Medical Instruments II (Third class)

Prepared by

Dr. Saad Mutashar Abbas

2024-2025
Electromyograph (EMG)

Lecture 5

Dr. Saad Mutashar Abbas

2024-2025
Purpose
An electromyograph (EMG) is an instrument used to study neuromuscular condition and function,
extent of nerve lesion, reflex responses, etc. It is specifically used for recording the electrical activity
of the muscles to determine whether the muscle is contracting or not. EMG measurements are
important for the myoelectric control of prosthetic devices (artificial limbs). Electromyography is the
technique that deals with the detection, analysis, and use of the electrical signal that emanates from
the muscles. The resultant record obtained via the electromyograph is known as electromyogram.

Principle
EMG Signal
The EMG signal is the electrical manifestation of the neuromuscular activation associated with a
contracting muscle. The activity is similar to that observed in the cardiac muscle, but in the skeletal
muscle, repolarization takes place much more rapidly, the action potential lasting only a few
milliseconds. The signal is effected by the anatomical and physiological properties of muscles and
the control scheme of the nervous system.
The muscle potentials range from 50 µV to 5 mV and the duration from 2 to 15ms. The signal lies in
the frequency range 0-500 Hz and most dominant in between 50 and 150 Hz.
Electrodes
The electrical activity of the underlying muscle mass can be observed by means of surface electrodes on
the skin. The surface electrodes may be disposable, adhesive types or the ones that can be used
repeatedly. A ground electrode is necessary for providing a common reference for measurement.
However, it is usually preferred to record the action potentials from individual motor units for better
diagnostic information using needle electrodes,
System Description ‫مهم‬
The block diagram in Figure 133.2 shows the various subsystems in an EMG
machine. The myoelectric signals are amplified by using a preamplifiers followed
by a differential
 amplifier together having an effective passband of 10-1000 Hz. The signals are
sampled at 10kHz with 16 bit analog-to-digital converter (ADC), rectified, and
smoothed with a running time window average with a window length of 240ms that
is updated every 80 ms. The processed signals are normalized by the amplitudes of
the maximum voluntary contractions and are displayed on a computer monitor.
 The amplitude of the EMG signals depends upon the type and placement of electrodes
used and the degree of muscular exertions. The needle electrode in contact with a
single muscle fibre will pick up spike-type voltages, whereas a surface electrode picks
up many overlapping spikes and therefore produces an average voltage effect. A
typical EMG signal ranges from 0.1 to 0.5mV. They may contain frequency
components extending up to 10kHz.
 The property of a differential amplification to reject signals common to both inputs is
determined by common mode rejection ratio (CMRR). A CMRR of 90 dB is adequate
for elimination of common signals for instrumentation amplifiers, but today's
technology provides us with a CMRR of 120dB. A calibrating square wave signal of
100 uV (peak to peak) at a frequency of 100 Hz is usually available. The main
amplifier has controls for gain adjustment from 5 |V/div to 10mV/div for selecting the
sensitivity most appropriate to the incoming signal from the patient.
EMG machines
Most EMG machines are PC based and are available in both console and laptop models. They provide full colour
waveform display, automatic cursors for marking and making measurements, and a keyboard for access to
convenient and important test controls. The system usually incorporates facilities for recording of the EMG and
evoked potentials. The stimulators are software controlled. For report generation in the hard copy form, popular
laser printers can be used. A typical EMG machine is shown in Figure 133.3.
 capacity of data recordings on digital storage media has become a common
feature. Wireless technologies such as Wi-Fi and Bluetooth have also been
incorporated into today's EMG equipment to provide the user with extended
mobility from the PC on PC-based systems. Acquired EMG signals can now be
picked up on the body and sent wirelessly to a PC where it is recorded,
processed, and analysed. Signal Analysis Usually, the electromyographic changes
in an advanced diseased state are readily recognized on a monitor screen display
and by the audio signal. However, since the loss of muscle fibres and, therefore,
the action potential changes are relatively small in early or mild disease states,
changes in the EMG signals may be obscured by the usual variability of action
potentials.
Common Artefacts in EMG
 While recording EMG, many types of artefacts may be present, if proper care is not taken.
1- Power line interference (50-60Hz) is caused by the electrical devices present around the EMG
equipment. Typically, this interference is removed by using a software implemented notch filter.
2- The instability of electrode skin interface and movement of the electrode cable result in
movement artefacts, which are caused whenever a patient moves and the electrodes are disturbed
or the cables are pulled. To minimize these artefacts, the electrodes must be placed in firm contact
with the skin and electrode cables must be fastened firmly.
3- The electrical signals generated by muscles other than the one under investigation results in
muscle crosstalk. This type of interference can be minimized through the appropriate placement of
the electrodes. The recommended inter-electrode distance is about 2 cm.
 Stimulators The modern EMG machines include another important feature in the form of a
built-in stimulator. The stimulator aids in nerve conduction or nerve velocity measurements.
Stimulus amplitude, duration, repetition, and delay are all adjustable, and facilities are provided
for external triggering. The output is either of the constant voltage type or of the constant
current type. The constant voltage type stimulator provides square wave pulses with amplitudes
in the range of 0-500 V, a pulse duration of 0.1-3ms, and frequency between 0 and 100Hz.
Output of the constant current generator can be adjusted from 0 to 100 mA.
Specifications
 Amplifier channels: 2 or 4
 Sensitivity: Adjustable from 1 uV/div to 10mV/div in steps
 High cut filters: Selectable from 30 to 10kHz
 Low cut filters: Selectable at 0.04 Hz, 2 kHz
 Notch filter: 50 or 60 Hz
 Common mode rejection: >100 dB
 Input impedance: >1000 MQ2 (common mode)
 Noise: < 6 V peak to peak
 Number of averages per channel: 1-10000
 Stimulators: Repetition rates at 0.1-90 pulses/s
Applications
Clinically, electromyography is being used as
1- diagnostic tool for neurological disorders, such as neuromuscular diseases
and low back pain, and disorders of motor control.
2- EMG is routinely employed as an evaluation tool in applied research,
physiotherapy, rehabilitation, sports medicine and training, and biofeedback
and ergonomics research.
Motor Units
The electrical activity of the underlying muscle mass can be observed by means of surface electrodes
on the skin. However, it is usually preferred to record the action potentials from individual motor units
for better diagnostic information using needle electrodes. In voluntary contraction of the skeletal
muscle, the muscle potentials range from 50 uV to 5 mV and the duration from 2 to 15 ms. The values
vary with the anatomic position of the muscle and the size and location of the electrode. In a relaxed
muscle, there are normally no action potentials. Figure shows the unprocessed EMG signal
characterized by positive and negative peaks. The amplitudes and frequency content of this signal
provides information about the contraction or resting state of the muscle under study.
 Recording Techniques:
There are two basic methods for recording of EMG signals.
1. EMG with voluntary muscular action, and
2. EMG with electrical stimulation.

EMG with Voluntary Action: