title: Preliminary evaluation of the sensitivity to change of DE-STA motor unit number estimation in the upper trapezius muscle in amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  To compare the sensitivity to change of decomposition-enhanced spike-triggered averaging (DE-STA) motor unit number estimation (MUNE) in the upper trapezius (UT) to that of various clinical outcome measures in subjects with amyotrophic lateral sclerosis (ALS).
  
  
  METHODS
  Ten patients with clinically probable or definite ALS were assessed at baseline, 2, 4 and 6months with the following outcome measures: manual muscle testing in five upper extremity muscle groups, scapular elevation and elbow flexion peak force measured with hand-held dynamometry, MUNE, forced vital capacity and the Revised ALS Functional Rating Scale (ALSFRS-R).
  
  
  RESULTS
  ALSFRS-R was the only outcome measure for which there was a significant difference between baseline and 6months (p=0.034). ALSFRS-R had the largest standardized response mean (SRM), and was thus the most sensitive to change. MUNE demonstrated a decline over 6months and a moderate SRM (-0.63).
  
  
  CONCLUSIONS
  This study has demonstrated a moderate degree of sensitivity to change for DE-STA MUNE as applied to the UT in subjects with ALS.
  
  
  CONCLUSIONS
  In this preliminary study, DE-STA MUNE detected motor unit loss over 6months, with a moderate degree of sensitivity, in the upper trapezius of subjects with ALS.
authors.affiliation: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada.
authors.forename: Colleen T
authors.initials: CT
authors.lastname: Ives
authors.affiliation: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Findlater
authors.affiliation: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada.
authors.forename: Christen L
authors.initials: CL
authors.lastname: Shoesmith
authors.affiliation: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Western University, London, Ontario, Canada. Electronic address: tim.doherty@lhsc.on.ca.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Doherty
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis / Q000503:physiopathology*; D004576:Electromyography / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000473:pathology / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology; D053581:Muscle Strength Dynamometer; D009410:Nerve Degeneration / Q000473:pathology / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D012044:Regression Analysis; D012720:Severity of Illness Index; D064171:Superficial Back Muscles / Q000294:innervation* / Q000503:physiopathology; D014797:Vital Capacity / Q000502:physiology
keywords: Amyotrophic lateral sclerosis (ALS); Decomposition-based quantitative electromyography (DQEMG); Decomposition-enhanced spike-triggered averaging (DE-STA); Motor unit number estimation (MUNE); Sensitivity to change; Trapezius muscle