BACKGROUND ART Many physicians encounter patients with complaints that involve injuries of the soft tissues, particularly those soft tissues of the perasPinal muscles. In many cases objective findings are obvious, but a percentage of patients have injuries that, while subtle, still cause symptoms that bring them to the attention of a care provider or specialist. In other cases, the injuries may be less recent, which provide no apparent physical findings. Direct palpation of soft tissues can, in some cases, reveal the nature or type of injury, but this manner of diagnosis relies on static testing. For some subject, problems may only be encountered during activity. Quantifying these dynamic conditions of the soft tissues is problematic.

Range of motion testing is often relied upon to determine the cause, yet measuring the muscle activity during range of motion testing is difficult. The extent to which a patient exerts him or herself also presents

a subjective bias. If muscle activity could be recorded during range of motion testing, the extent to which the muscles or muscle groups are activated and to what degree would provide helpful information about the nature of the soft tissue injury.

The Mayo clinic confirmed in their studies on sagittal gait patterns and knee joint functions that static measurements do not correlate well with true functional assessment of movement. As part of their conclusions, they recommended the use of functional assessments as a routine diagnostic tool in a similar manner as an electrocardiogram (EKG). In this setting, the use of tests like magnetic resonance imaging (MRI) or X-raYs are of little use, since they are static tests and not specifically designed to evaluate soft tissue damage and the subsequent change in function.

Therefore, there is a growing need within the medical, insurance and industrial communities for an objective analysis of biomechanics on a functional level.

Myofacial injuries represent a significant medical problem, with back pain accounting for a large number of medical visits. carpal tunnel syndrome (CTS) and repetitive stress injuries (R5I) account for the most days lost and is currently one of the most costly health problems. The cost of this health problem is expected to increase because OSt4A has passed a musculoskeletal disorder standard for repetitive stress injuries. With the implementation of the American's with disability (ADA) law, worker's compensation claims such as (OTS) can now sue in the federal court system, allowing for suits in excess of 10 million dollars.

These excessive claims could damage the economy and force employers to go outside of the United states.

A recent study revealed that over 45 percent of <BR> <BR> <BR> individuals who have undergone OTS release surgery were no better two years past the surgical intervention

because they were misdiagnosed. The individuals probably had cervical pathology that can refer pain and mimic the symptoms of CTS, ulnar neuropathy, cubital tunnel, tendonititis, DeQuarian's syndrome i. e., rePetitive stress injuries. The problem is that until the development of the instant invention, there was no way to ascertain if the Problem was proximal, cervical or distal.

In the past, many doctors have prescribed a profalatic work restriction limiting the amount an individual can lift. More often than not, the lifting restriction is too general and too limiting which prohibits the individual from returning back to their usual or any job. For example, a typical work restriction of not lifting over 50 pounds is highly restrictive. Doctors impose this restriction because they have no means of evaluating the muscle and disc pathology during movement.

The inventive combined physiological monitoring system (CPM5) solves many of the above problems on data gathering by combining up to 32 channels of proprietary surface EMG, up to 12 range of motion channels, two FCE sensors and a grip strength. There is also room for at <BR> <BR> <BR> <BR> least two cables of electromyography (EMG). The PMS also combines two channels of nerve conduction velocity (NOV) to apply a current to monitor NOV with temperature control and pro-set electrodes. The OPMS can also be designed to operate with utility power or to be battery operated to allow an individual to be monitored anywhere, including the worksite.

A search of the prior art did not disclose any patents that read directly on the claims of the instant invention. However, the following U. S. patents were considered related : PATENT NO. INVENTOR ISSUED 5, 513, 651 cusimano, et al 7 May 1996

5,462, 065 cusimano, et al 31 October 1995 5, 042, 505 Mayor, et al 27 August 1991 <BR> <BR> <BR> 4, 688, 581 MOSS 25 August 1P87 4, 667,513 Konno 26 May 1987 The 5,513,651 and 5, 462, 065 patents disclose an integrated movement analyzing system that utilises surface electromyography in combination with range of motion and functional capacity testing to monitor muscle groups in the human body. The system consists of an integrated movement analyzer (IMA) that receives inputs from surface EMC electrodes, a range of motion arm (ROMA), and a functional capacity sensor. When performing upper and lower back testing, the ROMA is connected between the patient's upper back and lower back by a shoulder harness and a waist belt. For cervical testing, the ROMA is connected between the patient's head and upper back by a cervical cap and the shoulder harness. The output of the IMA is provided via an analog to digital converter to a computer. The computer in combination with a software program produces an output consisting of comparative analytical data.

