Locomotion Problems Research Articles

The Sensitivity and Specificity of Auricular Diagnosis in Horses

The author previously observed the presence of localized tender points on the concave surface of the external auricle of horses with clinical signs of localized somatic pain. No similar point sensitivity was detected on the auricles of horses that were free of pain. The objective of this descriptive clinical study was to compare the presence or absence of auricular point pain with conventional physical examination findings to determine the validity of auricular diagnosis to predict when musculoskeletal pain was present or absent in the horse. One hundred performance horses of both sexes and varying ages and breeds, presented for locomotor problems were randomly selected from the author’s clinical practice. All horses first received palpation of the concave surface of the auricle (external ear) with either the medial or lateral edge of the thumb and the results were recorded. After the auricular examination, a complete conventional musculoskeletal and orthopedic examination was performed to detect pain of the head, body and limbs. The results of the auricular and conventional examinations were then compared. Good correlation (> 70% in both sensitivity and specificity) between the auricular diagnosis and the conventional examination was found in the head, low cervical region, shoulder, the upper and lower thoracic regions and lumbar and sacral regions. No conclusions could be drawn regarding the reliability of auricular diagnosis for other regions. The findings of this study indicate that auricular diagnosis may be a useful tool in clinical practice and support the theory that auricular points represent specific reflex connections between the auricle and corresponding somatic areas.

CARACTERIZAÇÃO DAS AFECÇÕES PODAIS EM REBANHO DE GADO HOLANDÊS CONFINADO

Due to high prevalence and incidence of lameness disorders in dairy cattle, many research studies have been carried out in this area, and some authors concluded that they constitute the third most important cause of discard in herds. Bovine hoof affections lead to a 5-20% decrease in milk production and losses caused by secondary diseases may also occur. This study characterizes podal diseases in cattle with locomotor disorders that were reared under a freestall barn breeding system in a milk farm. A total of 66 Holstein cows of different age groups and lactation periods were evaluated. They all showed some kind of lameness. Assessment of locomotor problems aimed to identify incidence of lesions and areas affected, such as fore and hind limbs and lateral and medial claws. White line disease was the most common problem (26,3%). Other disorders included heel ulcer (20,7%), sole erosion (14,6%), interdigital dermatitis (13,6%), sole hemorrhage (8,1%), septic pododermatitis (8,1%), double sole (6,1%), interdigital hyperplasia (2,0%), and toe ulcer (0,5%). The foot conditions were found to affect hind limbs in 69,3% of the cases, and fore limbs in 30,7%. A total of 58,1% of claw problems occurred in the lateral claw and 41,9% in the medial claw.

Field evaluation of broiler gait score using different sampling methods

Brazil is today the world's largest broiler meat exporter; however, in order to keep this position, it must comply with welfare regulations while maintaining low production costs. Locomotion problems restrain bird movements, limiting their access to drinking and feeding equipment, and therefore their survival and productivity. The objective of this study was to evaluate locomotion deficiency in broiler chickens reared under stressful temperature conditions using three different sampling methods of birds from three different ages. The experiment consisted in determining the gait score of 28, 35, 42 and 49-day-old broilers using three different known gait scoring methods: M1, birds were randomly selected, enclosed in a circle, and then stimulated to walk out of the circle; M2, ten birds were randomly selected and gait scored; and M3, birds were randomly selected, enclosed in a circle, and then observed while walking away from the circle without stimulus to walking. Environmental temperature, relative humidity, and light intensity inside the poultry houses were recorded. No evidence of interaction between scoring method and age was found however, both method and age influenced gait score. Gait score was found to be lower at 28 days of age. The evaluation using the ten randomly selected birds within the house was the method that presented the less reliable results. Gait score results when birds were stimulated to walk were lower than when they were not simulated, independently of age. The gait scores obtained with the three tested methods and ages were higher than those considered acceptable. The highest frequency of normal gait score (0) represented 50% of the flock. These results may be related to heat stress during rearing. Average gait score incresead with average ambient temperature, relative humidity, and light intensity. The evaluation of gait score to detect locomotion problems of broilers under rearing conditions seems subjective and difficult to be properly performed.

