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Dear EDX Colleagues,

I'm writing to ask for some input regarding study design with a colleague in our Urology dept.  We are interested in studying the anthropometric and hand indices differences among urologists performing flexible ureteroscopy and its effect on muscle strain and fatigue.  Prior work on this subject utilized surface EMG electrodes over the neck extensors, trapezius, deltoid, triceps, biceps, forearm extensors, forearm flexors and thenar muscles using muscle activation (expressed as %MVCRM - maximal voluntary contraction root mean square) as a surrogate for physical strain during the procedure. 

My understanding is that a higher %MVC is an indicator of higher muscle activation.  A lower median frequency (MDF) of the EMG signals from the muscles involved is an indicator of increased musclular effort (not sure I understand why).  To analyze muscle fatigue, higher %MVC tasks for longer intervals would need to be analyzed???

Here is our problem ... my colleague is a female urologist with a smaller hand size forced to use instruments designed for male surgeons with bigger hands.  We endeavor to look more closely at thumb and wrist movements which I don't think we would be able to do utilizing conventional surface EMG electrodes.  I was thinking that we may be able to isolate individual thumb and wrist movements more precisely using needle EMG placed under US guidance to speak to the contribution each muscle to strain patterns, pain and fatigue?  Theoretically, we could then place a pin in the FPL, EPL, FCR, FCU, EDC, etc. 

I'm not sure this would get past an IRB but I don't have much experience with the matter.

I appreciate any thoughts 

Todd Lefkowitz, DO