title: Electrodiagnostic Evaluation of Individuals Implanted With Extracellular Matrix for the Treatment of Volumetric Muscle Injury: Case Series.
abstract: BACKGROUND
  Electrodiagnosis can reveal the nerve and muscle changes following surgical placement of an extracellular matrix (ECM) bioscaffold for treatment of volumetric muscle loss (VML).
  
  
  OBJECTIVE
  The purpose of this study was to characterize nerve conduction study (NCS) and electromyography (EMG) changes following ECM bioscaffold placement in individuals with VML. The ability of presurgical NCS and EMG to be used as a tool to help identify candidates who are likely to display improvements postsurgically also was explored.
  
  
  METHODS
  A longitudinal case series design was used.
  
  
  METHODS
  The study was conducted at the McGowan Institute for Regenerative Medicine at the University of Pittsburgh. Eight individuals with a history of chronic VML participated. The intervention was surgical placement of an ECM bioscaffold at the site of VML. The strength of the affected region was measured using a handheld dynamometer, and electrophysiologic evaluation was conducted on the affected limb with standard method of NCS and EMG. All measurements were obtained the day before surgery and repeated 6 months after surgery.
  
  
  RESULTS
  Seven of the 8 participants had a preoperative electrodiagnosis of incomplete mononeuropathy within the site of VML. After ECM treatment, 5 of the 8 participants showed improvements in NCS amplitude or needle EMG parameters. The presence of electrical activity within the scaffold remodeling site was concomitant with clinical improvement in muscle strength.
  
  
  CONCLUSIONS
  This study had a small sample size, and participants served as their own controls. The electromyographers and physical therapists performing the evaluation were not blinded.
  
  
  CONCLUSIONS
  Electrodiagnostic data provide objective evidence of physiological improvements in muscle function following ECM placement at sites of VML. Future studies are warranted to further investigate the potential of needle EMG as a predictor of successful outcomes following ECM treatment for VML.
authors.affiliation: N. Han, MD, PhD, Department of Physical Medicine and Rehabilitation, University of Pittsburgh, and Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Busan, Republic of Korea.
authors.forename: Nami
authors.initials: N
authors.lastname: Han
authors.affiliation: M.A. Yabroudi, PT, MS, Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Yabroudi
authors.affiliation: K. Stearns-Reider, PT, PhD, Department of Physical Medicine and Rehabilitation, University of Pittsburgh, and McGowan Institute for Regenerative Medicine, University of Pittsburgh.
authors.forename: Kristen
authors.initials: K
authors.lastname: Stearns-Reider
authors.affiliation: W. Helkowski, MD, Department of Physical Medicine and Rehabilitation, University of Pittsburgh.
authors.forename: Wendy
authors.initials: W
authors.lastname: Helkowski
authors.affiliation: B.M. Sicari, PhD, McGowan Institute for Regenerative Medicine, University of Pittsburgh, and Department of Surgery, University of Pittsburgh.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Sicari
authors.affiliation: J.P. Rubin, MD, McGowan Institute for Regenerative Medicine, University of Pittsburgh; Department of Plastic Surgery, University of Pittsburgh; and Department of Bioengineering, University of Pittsburgh.
authors.forename: J Peter
authors.initials: JP
authors.lastname: Rubin
authors.affiliation: S.F. Badylak, MD, PhD, DVM, McGowan Institute for Regenerative Medicine, University of Pittsburgh, and Department of Surgery, University of Pittsburgh.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Badylak
authors.affiliation: M.L. Boninger, MD, Department of Physical Medicine and Rehabilitation, University of Pittsburgh, and McGowan Institute for Regenerative Medicine, University of Pittsburgh.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.affiliation: F. Ambrosio, PhD, MPT, Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 450 Technology Dr, Ste 308, Bridgeside Point Bldg II, Pittsburgh, PA 15219 (USA); McGowan Institute for Regenerative Medicine, University of Pittsburgh; Department of Physical Therapy, University of Pittsburgh; and Department of Microbiology and Molecular Genetics, University of Pittsburgh. ambrosiof@upmc.edu.
authors.forename: Fabrisia
authors.initials: F
authors.lastname: Ambrosio
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D004576:Electromyography; D005109:Extracellular Matrix; D005260:Female; D048091:Guided Tissue Regeneration; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000293:injuries* / Q000294:innervation / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology*; D054457:Tissue Scaffolds