
![]() |
MUSCLE PATTERN RECOGNITION (MPR) | |||
| Muscle Pattern Recognition (MPR) is a unique clinical tool for the analysis of muscle function. The MPR System analyzes patterns of muscle recruitment and provides detailed physiological information on muscle function that can assist in the diagnosis and treatment of back and neck injuries and illness. Brief History of Muscle Pattern Recognition Pattern Recognition has been described as the research area that studies the operation and design of systems that recognize patterns in data. Pattern Recognition has been in use for many years in a number of different areas including statistics, artificial intelligence, neural networks, speech recognition, engineering and medical science. In the area of medical science, Pattern Recognition is being used in the diagnosis of breast cancer, cerebrovascular disease, retinal microcirculation, macular disease; the classification of pulmonary disease; automatic interpretation of chest x-ray films, and; is the basis for computer-aided diagnosis (CAD) systems that support a physician’s interpretations and findings. Recently, in an effort to customize medical treatments to individual patients, the Mayo Clinic and IBM have started to apply Pattern Recognition and data mining to the electronic records of about 4.4 million Mayo patients.The MPR System is a unique clinical tool that uses the principles of Pattern Recognition by comparing a patient’s MPR test results against specific patterns in the Company’s proprietary normative database.Central to the MPR System is the fact that muscles in the back and neck function as an interactive system. In order to determine whether a particular muscle is functioning normally or abnormally, it must be examined in concert with all of the other muscle groups required for the body to make specific movements. Muscles also interact in a predictable manner that can be expressed in a kinesiological relationship.These principles have been incorporated into the MPR test, and form the basis behind this unique, patented system that measures the relationships among muscles during a given movement. By comparing relationships of muscles, MPR is able to normalize subjects with each other. The standardized protocols of movement that make up the MPR test provide the ability to compare patient results to the normative database. When patients replicate the carefully administered, standardized movements performed by subjects in the normal database, a valid and highly accurate comparison can be made. The comparison of a patient's patterns with those of "normal" subjects is the basis of the evaluation. DEVICE DESCRIPTION Muscle Pattern Recognition (MPR) Innovative medical testing modality that objectively and quantitatively measures biomechanical status associated with musculoskeletal injuries (strains and sprains) of the neck and back
Biomechanics and Kinesiology Three scientific papers have been accepted and published in peer review journals discussing the underlying kinesiological principles behind the MPR technology
iTech Medical has performed extensive clinical research which provides evidence that altered muscle recruitment patterns can reliably and safely be measured with the use of non-invasive surface electromyography (sEMG). Many other authors have also published the effectiveness of sEMG as a tool to differentiate normal from “not-normal” musculoskeletal back conditions in individuals with pain. Measuring individual muscle activity or just static structures alone, however, has historically been insufficient to completely assess the complexity of the neck and back physiologic interactionsMPR uniquely measures dynamic muscle patterns in a specific manner to identify the functional/biomechanical status of the neck and back much as an electrocardiogram (EKG) measures dynamic muscle patterns of the heart to identify clinically relevant cardiac problems. MPR Components and the Procedure for Use
Preliminary Performance Results Using the MPR technology to discriminate between a clinically asymptomatic population and one diagnosed with sprain/strain injuries of the neck and back, peer-reviewed publications have reported the following classification performance results for the MPR system: Proposed Intended UseiTech Medical’s Muscle Pattern Recognition (MPR) test is intended to provide detailed and quantitative physiologic measurements of the musculoskeletal function to assist in the diagnosis and treatment of neck and back dysfunctions. The MPR technology is non-invasive. It uses 15 conventional (versus proprietary) surface EMG electrodes placed at pre-specified, measured locations on the patient’s neck, mid-back, and low back. The MPR technology analyzes dynamic muscle patterns of coordinated muscle contractions simultaneously recorded