Scientific opinion on welfare of dairy cows in relation to behaviour, fear and pain based on a risk assessment with special reference to the impact of housing, feeding, management and genetic selection

Scientific opinion on welfare of dairy cows in relation to behaviour, fear and pain based on a risk assessment with special reference to the impact of housing, feeding, management and genetic selection

Scientific opinion on welfare of dairy cows in relation to leg and locomotion problems based on a risk assessment with special reference to the impact of housing, feeding, management and genetic selection

Scientific opinion on welfare of dairy cows in relation to leg and locomotion problems based on a risk assessment with special reference to the impact of housing, feeding, management and genetic selection

Analysis of morbidity and mortality data in riding school horses, with special regard to locomotor problems

The incidence of disease, mortality and survival of horses, focusing on locomotor problems, at riding schools were studied, using data from an animal insurance database during 1997–2002. In total 5140 horses from 136 riding schools were included in the analysis. The overall yearly incidence rate (IR) was 1584 events of veterinary care per 10,000 horse-years at risk (HYAR). The total and diagnostic mortalities were 790 and 763 deaths per 10,000 HYAR. Rates varied substantially among riding schools. For locomotor problems the rates were 1116 events of veterinary care and 524 deaths per 10,000 HYAR. Multivariable Cox proportional-hazards analysis was performed on horses enrolled in insurance during the study period, including riding schools as frailty effects. For the outcome veterinary care for locomotor problems, the hazard ratios (HR) increased with increasing life-insurance value and Swedish warmbloods and other horses had increased HR compared to ponies. In the model with outcome life claim because of locomotor problems the breed groups Swedish warmblood and other horses also had higher HR than ponies. Age at entry ≥8 years was associated with decreased HR for settled life-insurance cases due to locomotor problems and the two highest categories for insurance value had increased HR compared to the two lower categories. In the model with the outcome life claim because of previously claimed locomotor problems Swedish warmbloods had a higher HR than other horses and ponies. The HR increased by 33% for each year of age at entry. In south-urban areas of Sweden the HR was decreased compared to in all other areas, including baseline. Overall riding schools utilised the insurance more compared to all horses in the insurance database (∼22% for the veterinary-care insurance and ∼79% for the settled life insurance).

Activity Energy Expenditure is Under-Predicted for Walking in Adults in Peripheral Neuropathy

Accurate energy expenditure calculations are important for assessing free-living physical activity (PA), especially for sedentary populations. One such group, those afflicted with peripheral neuropathy (PN), posses locomotion and balance problems due to pain and lack of peripheral sensations. The impairments of PN lead to extremely low PA and challenge the existing energy expenditure measurement methods. PURPOSE: This study compared measured activity energy expenditure (AEE, kcals/ kg/min) during overground walking with predicted AEE derived from a commonly- used prediction equation to determine accuracy of the prediction for this population. METHODS: Five men (Mean±SD: 71±17 yrs age, 85.6±10.3 kg body mass, 28.6±3.2 kg/m2 BMI) and 12 women (72±6 yrs, 71.1±12.0 kg, 27.5±4.3 kg/m2 BMI), all diagnosed with peripheral neuropathy by physicians, volunteered to perform several structured activities: Sitting quietly (to estimate resting metabolic rate, RMR), and self-selected "slow" (52.6±15.1 m/min) and "brisk" (68.6±14.8 m/min) overground walking. Oxygen uptake (VO2) was measured using a portable metabolic system worn using a modified backpack. Steady-state VO2 for each activity was transformed into AEE by subtracting subjects' estimated RMR. Predicted AEE was derived from the ACSM walking equation (VO2 = 0.1xS + 3.5; S= walking speed, m/min) where gross VO2 was adjusted by subtracting either 3.5 (AEE1) or measured RMR (AEE2). Measured AEE was compared with AEE1 and AEE2 using repeated measures ANOVA. RESULTS: Predicted AEE1 for "slow" walking (Mean±SE: 0.0263±0.0018) and "brisk" walking (0.0343±0.0018) were significantly (P<0.05) lower than measured AEE "slow" (0.0356±0.0025) and "brisk" (0.0457±0.0038), respectively. Predicted AEE2 "slow" (0.0307±0.0022) and "brisk" (0.0387±0.0021) did not differ from either measured AEE or predicted AEE1. CONCLUSIONS: AEE prediction in this population is more accurate when subtracting measured RMR from V02 as opposed to subtracting an assumed RMR constant. Future studies with this population should focus on predicting AEE for locomotion-based activities to avoid the confounding influence of an assumed RMR.

Distributed Control Architecture for Self-reconfigurable Manipulators

In recent years self-reconfigurable modular robots have gained increasing interest from part of the international robotic community. Although recent robots of this type are characterized by advanced electro-mechanical designs, the development of their supporting control techniques have only registered strong results in the field of locomotion problems, while the manipulation capabilities of existing systems still appear to be quite limited. Aiming to provide a contribution along this latter direction, in this paper we propose a computationally distributed technique for controlling the motion of any tree-structured chain resulting from reconfiguration in its operational space. The presented strategy, which could actually be adopted when dealing with any kind of chain-based modular robotic system, turns out to be particularly well suited to self-reconfigurable structures for three main reasons: (i) it is not based on any explicit role assignment; all of the modules can be added, removed or exchanged online as required, with no impact on the overall control architecture; (ii) each module has only a very limited set of local information that must be known a priori and can be totally unaware of the remaining part of the chain; (iii) no external centralized controller is necessary; basic local processing and communication units onboard every module and a simple man—machine interface providing high-level commands are enough. A global self-coordinating behavior is automatically exhibited by the proposed technique at power-on or immediately after any configuration change as the result of a number of repeated data exchanges, performed online along the chain at every sampling interval. Although achievable performances depend on the available communication bandwidth, the convergence towards a final position error of zero is, however, always guaranteed. Moreover, because the computational burden required by every module is extremely light, the proposed technique represents an effective control solution that can be easily implemented onboard many of the low-cost and small control platforms available on existing self-reconfigurable robots.

Risk factors and milk yield losses associated with lameness in Holstein-Friesian dairy cattle

Weekly locomotion scores on a scale of 1 to 5 were used to investigate the relationship between cattle lameness, management systems and the impact of lameness on milk production. The data were 14026 locomotion scores from 248 Holstein-Friesian cows. Cows were managed in two groups, XE (high-concentrate feed and housed indoors all year) and XM (low-concentrate feed and outdoors in summer). Analysis was performed using residual maximum likelihood. Results indicated that the most significant variables affecting locomotion were time of year when the animal was locomotion scored and management group. Cows scored during February and August had increased locomotion problems. Cows in the more intensively managed group had significantly poorer locomotion compared with those in the more extensive group. Older animals were more susceptible to lameness than heifers. Body weight, body condition score and days in milk (DIM) also accounted for significant variation in locomotion score. Poor locomotion was associated with a significant reduction in the milk yield of later lactation cows. There was a significant difference in the shape of the lactation curve depending on whether or not the cow was lame during lactation. Average persistency was greater for the group of cows never lame throughout lactation compared with those lame before 60 DIM.

Estudio evaluativo de los costes asistenciales en atención primaria

To estimate the real costs of medical care by diagnostic groups at a primary care centre.Descriptive, retrospective study, based on the review of computerized medical records.Urban primary care centre (PCC).All patients who attended the PCC during 2005.Mean medical care cost per visit in euros, broken down for health professionals, diagnostic procedures and drugs costs, and stratified by diagnostic groups.The most frequent visits were for pulmonary, locomotor, cardiovascular, and gastro-intestinal conditions. The mean number of visits per patient attended was 8.7 (SD, 9.4); and per patient registered at the centre, 5.9 (8.7). The highest costs were for cardiovascular (18.96%; 95% CI, 18.93%-18.99%), locomotor (11.21%; 95% CI, 11.18%-11.23%), psychological (10.69%, 95% CI, 10.66%-10.71%), pulmonary (10.20%; 95% CI, 10.17%-10.22%) and endocrinal-nutritional (9.61%; 95% CI, 9.58%-9.63%) problems. Drugs expenditure accounted for 65% of the total cost; visits to health professionals, for 33%; and procedures, for 2%. Overall cost per inhabitant was 239.1 (493.6) euros, and per patient attended was 349.5 (563.5).Cardiovascular disease conditions are much the most costly ones in terms of overall medical cost. Psychological conditions are located in second place in terms of pharmaceutical cost; and in third place, in terms of overall medical-care cost.