The 5,042,505 patent discloses an electronic device for measuring relative angular positional displacement and angular range of motion for body segments and articulating joint5 of the human skeleton. The device has a hand-held interface unit which is placed against the body segment or joint to be tested. Mounted within the housing of the interface unit is a shaft with a pendulum at one end and an optical encoder at the other. As the body segment rotates or the joint articulates, the pendulum swings in the direction of gravity, causing the shaft to rotate. The optical encoder generates an electrical signal representative of the amount of rotation of the shaft. The generated signal is fed to a microprocessor which Processes the

information and can produce on a display the change in angular position relative to initial angular position or the angular range of motion of the body segment or articulating joint.

The 4,688,581 patent discloses an apparatus and a method for non-invasive in vivo determination of muscle fiber composition. The method includes the steps of electrically stimulating a chosen muscle ; determining the stimulation current ; measuring the electrical potential of the muscle ; the contraction time, and the force produced by the-contraction ; and by intercorrelating the data by multiple regression, determining the type, percentage and size of muscle fibers within the muscle stimulated. Apparatus for determining the muscle composition includes a muscle stimulator of controlled voltage electromyogram equipment, and a force transducer providing a tension curve as well as force measurements.

The 4, 667, 513 patent discloses an apparatus and a method for estimating the degree of the fatigue and pain of muscles. The apparatus comPoses subjects of different weights on the same basis by deriving the variation in the muscular strength such as dorsal muscular strength, shoulder muscular strength, grasping power and the like. An analogous electric signal integrates the muscular output on one hand, and provides an integrated value of the electromyogrammatic amplitude by processing the voltage induced from the muscle to be tested through an electromyogram amplitude and a waveform processor. The ratio between these integrated values, after correcting the ratio with a weight/muscular strength coefficient is digitally displayed,

For background purposes and as indicative of the art to which the invention relates, reference may be made to the following remaining Patents found in the search : PATENT NO. INVENTOR NVENTOR 5, 056, 530 Butler, et al 15 October 1991 5, 050, 618 Larsen 24 September 1991 5, 042, 505 Meyer, et al 27 AUgust 1971 5,038,795 Roush, et al 13 August 1991 5,012,820 Meyer 7 May 1991 4, 938, 476 Brunell, et al 3 July 1990 4,928,709 Allison, et al 29 May 1990 4,886, 073 Dillion, et al 12 December 1989 4,845, 987 Kenneth 11 July 1989 4, 834, 057 McLeod, Jr. 30 May 1989 4, 805,636 Barry, et al 21 February 1989 4, 800, 897 Nilsson 31 January 1989 4, 742, 832 Kauffmann, et al 10 May 1988 <BR> <BR> <BR> <BR> 4,667, 513 Konno 26 May 1987 4,586,515 Berger 6 May 1986 DISCLOSURE OF THE INVENTION The combined physiological monitoring system (CPMS) consist of a portable, non-loading electronic unit that simultaneously monitors muscle activity with standard electrodes. The muscle groups in the human body, including cervical, midback, low back and upper and lower extremities, are monitored. The CPMS also uses the gold standard in combination with a load cell and strain gauge to determine a person's lifting, gripping and range-of-motion ion capability. The CPMS functions with a dedicated computer and a proprietary software program, entitled Patient Data Acquisition system

(PDAS), which correlates muscle activity with a force produced by a person. The design of the CPMS allows electromyography (EMG), range-of-motion, grip assessment and functional assessment to be conducted during a single testing session.

During an injury to a muscle and/or fascial elements, many pathophysiological processes occur which follow a predictable pattern. When a muscle is strained, the fibers of that muscle are damaged and cells within the muscle are ruptured. These ruptured cells release substances which cause the muscle to reflexively tighten. Muscles that cause an action (agonist) and muscles which prevent the action (antagonist) are monitored. Muscle groups which are distant from the injury site may not be performing their proper function since theY are compensating for the 1055 of function due to the injury. The greater the pattern of compensation the more longstanding is the injury.