from 7 different muscle groups (14 muscles) as the subject performs 9 pre-defined specific body movements enabling quantitative discrimination between normal and abnormal muscle function, thus objectively characterizing the physical dysfunction associated with neck and back pain. On the MPR system, those muscle groups that are abnormally weak will contract with a less-than-normal or hypo-kinetic activity. Those muscle groups that are abnormally active (in spasm) will produce a greater-than-normal or hyper-kinetic activity. These different areas of recruitment are demonstrated on the MPR report, which also designates any interacting or compensating muscle groups in the area surrounding that muscle or group of muscles that are abnormal. This graphic display of muscle abnormality can more appropriately establish a rehabilitative protocol that will strengthen those areas of muscular hypoactivity (weakness) and reduce those areas of muscular hyperactivity. Background Current Unmet Clinical Need Currently, physicians and other health care providers diagnose and treat patients with back and neck injuries based on indirect, subjective data and a battery of traditional “anatomical” tests which includes:
These anatomical studies, however, can show significant abnormalities in individuals who are asymptomatic or have no specific history of neck or back pain. Large disc herniations, extensive spinal stenosis, and marked degenerative changes can be seen in totally asymptomatic patients and do not correlate well with, or necessarily have any direct relationship to, a patient’s possible pain experience. These imaging tests may show what exists anatomically, however, these medically accepted clinical studies of anatomic abnormalities are not always associated with clinical dysfunctions. These anatomical tests typically do rule-out certain specific pathological causes of pain or dysfunction such as tumors, infections, fractures, or disc herniations, but an accurate, objective diagnosis may still remain unknown for greater than 80% of patients with low back pain. As a result, many of these individuals with pain remain in the healthcare system far too long and incur unnecessarily high healthcare utilization costs. iTech Medical has performed extensive clinical research that provides evidence that MPR evaluations will allow a physician and other health care providers, for the first time, to actually identify and quantify the specific underlying physiological and biomechanical dysfunctions that correspond to an individual’s subjective complaints or causes of their functional loss. In the Currently, physicians and other health care providers diagnose and treat this large segment of the neck and back injured population with indirect, subjective data and a battery of traditional “anatomical” tests such as CT and MRI scans, X-rays, needle insertion EMG, bone Scans, discograms, etc. that will, at best, only rule out certain specific pathological causes of pain or dysfunction such as tumors, fractures, infections, or disc herniations. Spratt, et al, have commented that an accurate diagnosis is unknown for between 80%-90% of patients with low back pain.[1] In addition, many of these anatomical image findings can be seen in totally asymptomatic individuals and do not correlate well with, or necessarily have any direct relationship to, a patient’s possible pain experiences.[2] These diagnostic imaging tests may show what exists anatomically, but anatomic abnormalities are not always associated with clinical dysfunctions, as many cases of back and neck pains are thought to result from soft tissue injuries that implicate muscles, tendons, and/or ligaments. Unfortunately, without definitive tests or other objective assessment tools, health care providers must base their diagnoses and treatment decisions on subjective data that may be open to possible differing interpretations by other such providers. [1] Spratt, KF, Lebmann, TR, Weinstein, JN, & Sayne, HA; A new approach to the Low Back Physical Examinations. Spine, vol. 15, pp 96-102, 1990 [2] Jensen, JC, Previous anecdotal studies of the MPR System assess the practical aspects of using the test in real-world medical settings. These studies included:
These studies resulted in the publication of three scientific papers in three peer-reviewed journals. Peer-Reviewed Publication Three papers on the MPR system have been published in peer-reviewed journals. The studies reported in these papers have been subjected to scrutiny by the scientific community and were accepted for publication after extensive peer review. They validate the scientific basis for MPR, establish a normative model, and document its classification accuracy. A synopsis of the three papers follows: Evaluating Patterns of EMG Amplitudes for Trunk and Neck Muscles of Patients and Controls V. Reggie Edgerton, Steven L. Wolf, Daniel J. Levendowski and Roland R. Roy KEYWORDS: surface electromyography, muscle dysfunction, muscle ratios, muscle patterns, back pain We used ratios of EMG amplitudes to characterize neural strategies of motoneuron recruitment for seven bilateral muscle groups of the back and neck during nine motor tasks to discriminate patients who sustained sprain/strain injuries (n=61) from a control population (n=400). Compensatory relationships between muscle pairs improved the predictability of hypoactivity or hyperactivity based on the probability distribution of muscle rations obtained from uninjured subjects. We defined severity of hypoactive or hyperactive EMG activity by (a) the number of ratios that exceeded the normal range (95% confidence interval), (b) the compensatory relationship between these muscle pairs during each motor task, and (c) the consistency and frequency of hypoactivity or hyperactivity across nine motor tasks. Accuracy of the classification system was 88% with a specificity of 90% and a sensitivity of 70%. Between-session reliability for the overall classification of 40 controls and 44 patients was 93%. These results indicate that muscle ratios can objectively quantify altered strategies of motoneuron recruitment attributed to muscle trauma and pain common to sprain/strain injuries. Theoretical Basis for Patterning EMG Amplitudes to Assess Muscle Dysfunction V. Reggie Edgerton, Steven L. Wolf, Daniel J. Levendowski and Roland R. Roy KEYWORDS: surface electromyography, EMG, sprain/strain injuries, muscle dysfunction, muscle EMG ratios, muscle recruitment patterns, back pain A theoretical basis for assessing muscle dysfunction due to sprain/strain injuries is presented. We propose that muscle tissue trauma results in an alteration in the patterns of neural recruitment, a reduction in the force-generating capability of the injured muscle, and/or pain sensations. Furthermore, a lower than normal recruitment of motoneuron pools in the injured area can result in elevated recruitment levels from compensating motoneuron pools for a given motor task. It is proposed that these changes in motoneuron recruitment can be readily apparent in the rations of EMG amplitudes among multiple pairs of muscles associated kinesiologically with the affected muscle. Chronic compensating actions, such as those resulting from faulty neural feedback of the force-length-velocity relationships for a stretched tendon or muscle unit, could cause further injuries. It is proposed that consistent and valid measures of ratios of EMG amplitudes between many muscle pairs acquired for well-defined motor tasks can be used to facilitate diagnoses and direct treatment strategies for sprain/strain injuries and pain. EMG Activity in Neck and Back Muscles During Selected Static Postures in Adult Males and Females V. Reggie Edgerton, Steven L. Wolf, Daniel J. Levendowski and Roland R. Roy KEYWORDS: surface electromyography, EMG, sprain/strain injuries, muscle dysfunction, muscle EMG ratios, muscle recruitment patterns, back pain Surface electromyographic (EMG) amplitudes were gathered from 100 men and 100 women while maintaining the end range of nine motor tasks. Ratios of EMG amplitudes were used to characterize the activation patterns of 14 muscle groups of the back and trunk during 10 motor tasks. Procedures to identify electrode placement sites were developed to ensure reliability of all EMG recordings. Subcutaneous fat was estimated at each muscle site and a correction factor was used to account for signal attenuation due to the impedance attributable to adipose tissue thickness. Logarithmic transformations were performed to obtain a Gaussian distribution of the EMG amplitudes and muscle ratios. The transformed EMG amplitudes and transformed ratios were highly reliable between sessions across nine active motor tasks (Pearson's r and intra-class correlations ranged form 0.74 to 0.96). Significant gender differences were observed in the transformed EMG amplitudes and ratios of amplitudes in selected muscles and muscle pairs. It appears that the transformed EMG ratios represent a reliable means of assessing muscle recruitment patterns in a series of well-defined motor tasks in a large population of presumable normal adult male and female subjects. The acquisition of this large database under well-controlled conditions using defined criteria for each motor task provides a template to which individuals with injuries involving the neck and trunk musculature can be compared. The Latest News on Clinical Trial Updates NEWS RELEASE 06.10.2009 NEWS RELEASE 04.23.2009 For some of the documents, you will need Adobe Acrobat Reader. You can download the reader at this link: |
||||
|
|
||||
![]() |
||||