Veterinary-care events and costs over a 5-year follow-up period for warmblooded riding horses with or without previously recorded locomotor problems in Sweden

Our objective was to determine the amount, type and cost of veterinary care during a 5-year follow-up period, in Swedish warmblooded riding horses with and without locomotor problems as recorded in 1997. The study population comprised horses with complete insurance both for veterinary care and life during 1997. The horses were followed from the beginning of January 1998 to the end of December 2002. The exposed cohort was composed of 1558 horses that had experienced ≥1 veterinary-care event because of locomotor problems in 1997 (LP-cohort). The exposure-negative (LN) cohort was composed of 16,513 horses that had no recorded locomotor problem during 1997. For the outcome of locomotor problems during the follow-up period, stratified incidence proportions and a repeated-measures multivariable-logistic regression model in general produced the same conclusions. An interaction between year and cohort showed larger odds ratios (ORs) in the first year of follow-up compared to later (OR 4.8 and 1.2 in the LP- and LN-cohort, respectively), but a smaller difference during the subsequent years (in the 5th year OR 1.8 and 1.0, respectively). Horses with life-insurance values of >30,000 SEK in the LP- and LN-cohorts had ORs of 4.7 (99% CI 3.9, 5.6) and 2.6 (99% CI 2.3, 2.9), respectively. For life-insurance values of ≤10,000 SEK the respective ORs were 3.4 (99% CI 2.6, 4.4) and 1 (baseline). The yearly costs for reimbursed veterinary care for locomotor problems during the 5-year follow-up, per horse at risk, varied from 880 to 1320 SEK (approximately US$ 100–150) in the LP-cohort and between 410 and 580 SEK (US$ 46–66) in the LN-cohort. In conclusion, the horses with previous locomotor problems continued to have considerably more veterinary-care events and higher costs for locomotor problems during the follow-up period.

First occurrence of periosteal chondroma (juxtacortical chondroma) inUromastyx maliensis(Reptilia: Sauria: Agamidae)

The occurrence of a periosteal chondroma (juxtacortical chondroma) in an adult male Uromastyx maliensis is documented for the first time. The chondroma developed near the right shoulder joint from the periosteal membrane, causing partial atrophy in the surrounding skeletal muscles. In the chondroma tissues widespread central necrosis and secondary calcium salt deposition were observed. Monomorphic chondrocytes were irregularly spread in the chondromucin matrix. The lizard had locomotor problems due to irritation of the periosteum and reduced movement of the bones constituting the shoulder joint caused by the chondroma.

Basic Assessment of Diagnosis by MDCT in Horses

In this equine study, we used an MDCT unit and a trestle for large animals to assess the utility of MDCT in the diagnosis locomotor system disorders and problems in the head and spine. We used a mature thoroughbred horse under general anesthesia and 5 specimens. For specimens, MDCT images were compared with other images taken by a computed radiography X-ray unit. In the live horse, use of the trestle for large animals enabled scanning under general anesthesia. In specimens, MDCT created 3D images of the fractured lesions and evaluation of multiple cross-sectional and sagittal images was possible. Further, multiple sagittal images and virtual endoscopic images revealed details of a spinal canal stenosis in the swayback case. These results indicate that MDCT is useful for diagnosing and viewing details of cases that conventional X-ray images do not capture.

Assessment of producer conducted antemortem inspection of market pigs in Australia

A field trial was conducted to evaluate the effectiveness of on-farm antemortem inspection performed by Australian pig producers in terms of proficiency in detecting unhealthy animals (suspects), the impact on food safety and animal welfare outcomes. A total of 64 trial groups of market pigs (n= 10,703) were dispatched from 20 herds to three abattoirs in three states. All producers and abattoir antemortem inspectors were trained in antemortem inspection prior to the trial using a standardised set of antemortem criteria. Study 1 consisted of three comparisons: on-farm versus abattoir antemortem inspections on the same pigs, transport effects in suspect and normal pigs, and meat rejection and carcase disposition in suspect and normal pigs. Study 2 compared Salmonella spp status of suspect and normal pigs. Studies 3 and 4 were conducted to assist the interpretation of the results of on-farm versus abattoir inspection. Antemortem inspection results of three producers and one abattoir antemortem inspector were compared with those of a reference inspector (Gold Standard). Of the pigs examined, 2.12% (95% CI: 1.84%, 2.42%) were classified as suspect at on-farm antemortem inspection compared to only 0.14% at abattoir antemortem inspection. Forty one percent of pigs classified as suspect on-farm had locomotor problems (arthritis, lameness and foot abscess). Compared to normal pigs, suspect pigs had a relative risk of 67.7 (P < 0.0001) of suffering transport injuries. Meat rejection amounted to the equivalent of 9.68% of suspect carcases, compared to the equivalent of 0.35% of normal carcases. The isolation of Salmonella species from caecal content from 20.9% of 67 suspect pigs and 18.8% of 133 control pigs (two matched healthy pigs from the same batch for each suspect pig) were not significantly different. When compared with the reference inspector on-farm, three producers classified abnormalities in 2,495 pigs with high specificity (0.98), acceptable sensitivity (0.82) and kappa (0.57). With training, producer sensitivity in antemortem inspection may be high and more proficient than abattoir antemortem inspection. Use of producer inspections may have benefits for animal welfare and chain efficiency, but not food safety.

