Ultrasonographic Median Nerve Changes After a Wheelchair Sporting Event

Impink, Bradley G; Boninger, Michael L.; Walker, Heather; Collinger, Jennifer L.; Niyonkuru, Christian

doi:10.1016/j.apmr.2009.02.019

Cited by 26 publications

(25 citation statements)

References 34 publications

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“…(31, 36, 37) The magnitude of change in median nerve measures in the previous studies, including one in our laboratory, ranged from 4 to 20%, while a majority were rather small changes of less than 10%. In this study, using ultrasound, we were able to detect changes in the median nerve CSA, swelling ratio, and flattening ratio which varied from 3.5% to 12.7%.…”

Section: Discussionmentioning

confidence: 82%

“…(25–30) Our laboratory has demonstrated good reliability of intra-rater measures of median nerve ultrasound characteristics, including the cross-sectional area, swelling ratio, and flattening ratio at the pisiform and distal radius levels. (31, 32)…”

Section: Methodsmentioning

confidence: 99%

“…The machine settings were optimized as in our previous studies and held constant across all participants. (31, 32) The ultrasonographic images were collected while participants remained seated with upper arm relaxed and fully adducted with no internal/external rotation, the elbow flexed to 90 degrees, forearm supinated and supported, and the wrist maintained at neutral posture with the fingers relaxed. The baseline images were collected prior to participation in the keyboarding task and served as a reference for comparing the post-keyboarding measurements in order to quantify acute changes of the median nerve.…”

Section: Methodsmentioning

confidence: 99%

“…(31, 32) Briefly, median nerve diameter and cross-sectional area were determined by performing a boundary trace along the border between the hypoechoic inner median nerve and the hyperechoic outer epineurium. Figure 2 shows an example of the boundary trace and major and minor axis selections.…”

Section: Methodsmentioning

confidence: 99%

“…The details of the quantitative ultrasound examination were described elsewhere [Impink et al, 2009;Impink et al, 2010]. Briefly, ultrasound images of the carpal tunnel, with primary emphasis on the median nerve, were collected at the distal radius and the pisiform levels.…”

Section: Quantitative Ultrasound Examinationmentioning

confidence: 99%

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Effects of computer keyboarding on ultrasonographic measures of the median nerve

Toosi

Impink

Baker

et al. 2011

American J Industrial Med

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Background Keyboarding is a highly repetitive daily task and has been linked to musculoskeletal disorders of the upper extremity. However, the effect of keyboarding on median nerve injuries is not well understood. The purpose of this study was to use ultrasonographic measurements to determine whether continuous keyboarding can cause acute changes in the median nerve. Methods Ultrasound images of the median nerve from twenty-one volunteers were captured at the levels of the pisiform and distal radius prior to and following a prolonged keyboarding task (i.e., one hour of continuous keyboarding). Images were analyzed by a blinded investigator to quantify the median nerve characteristics. Changes in the median nerve ultrasonographic measures as a result of continuous keyboarding task were evaluated. Results Cross-sectional areas at the pisiform level were significantly larger in both dominant (p=0.004) and non-dominant (p=0.001) hands following the keyboarding task. Swelling ratio was significantly greater in the dominant hand (p=0.020) after 60 minutes of keyboarding when compared to the baseline measures. Flattening ratios were not significantly different in either hand as a result of keyboarding. Conclusion We were able to detect an acute increase in the area of the median nerve following one hour of keyboarding with a computer keyboard. This suggests that keyboarding has an impact on the median nerve. Further studies are required to understand this relationship, which would provide insight into the pathophysiology of median neuropathies such as carpal tunnel syndrome.

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Section: Discussionmentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Quantitative Ultrasound Examinationmentioning

confidence: 99%

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Effects of computer keyboarding on ultrasonographic measures of the median nerve

Toosi

Impink

Baker

et al. 2011

American J Industrial Med

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Repeatability of ultrasonographic median nerve measures

et al. 2010

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In this study we investigated the reliability of ultrasound in measuring median nerve characteristics including cross-sectional area (CSA), flattening ratio (FR), swelling ratio (SR), and mean grayscale. Generalizability theory was used to assess inter- and intrarater reliability using the dependability coefficient (phi), normalized standard error of measurement, and normalized minimum detectable change (MDC(NORM)) for multiple study design protocols. Interrater reliability was generally moderate. Intrarater reliability was mostly good (phi > 0.876) when using a single image, captured on one occasion, and being read once. Intrarater MDC(NORM) ranged from 3.8% to 6.2% for all CSA measures and SR. Using multiple images and/or readings at multiple occasions did not appreciably improve reliability measures. Ultrasound is a reliable tool for measuring median nerve characteristics. We recommend that a single evaluator capture all images for protocols aimed at quantifying median nerve ultrasound measures. We believe an appropriately designed protocol can utilize ultrasound to accurately assess changes in median nerve characteristics after activity.

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The Disabled Athlete in Ball Sports

Webborn

2013

Acute and Chronic Finger Injuries in Ball Sports

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Ultrasonographic Median Nerve Changes After a Wheelchair Sporting Event

Cited by 26 publications

References 34 publications

Effects of computer keyboarding on ultrasonographic measures of the median nerve

Effects of computer keyboarding on ultrasonographic measures of the median nerve

Repeatability of ultrasonographic median nerve measures

The Disabled Athlete in Ball Sports

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