Bedside electromyography for clinical assessment of sacral motor and reflex activity adapted for patients hospitalized with acute neurological conditions: a pilot study.

Abstract

Study design: Pilot cohort study.

Objective: To develop and implement a sacral electromyographic (sEMG) technique at bedside to ascertain sparing of sacral motor activity and reflexes in patients hospitalized for acute neurological conditions.

Setting: Hôpital du Sacré-Coeur de Montréal a Canadian Level-1 university trauma center specialized in SCI care.

Methods: Nine patients underwent digital rectal examination (DRE) and sEMG, assessing voluntary anal contraction and sacral spinal reflexes (bulbocavernosus reflex and the anal wink). Our sEMG technique utilized surface recording electrodes and tactile elicitation of reflexes. EMG signal was acquired at bedside through the Noraxon MR3 system.

Results: It was quick, well accepted and did no harm. We found that contrary to the DRE, sEMG detected subclinical sacral motor activity and reflexes in 20% of cases for voluntary anal contraction and 40% of cases for the anal wink.

Conclusion: We believe our sEMG technique is a powerful tool able to enhance management of patients suffering from acute neurological impairments and requiring sacral function assessment.