measurement techniques is inconsistent. This makes it difficult to compare studies of rEMG technique. This study summarizes the current available literature on rEMG and focuses on the validation of the techniques. Furthermore, we propose to use validation criteria to improve the quality, for further research.
Methods
Pubmed, Ovid Medline and EMBASE were searched for studies describing rEMG experiments with transcutaneous (tc-rEMG) and/or transesophageal (te-rEMG) methods.Validation criteria included feasibility, repeatability, signal disturbance and ECG gating.
Results
650 studies were eligible for reviewing; 211 were excluded, and 39 articles described the measurement technique and were analyzed according to the criteria. 194 studies referred to another paper with a description of the technique and 206 failed to describe the technique nor had references to it.
Conclusions
Many studies showed neither a description of the technique used, nor a validation of this technique. Others referred to studies that described the measurement technique. We propose that future studies on rEMG measurements at least meet the above mentioned criteria, in order to be able to compare study results.
Department of Paediatric Pulmonology, Academic Medical Centre (G8-211), Emma Children’s Hospital, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands