This study aimed to determine the proper and safe needle insertion point in the flexor carpi radialis (FCR) muscle under ultrasonography guidance. Methods: We identified the center point (CP) of the FCR as the optimal needle insertion point using ultrasonography. The location of the CP was analyzed using ratios and distances from other landmarks. The vertical distance (CP-VD) was measured by drawing an imaginary vertical line from the CP to the elbow crease. We measured the horizontal distance from the point where the imaginary vertical line from the CP meets the elbow crease to the biceps tendon at the elbow crease level (CP-HD). We presented the ratio of CP-HD to forearm circumference (HD ratio) and the ratio of CP-VD to forearm length (VD ratio) as percentages. Results: The mean values of CP-HD and CP-VD were 2.0 ± 1.0 cm and 8.2 ± 1.1 cm, respectively. The mean HD and VD ratios were 8.4% ± 4.2% and 32.0% ± 3.1%, respectively. Conclusion: When performing electromyography (EMG) of the FCR muscle, it is recommended to perform EMG at the point about 2 cm medial from the biceps tendon at the elbow crease level, to nearly the proximal one-third of forearm length.

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Objective To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients.Methods Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS).Results The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%.Conclusion There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.

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