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Physical Therapist Compliance with Electromyography Guidelines

Armantrout, Elaine Ann PT, DSc, ECS; Hummel-Berry, Kathleen PT, PhD; Underwood, Frank PT, PhD, ECS; Nelson, Charlene PT, MA

Journal of Neurologic Physical Therapy: December 2008 - Volume 32 - Issue 4 - pp 177-185
doi: 10.1097/NPT.0b013e31819008f9

Purpose: The purpose of this study was to determine compliance rates for following three electromyography (EMG) clinical practice guidelines and to determine the reliability of two performance measurement tools developed for this study.

Methods: This was a retrospective descriptive and correlation study of chart reviews of voluntary submissions of EMG reports performed by physical therapists (PTs). Chart reviewers included a PT, a neurologist, and a physiatrist. EMG reports leading to diagnosis of carpal tunnel syndrome (CTS) (n = 43), ulnar neuropathy at the elbow (n = 36), and cervical radiculopathy (n = 38) were collected. The performance measurement tools were analyzed for interrater reliability.

Results: The mean (median) score for CTS was 84% (89%), ulnar neuropathy at the elbow was 71% (72%), and cervical radiculopathy was 83% (85%). The reliability calculation (95% confidence interval) for the performance measurement tool for CTS was 0.74 (0.49–0.86), ulnar neuropathy at the elbow was 0.75 (0.56–0.86), and cervical radiculopathy was 0.57 (0.16–0.79). All three reliability calculations were statistically significant (P < 0.05).

Conclusions: The EMG reports performed by PTs had high compliance rates for following the three clinical practice guidelines. The performance measurement tools developed for CTS, ulnar neuropathy at the elbow, and cervical radiculopathy were moderately reliable. They may be useful for quality improvement projects in individual EMG laboratories.

Doctorate of Science in Clinical Electrophysiology, Rocky Mountain University of Health Professions, Provo, Utah.

Address correspondence to: Dr. Elaine Armantrout, E-mail:

© 2008 Neurology Section, APTA