The EMG provided by the OPMS will record a signal of increased amplitude and frequency from a muscle which is characteristic of an acute injury. The process of aging an injury is multi-factorial and involves not only muscle groups, but their interrelationship with each other. An electrodiagnostic functional assessment (EFA) provided by the OPMS can monitor up to a total of 19 muscle groups simultaneously.

By understanding the natural progression of a myofascial injury, and the information provided by the cPM5, the relative age of an injury can be determined.

In its most basic form, the OPMS is comprised of the following elements, which are shown in FIGURE 1 and described in the Best Mode for carrying Out the Invention : a) a plurality of EMG sensors, b) a range-of-motion (ROM) arm s y

c) a plurality of functional capacity evaluation (FOE) sensors, d) a grip sensor, e) a pinch sensor, f) a power supply g) a computer, h) software, and i) a CPMS control circuit.

In view of the above disclosure, the primary object of the OPMS is to monitor selective muscle activity in a human body, which includes cervical, thoraic, upper and lower extremities and lumbosacral. The OPM5 can simultaneously correlate the muscle activity with EMG, range-of-motion, grip assessment and a functional assessment.

In addition to the primary object of the invention, it is also an object of the invention to produce a OPALS that : o identifies malingering persons, workers who may be magnifying symptoms, and most importantly, in diagnosing real injuries and allows the acquired data to be reviewed to determine appropriate treatment, o assesses the actual extent of myofascial injuries that might be job or accident related, o allows muscle pathology to be assessed above and below the area of the reported injury which then allows the total extent of an injury to be established to determine future treatment, the probability of permanent disability and the need for potential vocational rehabilitation, o provides a real time diagnosis of muscle activity, o provides a powerful tool for establishing an evaluation and treatment program,

o can assess chronic versus acute injuries by evaluating muscle compensation, o can assist physicians who care for professional or high level college athletes, in determining the extend of sports-related musculoskeletal injuries, and provide accurate data that can be used in designing site-specific treatment protocols, thus allowing a more rapid, predicable and safe return to competition. It can also be used in pre-participation physical examinations and allow trainers to address otherwise undiagnosed deficiencies, and o can assess the clinical significance of disc pathology.

In summary, the CPMS identifies the severity of injuries allows future diagnostic and treatment grograms to be established that take into account both the needs of the injured person and the need to contain the runaway costs of potential long term or unsubstantiated cases.

These and other objects and advantages of the present invention will become apparent from the subsequent detailed description of the preferred embodiment and the appended claims taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS FIGURE 1 is a block diagram showing the basic elements that comprise the combined physiological monitoring system (CPMS).

FIGURE 2 is a detailed block diagram of the overall combined physiological monitoring system (OPMS).

FIGURE 3 is a detailed block diagram of the control circuit which is integral element. of the OPMS.

FIGURE 4 is a side elevational view of an electromYograph (EMG) cable assembly.

FIGURE 5 is an elevational view of the multi-pin connector of the. EMG cable assembly.

FIGURE 6 is a sectional view of the EMs cable assembly taken along the lines 5-5 of FIGURE 3.

FIGURE 7 is a module flow diagram of the UPMS spatent Data Acquisition system (PDAS) software program.

BEST MODE FOR CARRYING OUT THE INDENTION The best mode for carrying out the invention is presented in terms of a preferred embodiment for a combined Physiological monitoring system (CPMS) 10. The OPRIS performs an electrodiagnostic functional assessment (EFA) by analyzing muscle activity by means of electroymography (EMG). When using EMA, a standard silver-silver chloride electrode is attached to a muscle or muscle group. The'electrical activity of the muscle or muscle group is measured and recorded.

The muscle groups monitored by the spMS lo are: cervical, thoraic, upper extremity, lower extremity and lumbosacral. Data pertaining to each muscle group is typically taken in the following five steps, while the monitored muscle or muscle group is: 1) at rest, 2) going through a range of motion protocol, 3) at rest 4) being applied a gripping, lifting and/or pulling force, and 5) at rest.

