Medical Student Research Fellowship for Summer 2006

Mentor: Drs. Samuel Bierner and Thiru Annaswamy
Department: Physical Med & Rehab
Room number: Sprague 4th flr (UTSW), 2C-222 (VAMC)
Mail Code: 9055 (UTSW), 117 (VAMC)
Phone number: 2146482288 (UTSW), 2148570273 (VAMC)
E-mail: Samuel.bierner@utsouthwestern.edu (UTSW), thiru.annaswamy@va.gov (VAMC)
Project title: Prediction of Response to Lumbar Epidural Steroid Injection by EMG Findings in Lumbar Radiculopathy

Human subjects IRB approved project number (where applicable): VAMC (05-078); UTSW (submitted)

Animal subjects IRB approved project number (where applicable):

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient-based

Brief Description of Project:

Our primary aim is to determine whether an abnormal needle electromyography examination (EMG) that is consistent with radiculopathy (defined as positive sharp waves and/or fibrillation potentials occurring in a myotomal distribution) has predictive value for the patient's response to lumbar epidural steroid injection (LESI). If found to be an independent predictor, then the EMG findings have value for prognosticating outcome, and may help guide treatment decisions, such as limiting the use of repeat epidural steroid injections and proceeding to surgical intervention for patients with positive EMG studies.
Our secondary aim is to ascertain whether any of the other risk factors are independent predictors of whether a patient will fail a trial of LESI. These other factors include: body mass index, smoking history, duration of pain prior to entry into study, age, gender, rating of pain dysfunction questionnaire (PDQ) [32], visual analog scale of pain rating (VAS), and medication consumption. Since EMG is most sensitive to motor nerve involvement, it may turn out that self-reported pain or disability may have independent predictive value or additive predictive value in conjunction with a positive EMG examination. We expect to derive an equation based on regression of the potentially significant variables listed to include the EMG score as an independent predictor variable.

Previous Research Activities or Publications with Medical Students:

1. Thirunarayan MA, Kerrigan DC, Rabuffetti M, Della Croce U and Saini M. Comparison of three methods for estimating vertical displacement of COM during level walking in patients. Journal of Gait & Posture; 1996. 4:306-314
2. Saini M., Kerrigan DC, Thirunarayan MA and Duff-Raffaele M. The vertical displacement of the center of mass during Walking: A comparison of four measurement methods. Journal of Biomechanical Engineering; 1998. 120:133-139
3. Annaswamy TM, Eisenhardt E, Satwicz P and Borg-Stein J. Self-rated pain and functional status with acupuncture. Medical Acupuncture; 2001. 13/1: 13-15
4. Annaswamy TM, Giddings C, Della Croce U and Kerrigan DC. Rectus Femoris: Its role in normal gait. Archives of Physical Medicine & Rehabilitation; 1999. 80/8: 930-934

The above publications were about research that was performed with students (Medical and Engineering). My name is bolded and the students' name is italicized.

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