Respiration-related activity in the biceps brachii muscle after intercostal-musculocutaneous nerve transfer

Needle EMG and polygraphic recordings of respiration and biceps activity were obtained in 7 patients who had undergone intercostal to musculocutaneous nerve transfer because of severe traumatic injury to the brachial plexus. EMG activity during expiration and inspiration was assessed during quiet breathing, deep breathing, and during sustained inspiration and expiration, and compared to the clinical strength of the biceps muscle. Biceps activity was consistently found during both expiration and inspiration, and in either case separately related to the flexion force levels. Initially this relationship appeared equally strong for both phases. With time, control over flexion changes from a completely respiratory-driven control to a conscious volitional control; however, involuntary effects of respiration always remained present in polygraphic recordings. Theoretical explanations for the change in control are put forward.