The above test allow the CPMS 10 to determine muscle tone (contracture amplitude), muscle sPasms (frequency), blood flo to muscles (vasoconstrive states), muscle activity (frequency and recruitment patterns), and muscle response (fatigue). Thus, the CPM5 can assess the condition and the dynamic functions of any particular muscle or muscle group.

In a typical configuration, the CPMS 10 is comprised of : a) uP to 32 channels of surface electromyography (EMG), wherein each channel can be designed to incorporate an analog-to-digital converter (ADO,

b) two channels of nerve conductive velocity (NO with temperature control and pre-set electrodes, c) two channels for receiving range-of-motion (ROM) arms, d) two channels for receiving functional capacity evaluation (FCE) sensors, e) a channel for receiving a grip strength sensor, and f) a channel for receiving a pinch strength sensor.

The electrodiagnostic functional assessment (EFA) can be conducted one test at a time or can be combined with EMG, ROM, FOE and the grip and pinch strengths to provide an integrated test, which is conducted during a single test session. The OPMS 10 can also be configured to function as an electrocardiagram (EKG) and to allow additional physiological functions to be added such as temperature, heart rate and skin response. To function as an EKG, the c4pMs is modified by using only eight channel(s). The EKG provided by the UPS is better because there is no movement artifact and can simultaneously monitor blood flow.

The preferred embodiment of the CPM5 10, as shown in FIGURE5 2-7, is comprised of the following major elements : a CCPMS control circuit 14, a leads-off circuit 5Or an ENG sensor 52, a range of motion (ROM) arm 54, functional capacity evaluation (FCE) sensors 56, a grip and a pinch sensor 58, a power supply interface circuit 62, an analog Power supply 64, a digital power supply 66, an EMG cable assembly 70, a patient data acquisition system (PDAS) software program 80 which resides in a Pc computer 82, and a computer/system interface circuit 84.

The CPM5 control circuit 14 has means for processing the digital and analog signals which operate

the CPMS 10. The circuit 14, which is shown in its overall relationship with the CPMS 10 in FIGURE 2 and in detail in FIGURE 3, is partitioned into an analog section 16, a digital section 40 and a power distribution circuit 48. The analog section 16 is comprised of an electromyography (EMU) leads connection circuit 13, an EMG front end circuit 20, a leads-off detection circuit 22, a leads-off displaY circuit 24, a range of motion (ROM)/functional capacity evaluation (FOE) /grip and pinch interface circuit 26, a ROM front end circuit 28, an FUEfgriPand pinch front end circuit 30, and a data acquisition circuit 34.

The ENG leads connection circuit 18 has means for determining the structural integrity of the leads from the EMS sensors 52, and can accommodate from one to nineteen leads. The circuit 18 is connected to a first signal, a second signal and a third signal. The first signal is connected to the EMG sensor 52 and the second signal is connected to the EMG front end circuit 20 which has means for assessing the muscle activity sensed by the EMG sensors 52. The circuit 20 produces a fourth signal that is applied to the data acquisition circuit 34 for further processing.

The third signal from the circuit 18 is connected to the leads-off detection circuit 22, which has means for determining if the EMO sensor leads are properly attached by measuring the impedance of the muscle and the surrounding skin area. The circuit 22 is also connected to a fifth, sixth and seventh signal. The fifth signal is applied to the data acquisition circuit 34 for further processing, the seventh signal is connected to the EMG sensors 52 and the sixth signal is applied to the leads-off display circuit 24 which has means for producing a display when an electrode attached to a muscle or the surrounding skin area is not properly attached. This determination is made by

measuring the impedance of each electrode, If the impedence is not at a correct level, a corresponding LED illuminates. The circuit 24 allows uP to 32 electrodes to be utilised, wherein each electrode pertains to a specific muscle placement. The circuit 24, which functions in combination with the circuit 22, is connected to the circuit 22 via the sixth signal.

The range of motion (ROM) functional capacity evaluation FOE/grip and pinch interface circuit 26 is shown as a single element for purposes of eKplanantion.

