title: Surface electromyography for respiratory assessment of liver transplant candidates, healthy subjects and after chevron post-operative incision.
abstract: BACKGROUND
  Surface electromyography is a noninvasive technique for detecting the activity of skeletal muscles and especially the muscles for respiratory compliance; namely, the diaphragm and rectus abdominis. This study compares these muscles in healthy individuals, liver disease patients, and after abdominal surgery.
  
  
  OBJECTIVE
  To study muscle activity by surface electromyography of the right diaphragm muscles and right rectus abdominis (root means square, RMS), and the manovacuometry muscle strength (maximal inspiratory pressure, MIP; and maximal expiratory pressure, MEP).
  
  
  RESULTS
  We evaluated 246 subjects who were divided into 3 groups: healthy (65), liver disease (171), and post-surgery (10). In liver disease group the BMI was higher significantly for ascites (P = .001), and was increase in RMS rectum (P = .0001), RMS diaphragm (P = .030), and a decreased inspiratory and expiratory indices (P = .0001) pressure in the post-surgery group. A multivariate analysis showed tendency to an increased BMI in liver disease and in the post-surgery groups correlated with an increased RMS rectum and the lower MIP/MEP (P = .11). The receiver operating characteristic curve showed that RMS rectus was capable of discriminating liver disease and post-surgery patients from healthy subjects (area = 0.63; 95% CI 0.549-0.725).
  
  
  CONCLUSIONS
  The muscle activity of normal individuals is lower than in subjects with deficit muscles because less effort is necessary to overcome the same resistance, observed by surface electromyography and muscle strength.
authors.affiliation: Department of Surgery, Liver Transplant Program, State University of Campinas, Campinas, Brazil.
authors.forename: A M
authors.initials: AM
authors.lastname: Oliveira Da Silva
authors.affiliation: Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
authors.forename: D C
authors.initials: DC
authors.lastname: Dos Santos
authors.affiliation: Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Limongi
authors.affiliation: Department of Internal Medicine Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Cliquet
authors.affiliation: Department of Surgery, Faculty of Medical Science, State University of Campinas, Campinas, Brazil. Electronic address: ilkaboin@yahoo.com.
authors.forename: I F S F
authors.initials: IF
authors.lastname: Boin
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003964:Diaphragm / Q000502:physiology* / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011184:Postoperative Period; D011312:Pressure; D011446:Prospective Studies; D012372:ROC Curve; D017568:Rectus Abdominis / Q000502:physiology* / Q000503:physiopathology; D055815:Young Adult