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Gary Krasilovsky, PT, PhD, SST

Nerve Conduction Testing and Electromyography for the Physical Therapist.

About the Author

Gary Krasilovsky, Ph.D., P.T. SST, is an Associate Professor & Department Chair (retired) of the Hunter College, City University of New York Doctorate of Physical Therapy Program. He has been a physical therapy clinician, educator, and researcher for almost forty years. He earned a BS degree in Special Education, a Certificate in Physical Therapy, and his MA and PhD in Physical Therapy from New York University. His career in physical therapy included ten years at the Rusk Institute of Rehabilitation Medicine of NYU, where he worked as a clinician, researcher, and received advanced training and mentoring in the electrodiagnostic department. He also worked in the Jerry Lewis Muscular Dystrophy clinic based at Rusk Institute. He also served as Chief of Physical Therapy at Norwalk hospital before beginning his full time teaching career at Hunter College. He began his full time teaching career in 1987 and became acting program director two years later. He has continued to serve as program director and teaches clinical neurology, adult neurological rehabilitation, electroneuromyography and therapeutic exercise. He has published in various peer reviewed journals and textbooks on various areas related to physical therapy, with an emphasis on neurology based topics.

CHAPTER ONE.................................................................................................................... 1

Introduction to Electrophysiological Evaluation - Peripheral Nerve and Muscle 1

CHAPTER TWO................................................................................................................. 17

Instrumentation used in Electroneuromyography Examinations 17

CHAPTER THREE.............................................................................................................. 24

Upper Extremity Motor Nerve Conduction Studies & Sensory Nerve

Action Potential’s (SNAP's) .....................................................................24

Motor Nerve Conduction Studies - Overview....................................... 24

Sensory Nerve Conduction Studies....................................................... 43

CHAPTER FOUR............................................................................................................... 54

Lower Extremity Motor Nerve Conduction Studies &

Sensory Nerve Action Potential’s .............................................................54

Motor Nerve Conduction Studies............................................................. 55

Sensory Nerve Conduction Studies.......................................................... 62

CHAPTER FIVE.................................................................................................................. 67

Advanced Techniques of Nerve Studies - Late Responses .......................67

Somatosensory Evoked Potentials (SSEP’s)............................................ 67

Brainstem Auditory Evoked Potentials (BAER's)..................................... 70

Visually Evoked Potentials (VEP's)............................................................ 70

H- Reflex...................................................................................................... 71

F- Wave Testing.......................................................................................... 73

Repetitive Nerve Stimulation (RNS) - Myasthenia Gravis ........................74

CHAPTER SIX................................................................................................................... 79

Diagnostic Electromyography..................................................................... 79

CHAPTER SEVEN............................................................................................................. 93

Problem Solving in Electroneuromyography and Case Studies ................93

Case Study # 1: Carpal Tunnel Syndrome.................................................. 96

Case Study # 2: Age 5 – Duchenne MD (DMD).......................................... 97

Case Study # 3: Suspected L5 Root Compression.................................... 98

Case Study # 4: Suspected Peripheral Polyneuropathy .........................100

Case Study #5: EMG Report #1................................................................ 101

Case Study #6: EMG Report #2.................................... ........................... 103

Case Study #7: EMG Report #3................................................................ 104

Case Study #8: Gun Shot Wound to the Cauda Equina, L1 - L2............ 106

Case #9: Anterior Glenohumeral Joint Dislocation ................................108

Case #10: Mid Humeral Fracture............................................................. 108

Case #11: Multiple Sclerosis................................................................... 108

Case #12: Isolated Scapula Winging...................................................... 108

Case #13: Idiopathic Bell’s Palsy............................................................ 108

Appendix A................................................................................................................ 111

Anatomical Correlates and Associated Impairments ............................................111

Appendix B................................................................................................................ 113

Common Causes of Peripheral Neuropathies......................................................... 113

Appendix C................................................................................................................ 114

Upper Extremity - Root and Peripheral Nerve Innervations ...................................114

Lower Extremity - Root and Peripheral Nerve Innervations ....................................115

References................................................................................................................ 116

Reviews and Comments - Go to Amazon link for further reviews

Dr. Krasilovsky gives an excellent overview of the procedures used in clinical electrophysiologic testing. The cases help illustrate the relevance of motor and sensory testing in differential diagnosis, as well as the role of EMG and NCV testing in comprehensive patient assessment for diagnosis and prognosis of neuromuscular impairments. Common findings of electrophysiologic testing are presented in relation to peripheral vs central nervous system pathologies, neurologic vs muscular involvement, and the ability to locate the site of the lesion. The illustrations provided are very helpful in understanding the testing procesures, as well as the interpretation of data. This book is helpful not only for educators and clinicians who perform electrophysiologic testing, but is also a guide for physical therapists and students who need to be able to understand and apply information contained within the patient's medical record. Rose Pignataro, PhD, PT, DPT, CWS, CHES, Associate Professor, Adventist University of Health Sciences.

Just wanted you to know that we required students to purchase this book for one of our summer classes. It was very well received. Wishing you well. Doreen Stiskal, PT, PhD, Fellow, APTA Educational Leadership Institute, Chair, Department of Physical Therapy, Seton Hall University.

The Rocky Mountain University of Health Professions has also adopted this book.

Files coming soon.

Gary Krasilovsky, PT, PhD, SST

Nerve Conduction Testing and Electromyography for the Physical Therapist.

About the Author

Table of Contents

The Book

Link to Amazon:

Reviews and Comments - Go to Amazon link for further reviews

Just wanted you to know that we required students to purchase this book for one of our summer classes. It was very well received. Wishing you well. Doreen Stiskal, PT, PhD, Fellow, APTA Educational Leadership Institute, Chair, Department of Physical Therapy, Seton Hall University.

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