The circuit 26 is connected, to an eighth, ninth and tenth signal which are connected respectively to a ROM sensor 54, a plurlaity of FOE sensors 56 and a grip and pinch sensor 58, which are further described infra. The circuit 26 also produces an eleventh signal which is applied to the ROM front end circuit 28 and a twelfth signal applied to the FCE/grip and pinch front end circuit 30. The ROM front end circuit 28 has means for receiving and processing the data applied from the circuit 26 via the eleventh signal. The received data is amplified and filtered prior to producing a thirteenth digital signal that is applied to the data acquisition circuit 34 for further processing.

The FOEfgrip and pinch front end circuit 30 has means for receiving and processing the data applied from the circuit 26 via the twelfth signal. The received data is amplified and filtered prior to producing a fourteenth digital signal that is applied to the data acquisition circuit 34 for further processing.

The data acquisition circuit 34 is designed to include a first DAQ module 34A and a second DAQ module 34B. The DAQ modules function in combination to receive the fourth signal from the circuit LOF the fifth signal from the circuit 22, the thirteenth signal from the circuit 28 and the fourteenth signal from the

circuit 30. The input signals are processed by the circuit 34 to produce a fifteenth digital signal that is applied to the digital section 40 for further processing as shown in FIGURE 3.

The digital section 40 of the CPMS control circuit 14 is comprised of an optical isolation circuit 42, a data processing circuit 44 and a computer interface circuit 46.

The optical isolation circuit 42 has means for isolating a person from external electrical sower sources which may harm a person and can cause erroneous test readings. The circuit 42 is connected to the data acquisition circuit 34 via the fifteenth signal, to the data processing circuit 44 via a seventeenth signal, and to the computer interface circuit 46 via an eighteenth signal. The circuit 42 also has connected a sixteenth digital power signal. The data processing circuit 44, which is designed to process, transfer and store data, is also connected to the computer interface circuit 46 via a nineteenth signal.

The computer interface circuit 46 is also connected to a twenty-sixth signal, as shown in FIGURES 2 and 3, that is applied from the comPuterXsystem interface circuit 84 which interfaces with the computer 82 via a twenty-fifth signal. The circuit 46 can be designed to operate with a universal Serial Bus (USE), a Firewire (IEEE 1394) bus or a parallel port. The circuit 46 is designed to interface with the software 80 via the computer 82.

The final element of the CPMS control circuit 14 is the power distribution circuit 48, which is applied a twentY-second analog power signal and a twenty-fourth digital power signal as shown in FIGURE 2. The circuit 48 has means for regulating and distributing digital power to the digital circuits in the CPMS control circuit 14 via the optical isolation circuit 42, which

is applied the sixteenth signal from the circuit 48.

The circuit 48 also applies analog power to the analog section 16 of the CPMS control circuit 14 via a twentieth signal.

The preferred embodiment, of the overall combined physiological monitoring system (OPUS) 10 is shown in FIGURE 2, which includes the signal inputs applied to the UPMS control circuit 14 as described above. The first signal applied to the circuit 14 is from the leads-off circuit 50, which includes a means for determining if an electrode'is not properly attached to a muscle. The first signal is sent sequentially to the circuit 18 and 22, and to the leads-off display circuit 24 where an improperly-attached lead is displayed and a signal is sent to the software 80 to shut off the CPMS 10. The EMG sensors 52 produce the seventh signal which is applied to the leads-off detection circuit 22 in the CPMS circuit 14. The EMG sensors 52 sense the amplitude and frequency of various muscles or muscle groups. This data is used to monitor muscle, EKG or blood flow activity.

The range of motion (ROM) arm 54 includes a means for measuring the range of motion in the cervical, thoracic, lumbosacral, upper extremitY, lower extremity and digits. The ROM arm 54 measures a person's lateral movement, flexion, extension and rotation, each having six degrees of freedom. The ROM arm 54 incorporates two triaxial, silicon, micromatched accelerometer systems, wherein each system includes three hermetically-sealed ALXL05 accelerometers. The device 54 has a bandwidth of 1 KHZ to 4 KHZ andt if required, can be a-c coupled. optimally, the ROM arm 54 can be designed with precision potentiometers having three joints for monitoring segmental changes Plus range of motion. All the analog data collected is converted to a d-c signal that is applied via an eighth signal to the

ROM interface circuit 26 located in the CPMS control circuit 14.