Evaluation of transformation growth factor β 1, interleukin-10, and interferon-γ in male symptomatic and asymptomatic dogs naturally infected by Leishmania ( Leishmania) chagasi

The aims of this study were to evaluate the immunomodulatory role of TGF-β 1, IL-10, and INF-γ in spleen and liver extracts and supernatant cultures of white spleen cells from male symptomatic and asymptomatic dogs, naturally infected by Leishmania ( Leishmania) chagasi. Thirty dogs from Araçatuba, São Paulo, Brazil, an endemic leishmaniosis area, were selected by positive ELISA serological reaction for Leishmania sp. and divided into two groups: asymptomatic ( n = 15) and symptomatic ( n = 15) consisting of animals with at least three characteristic signs (fever, dermatitis, lymphoadenopathy, onychogryphosis, weight loss, cachexia, locomotion problems, conjunctivitis, epistaxis, hepatosplenomegaly, edema, and apathy). After euthanasia, spleen and liver fragments were collected for ex vivo quantification of TGF-β 1, IL-10, and INF-γ. Naturally active in vitro produced TGF-β 1 was also evaluated in spleen cell culture supernatant. Spleen and liver extract of asymptomatic dogs had higher mean TGF-β 1 levels than symptomatic dogs. High concentrations of IL-10 were found in spleen, and mainly in liver extract of both groups. Higher INF-γ concentrations were found in spleen extracts of symptomatic dogs, and in liver extracts of asymptomatic dogs. Extract of this cytokine was lower in spleen extract. Although INF-γ is being produced in canine infection, mean levels of TGF-β 1 and IL-10 from spleen and liver extracts were quantitatively much higher; suggesting that immune response in both asymptomatic and symptomatic dogs was predominantly type Th2.

Clinicopathologic findings and outcome in dogs with infective endocarditis: 71 cases (1992–2005)

To evaluate clinical, laboratory, and necropsy findings in dogs with infective endocarditis (IE). Retrospective case series. 71 dogs with possible or definite IE. Medical records were reviewed for signalment, clinical features, and results of clinicopathologic testing and diagnostic imaging. Yearly incidence and the effect of variables on survival were determined by use of survival curve analysis. The overall incidence of IE was 0.05%. Most affected dogs were of large breeds, and > 75% were older than 5 years. The aortic valve was affected in 36 of the 71 (51%) dogs, and the mitral valve was affected in 59%. Lameness caused by immune-mediated polyarthritis, septic arthritis, or peripheral arterial thromboembolism was observed in 53% of the dogs. Neurologic complications were diagnosed in 17 of 71 (24%) dogs. Thromboembolic disease was suspected in 31 of 71 (44%) of dogs. The mortality rate associated with IE was 56%, and median survival time was 54 days. Factors negatively associated with survival included thrombocytopenia, high serum creatinine concentration, renal complications, and thromboembolic complications. A diagnosis of IE should be suspected in dogs with fever, systolic or diastolic murmur, and locomotor problems. Dogs with thrombocytopenia, high serum creatinine concentration, thromboembolism, or renal complications may have a shorter survival time.

