Physical therapist compliance with electromyography guidelines

J Neurol Phys Ther. 2008 Dec;32(4):177-85. doi: 10.1097/NPT.0b013e31819008f9.

Abstract

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.

MeSH terms

  • Carpal Tunnel Syndrome / diagnosis*
  • Electromyography*
  • Guideline Adherence*
  • Humans
  • Neural Conduction / physiology
  • Observer Variation
  • Physical Therapy Specialty*
  • Practice Guidelines as Topic
  • Radiculopathy / diagnosis*
  • Reproducibility of Results
  • Retrospective Studies
  • Ulnar Neuropathies / diagnosis*