The functional capacity evaluation (FOE) sensors 56 include a means for measuring a person's lift, pull and push capability. The FOE sensor function by utilizing load cells which convert an analog signal produced by the sensors to a corresponding digital signal that is applied via a ninth signal to the FOE interface circuit 26 located in the CPMS control circuit 14.

The grip/pinch sensors 58 include a means for measuring a person's hand. grip strength and pinch strength. The hand grip strength is measured by a load sensor that produces an analog signal proportional to the grip force. The analog grip force signal is converted by an'ADO to a corresponding digital signal that is applied via a tenth signal to a grip interface circuit 26 located in the OPMS control circuit 14. The pinch strength is comprised of a load button-load cell.

The load button-load cell, which has a range of 0 to 50 Ibs, is placed between the thumb and index finger and squeezed to produce an analog signal which is likewise converted to a digital signal that is applied, via the tenth signal, a pinch, interface circuit 26 also located in the OPMS control circuit 14.

The power input to the CAMS 10 is provided by an external power source that is applied to a power supply interface circuit 62. The circuit 62 has means for receiving and processing a power input ranging from 120-250 volts at a frequency of 50 or 60 Hs. The circuit 62, which incorporates circuit protection in the form of a circuit breaker or fuse, produces a twenty-first analog power signal and a twenty-third digital power signal.

The analog power supply 64, which is connected to the twenty-first signal, produces a twenty-second output signal consisting of a regulated 5-volts d-c

which powers the analog circuits in the CPMS control circuit 14. Likewise, the digital Power supply 66, which is isolated from the analog power supply 64, is connected to the twenty-third signal and produces a twenty-fourth output signal consisting of a regulated 5-volt d-c which Powers the CPMS 10.

The EMG cable assembly 70, as shown in FIGURES 4,5 and 6, is designed to connect the EMs sensors to the muscle or muscle group of a person being tested. The cable 70 includes a multi-pin connector 72, as shown in FIGURES 4, and 5, ten shielded wire pairs 74, as shown in FIGURE 6, and three EMs electrodes 76, 77 and 78, a5 shown in FIGURE 4. The first electrode 76 is active and is common with the second electrode 77 which is also active. The third electrode 78 attaches to circuit ground.

The EMG cable assembly 70 incorporates a separation bar 7S, as shown in FIGURE 4, which can be locked at a distance between 3 to 5 inches. The separation bar 79 allows the two active electrodes 76, 77 to remain isolated from each other. Additionally, the EMG cable assembly 70 can be designed to include a temperature sensor (not shown) which allows temperature readings to be taken in combination with other EMs sensor readings.

The Patient Data Acquisition System (PDAS) software program 80, as shown in FIGURE 7, is designed to provide control and data collection for the combined Physiological Monitoring System (OPMS) 10. The software so provides error detection, interactive computer interface and resides in a dedicated PC computer 82, which preferably consists of a laptop computer 82 which operates at least 400 lflHz and has 64 to 256 megabyte of RAM. Additionally, the computer 82

incorporates at least a 10-gigabyte hard drive, a 14-inch active matrix LCD, an enhanced parallel port (EPP), a universal Serial Bus (USB), a V. ? 0 modem and 10base ? network cards. The oPerating system preferably consists of MS windows or Linux, and the overall design methodology is Booch's object oriented design (OOD).

The computer 82 is connected via a twenty-fifth signal to a computer/system interface circuit 84 which allows the computer 82 to communicate with the CPMS 10 via the CPMS control circuit 14 as shown in FIGURE 1.