Assessment of producer conducted antemortem inspection of market pigs in Australia

A field trial was conducted to evaluate the effectiveness of on-farm antemortem inspection performed by Australian pig producers in terms of proficiency in detecting unhealthy animals (suspects), the impact on food safety and animal welfare outcomes. A total of 64 trial groups of market pigs (n = 10,703) were dispatched from 20 herds to three abattoirs in three states. All producers and abattoir antemortem inspectors were trained in antemortem inspection prior to the trial, using a standardised set of antemortem criteria. Study 1 consisted of three comparisons: on-farm versus abattoir antemortem inspections on the same pigs, transport effects in suspect and normal pigs, and meat rejection and carcase disposition in suspect and normal pigs. Study 2 compared Salmonella spp. status of suspect and normal pigs. Studies 3 and 4 were conducted to assist the interpretation of the results of on-farm versus abattoir inspection. Antemortem inspection results of three producers and one abattoir antemortem inspector were compared with those of a reference inspector (Gold Standard). Of the pigs examined, 2.12% (95% CI: [1.84%, 2.42%]) were classified as suspect at on-farm antemortem inspection compared to only 0.14% at abattoir antemortem inspection. Forty one percent of pigs classified as suspect on-farm had locomotor problems (arthritis, lameness and foot abscess). Compared to normal pigs, suspect pigs had a relative risk of 67.7 (P < 0.0001) of suffering transport injuries. Meat rejection amounted to the equivalent of 9.68% of suspect carcases, compared to the equivalent of 0.35% of normal carcases. The isolation of Salmonella species from caecal content from 20.9% of 67 suspect pigs and 18.8% of 133 control pigs (two matched healthy pigs from the same batch for each suspect pig) were not significantly different. When compared with the reference inspector on-farm, three producers classified abnormalities in 2495 pigs with high specificity (0.98), acceptable sensitivity (0.82) and kappa (0.57). With training, producer sensitivity in antemortem inspection may be high and more proficient than abattoir antemortem inspection. Use of producer inspections may have benefits for animal welfare and chain efficiency, but not food safety.

Specific causes of morbidity among Swedish horses insured for veterinary care between 1997 and 2000

The principal aim of this study was to analyse the incidence of disease due to general and more specific causes among over 100,000 horses covered by complete insurance for veterinary...

High Incidence of Polyarteritis Nodosa in the Brains of Culled Sows

A total of 307 brains of purebred sows obtained from an abattoir were retrospectively examined. These sows were culled with reasons of reproductive failure, urogenital infections, or locomotor problems. The most common macroscopic lesions were cavitations or lacunae in the basal nuclei (9.1%, 28/307) and coarse and thickened leptomeninges with marked vessels (3.9%, 12/307). The most frequent microscopic lesion was polyarteritis nodosa (21.2%, 65/307), which was found in all 40 brains with the above-mentioned gross lesions and in all 25 brains with microscopic cerebral infarcts or cavitations. The affected arteries of polyarteritis nodosa were distributed primarily in the cerebral leptomeninges, basal nuclei, and internal and external capsules. Histopathologically, a characteristic change of the affected arteries was transmural fibrinoid necrosis with severe infiltration of mixed inflammatory cells; narrowing or occlusion of the lumen. The inflammatory cells were chiefly composed of lymphocytes, macrophages, and plasma cells, with a few eosinophils and occasional multinucleated giant cells. Polyarteritis nodosa was found at a high percentage in the brains from culled sows. It may result in cerebral ischemia, infarcts, and hemorrhage, and possibly play a role in the necessity for culling due to locomotor problems.

The role of electromyography in clinical diagnosis of neuromuscular locomotor problems in the horse

Systematically performed EMG needle examination of muscles provides essential information about the functional aspects of the motor unit. However, clinical studies in which information is given on the diagnostic and discriminative values of electromyography (EMG) in the horse are scarce. To determine to what extent inclusion of EMG analysis in clinical examination contributes to determination of type and localisation of abnormality. EMG analysis, complete clinical examination and diagnosis of 108 horses (mean +/- s.d. age 75 +/- 3.8 years; bodyweight 548 +/- 86 kg; height 1.67 +/- 0.07 m) were performed, and results without and with EMG analysis compared. Without EMG, myopathy and neuropathy were diagnosed in 20 and 58 horses, respectively, and with EMG in 17 and 82 horses. EMG changed localisation in myopathy and neuropathy in 12 and 37% of cases, respectively. Lesions in the C1-T2, T2-L3 and L3-S3 segments were, respectively, diagnosed without EMG in 7, 11 and 30%, and with EMG in 27, 7 and 17% of cases. Where no clinical diagnosis could be made prior to EMG, many patients appeared to be suffering from localised cervical lesions (29%) or generalised neuropathy (54%). The assistance of EMG in discriminating between normal, neuropathy and myopathy, and in locating pathology, contributes to diagnosis of neuromuscular problems.