{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:51:09Z","timestamp":1747151469956,"version":"3.40.5"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Prior work demonstrates that fibular compound motor action potential (CMAP) amplitude &lt;4.0\u2009mV predicts impairment of ankle proprioceptive precision and increased fall risk. Extensor digitorum brevis (EDB) inspection may present a simple clinical surrogate for CMAP amplitude.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>(1) To estimate the inter\u2010rater reliability of assessment of EDB bulk. (2) To determine whether inspection of EDB bulk is associated with fibular CMAP amplitude.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective inter\u2010rater reliability study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic center outpatient Physical Medicine &amp; Rehabilitation electromyography (EMG) clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Fifty\u2010two adult participants (102\u2009feet).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>(1) Inter\u2010rater reliability of assessment of EDB bulk. (2) Mean fibular CMAP amplitude. (3) A binary measure of fibular CMAP amplitude at\/above or below a 4.0\u00a0mV threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Inter\u2010rater reliability of EDB bulk grading was moderate (kappa: 0.65 [95% confidence interval (CI) 0.48\u20100.82]). The mean CMAP value was 5.9\u2009\u00b1\u20092.2\u00a0mV when bulk was normal, 3.4\u2009\u00b1\u20092.1\u00a0mV when diminished, and 0.6\u2009\u00b1\u20090.9\u00a0mV when atrophied. A multivariable analysis demonstrated that EDB bulk, distal symmetric polyneuropathy (DSP), and lumbar radiculopathy were all associated with CMAP amplitude. The sensitivity and specificity of grading muscle bulk as normal versus abnormal in detecting CMAP amplitude above or below 4.0\u00a0mV were 0.86 (95% CI 0.78\u20100.94) and 0.71 (95% CI 0.54\u20100.88), respectively. An atrophied EDB was a highly specific indicator that CMAP amplitude was abnormal (&lt;4.0\u00a0mV) in 100% of cases (8\/8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EDB bulk was associated with fibular CMAP amplitude. Atrophy was a highly specific indicator for CMAP amplitude below 4.0\u00a0mV. Evaluation of EDB bulk may represent a quick and easy clinical surrogate marker for CMAP amplitude and distal neuromuscular impairment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12608","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T04:55:41Z","timestamp":1618894541000},"page":"428-433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extensor digitorum brevis bulk and associations with fibular motor nerve conduction amplitude"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2208-1185","authenticated-orcid":false,"given":"Josh","family":"Levin","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University  Stanford California USA"},{"name":"Department of Neurosurgery Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Lowe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-4757","authenticated-orcid":false,"given":"Lyndly","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-3004","authenticated-orcid":false,"given":"Emily","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayme","family":"Koltsov","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Kenrick","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Barrette","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6537a2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly250"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/50A.4.M211"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001714"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1152"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0433"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13152"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23618"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21194"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24134"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22325"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2015.08.017"},{"issue":"7","key":"e_1_2_9_15_1","first-page":"399","article-title":"Variable innervation of the intrinsic foot muscles. 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