The software 80 is comprised of nine major modules : a) PDAS Start-provides start up routines and initialization routines for the CfPMS 10. Upon startup a main window is displayed and user commands are concurrently sent to selected elements of the OPMS 10. b) Location-provides routiness to verify the location of the selected CPMS element, c) Password-provides access control over specialized routines for demonstration purposes, d Select patient-provides. services to add a new patient, selects a previous patient for retest and selects a patient for demonstration. This module also calls Patient Info (described below) to collect patent information. e) Patient Info-provides interactive forms for the collection of patient information. Five patient information forms are available : Info 1, Info 2, Info 3, Info 4 and Info-Note. After all data is validated, control is returned to the Select Patient module which then returns control to the PDAS 74 Start module. f) select protocol-provides control and message passing for eight specialized protocols and one custom protocol. Each protocol provides

instructions to the Patient and instructions on the placement of the ENG sensors. This module also provides support for the muscle groups : cervical, Thoraic, Upper Extremity, Lower Extremity, Lumbosacral, and chest. g) acquire-provide data capture routines based on messages from the Select Protocol module via the PDAS 5tart module. Data is collected and monitored via the CPMS. If a lead fail is detected during the data capture, the Acquire module cancels the-data capture and sends a naming to the SelectProtocol module via the PDAS start module. A successful data capture results in a data file being saved to a disk. h) scanEMG'-provides testing of the EMS channels.

This module provides services to select a single channel or to select all channels for verification. i) TestPlot-provides a strip chart for testing all channels and their functions.

Operation To conduct an electrodiagnostic functional assessment (EFA) a person's muscle activity is analysed. This analyses is performed by attaching a set of electrodes from the OPMS to selected muscle groups and measuring their electrical activity. The muscle groups and the measurement process is as follows:

a) measure the cervical muscle group by placing a range of motion (ROM) arm on the top of a person's head, take measurements while the person i5 : (1) at rest, (2) performing selected range of motion protocols, and (3) at rest, b) measure the thoraic muscle group by placing the ROM arm at the center of the person's mid back and on the shoulders, take measurements while the person is : (1) at rest, (2) performing 5elected range of motion protocols, and (3) at rest, c) measure the lumbosocral muscle group by placing the ROM arm at the center of the person's low back, take measurements while the person is : 1) at rest, (2) performing selected range of motion protocols, and (3) at rest, d) measure the lower extremities muscle group by placing bilateral sets of electrodes on the front and back of a person's thigh and ankles ; place the ROM arm on each leg at the hip and knee joint, take measurements while the person is : (1) at rest, (2) performing selected range of motion protocols, and (3) at rest,

(4) performing selected range of motion protocols, (5) at rest, measure the foot muscle group by placing the ROM arm on the person's ankle, take measurements while the person is : (1) at rest, (2) performing selected range of motion protocols, and (3) at rest, f) measure the.. upper extremities muscle group by placing the ROM arm on the person's head, on one shoulder and on one wrist, take measurements while the person is: (1) at rest, (2) performing selected range of motion protocols, and (3) at rest, (4) performing a grip test utilizing a grip sensor, (5) at rest, (6) performing a pinch test utilizing a pinch sensor which is placed between the thumb and forefinger, (7) at rest, g) measure the hand muscle group by placing the ROM arm on the person's wrist, take measurements while the person is : (1) at rest, (2) performing selected range of motion protocols, (3) at rest, (4) performing a pinch test utilizing a pinch sensor which is placed between the thumb and the forefinger,

(5) at rest, and h) measure the face muscle group by placing the ROM arm on top of TM, take measurements while the person is : (1) at rest, (2) performing selected range of motion protocols, and (3) at rest.

The muscle groups are classified as follows : a) the cervical muscle group comprises : sternocleidomastoid, scalene, paracervical, and upper trapzii, b) the thoraic muscle group comprises : mid trapezii, lower trapesii, paraspinal muscles T5-T8, T8-T12, terses, and stratus, c) the lumbosacral muscle group comprises : paraspinal muscles L1-L3, L5-L51, quaratus lumborum, gluteal muscles, abdominal, and hamstrings, d) the lower extremities muscle grouP comprises : all muscles in pelvis, legs and feet, e) the foot muscle group comprises : all muscles in feet, f) the uPPer extremities muscle group comprises : bilateral SCM, scalene, deltoid, bicePs, triceps, and wrist flexors/extensors, g) the hand muscle group comprises : all muscles in the hand, h) the face muscle group comprises : fontalis, massater TMJ

While the invention has been described in complete detail and pictorially shown in the accompanying drawings it is not to be limited to such details, since many changes and modifications may be made to the invention without departing from the spirit and the scope there of. Hence, it is described to cover any and all modifications and forms wliich may come within the language and scope of the claims.