The Role Electromyography and Nerve Conduction Studies Can Have for Physical Therapists

The majority of patients treated in an outpatient setting are generally referred for low back pain.  For physical therapists not pigeon-holed into only treating back pain, that means patients will be treated for other issues outside of back pain.

I know the particular area of clinical electrophysiology isn't popular or necessarily mainstream for physical therapists.  This is readily evident by the fact that only 139 physical therapists in the States are board certified in this specialty.

Electromyography and nerve conduction studies have their place in assisting physical therapists in determining interventions for patients.  Take for example a situation I had in 2009.  I had a middle schooler referred to physical therapy by an orthopaedic surgeon with a diagnosis of "shoulder instability."  What seemed like a straightforward diagnosis on paper turned out to be way more complex than "shoulder instability."  Of course, kids don't talk too much and it sometimes seems to take forever to really understand what's really going on outside of the, "I couldn't move my shoulder after I did 2 push ups."   The boy in front of me was an adopted African American with significant muscle atrophy occurring 3-4 weeks after an upper respiratory infection and severe neck pain.  Heck yeah, the shoulder was unstable, but it probably wasn't from performing push ups.  Some differential diagnostic thoughts:  Was it cervical radiculopathy?  It didn't seem to be.  Was the virus the culprit?  Did he have some sort of genetic muscular dystrophy?  For this particular boy EMG/NCS assisted substantially in determining the role physical therapy would have in improving his function and how physical therapy would be progressed.  Not to leave anyone hanging - the physiatrist diagnosed him with Parsonage-Turner Syndrome, or as I did more searching, neuralgic amyotrophy.

If you are headed to the American Physical Therapy Association Combined Sections Meeting, you have the opportunity to meet two of the 139 clinical electrophysiologic specialists.  James Mills, II, PT and Scott Shaffer, PT will be presenting on the prognostic value of electromyography and nerve conduction testing for clinical outcomes and function.  They will be presenting on February 18 from 2:30-4:00 pm.

Photo by Rob via Flickr

~Selena