Reduced longitudinal excursion of the median nerve in carpal tunnel syndrome

A. Hough, A. Moore, Mark Jones

Research output: Contribution to journalArticle

Abstract

To determine if longitudinal excursion of the median nerve is reduced in patients with carpal tunnel syndrome (CTS). Design Case-control study. Setting University human movement laboratory. Participants Nineteen patients with CTS (8 men, 11 women; mean age, 57±15y), and 37 healthy controls (8 men, 29 women; mean age, 48±10y). Interventions Not applicable. Main Outcome Measures Longitudinal excursion of the median nerve, and the ratio of nerve to flexor digitorum superficialis tendon excursion at the carpal tunnel evoked by finger extension. Measurements were taken using a validated Doppler ultrasound technique, and tests were conducted with the elbow positioned in extension and flexion. Results Mean longitudinal excursion of the median nerve was significantly greater in controls (11.2±2.8mm) than patients (8.3±2.6mm) with the elbow extended (P=.013), but not with the elbow flexed (controls, 12.5±2.5mm; patients, 10.2±3.1mm; P=.089). Mean nerve/tendon excursion ratios were significantly greater in controls (.32±.07) than patients (.23±.06), with the elbow extended (P<.001), and flexed (controls, .36±.06; patients, .28±.10; P=.019). Discriminant analysis identified that 11 (58%) of the 19 patients and 3 (8%) of the 37 controls showed a nerve/tendon excursion ratio of .25 or less when tested with the elbow in extension. Conclusions Reduced longitudinal excursion of the median nerve at the carpal tunnel was identified in a substantial proportion of patients with CTS. Further studies are merited to determine if reduced median nerve excursion at the carpal tunnel is clinically relevant in CTS, and can be influenced by movement-based interventions.
Original languageEnglish
Pages (from-to)569-576
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume88
Issue number5
Publication statusPublished - May 2007

Fingerprint

Carpal Tunnel Syndrome
Median Nerve
Elbow
Wrist
Tendons
Doppler Ultrasonography
Discriminant Analysis
Fingers

Keywords

  • Carpal tunnel syndrome
  • Median nerve
  • Rehabilitation
  • Ultrasonography, Doppler

Cite this

@article{5f4481b87dd341e6982f3e722c72d616,
title = "Reduced longitudinal excursion of the median nerve in carpal tunnel syndrome",
abstract = "To determine if longitudinal excursion of the median nerve is reduced in patients with carpal tunnel syndrome (CTS). Design Case-control study. Setting University human movement laboratory. Participants Nineteen patients with CTS (8 men, 11 women; mean age, 57±15y), and 37 healthy controls (8 men, 29 women; mean age, 48±10y). Interventions Not applicable. Main Outcome Measures Longitudinal excursion of the median nerve, and the ratio of nerve to flexor digitorum superficialis tendon excursion at the carpal tunnel evoked by finger extension. Measurements were taken using a validated Doppler ultrasound technique, and tests were conducted with the elbow positioned in extension and flexion. Results Mean longitudinal excursion of the median nerve was significantly greater in controls (11.2±2.8mm) than patients (8.3±2.6mm) with the elbow extended (P=.013), but not with the elbow flexed (controls, 12.5±2.5mm; patients, 10.2±3.1mm; P=.089). Mean nerve/tendon excursion ratios were significantly greater in controls (.32±.07) than patients (.23±.06), with the elbow extended (P<.001), and flexed (controls, .36±.06; patients, .28±.10; P=.019). Discriminant analysis identified that 11 (58{\%}) of the 19 patients and 3 (8{\%}) of the 37 controls showed a nerve/tendon excursion ratio of .25 or less when tested with the elbow in extension. Conclusions Reduced longitudinal excursion of the median nerve at the carpal tunnel was identified in a substantial proportion of patients with CTS. Further studies are merited to determine if reduced median nerve excursion at the carpal tunnel is clinically relevant in CTS, and can be influenced by movement-based interventions.",
keywords = "Carpal tunnel syndrome, Median nerve, Rehabilitation, Ultrasonography, Doppler",
author = "A. Hough and A. Moore and Mark Jones",
year = "2007",
month = "5",
language = "English",
volume = "88",
pages = "569--576",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
number = "5",

}

Reduced longitudinal excursion of the median nerve in carpal tunnel syndrome. / Hough, A.; Moore, A.; Jones, Mark.

In: Archives of Physical Medicine and Rehabilitation, Vol. 88, No. 5, 05.2007, p. 569-576.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Reduced longitudinal excursion of the median nerve in carpal tunnel syndrome

AU - Hough, A.

AU - Moore, A.

AU - Jones, Mark

PY - 2007/5

Y1 - 2007/5

N2 - To determine if longitudinal excursion of the median nerve is reduced in patients with carpal tunnel syndrome (CTS). Design Case-control study. Setting University human movement laboratory. Participants Nineteen patients with CTS (8 men, 11 women; mean age, 57±15y), and 37 healthy controls (8 men, 29 women; mean age, 48±10y). Interventions Not applicable. Main Outcome Measures Longitudinal excursion of the median nerve, and the ratio of nerve to flexor digitorum superficialis tendon excursion at the carpal tunnel evoked by finger extension. Measurements were taken using a validated Doppler ultrasound technique, and tests were conducted with the elbow positioned in extension and flexion. Results Mean longitudinal excursion of the median nerve was significantly greater in controls (11.2±2.8mm) than patients (8.3±2.6mm) with the elbow extended (P=.013), but not with the elbow flexed (controls, 12.5±2.5mm; patients, 10.2±3.1mm; P=.089). Mean nerve/tendon excursion ratios were significantly greater in controls (.32±.07) than patients (.23±.06), with the elbow extended (P<.001), and flexed (controls, .36±.06; patients, .28±.10; P=.019). Discriminant analysis identified that 11 (58%) of the 19 patients and 3 (8%) of the 37 controls showed a nerve/tendon excursion ratio of .25 or less when tested with the elbow in extension. Conclusions Reduced longitudinal excursion of the median nerve at the carpal tunnel was identified in a substantial proportion of patients with CTS. Further studies are merited to determine if reduced median nerve excursion at the carpal tunnel is clinically relevant in CTS, and can be influenced by movement-based interventions.

AB - To determine if longitudinal excursion of the median nerve is reduced in patients with carpal tunnel syndrome (CTS). Design Case-control study. Setting University human movement laboratory. Participants Nineteen patients with CTS (8 men, 11 women; mean age, 57±15y), and 37 healthy controls (8 men, 29 women; mean age, 48±10y). Interventions Not applicable. Main Outcome Measures Longitudinal excursion of the median nerve, and the ratio of nerve to flexor digitorum superficialis tendon excursion at the carpal tunnel evoked by finger extension. Measurements were taken using a validated Doppler ultrasound technique, and tests were conducted with the elbow positioned in extension and flexion. Results Mean longitudinal excursion of the median nerve was significantly greater in controls (11.2±2.8mm) than patients (8.3±2.6mm) with the elbow extended (P=.013), but not with the elbow flexed (controls, 12.5±2.5mm; patients, 10.2±3.1mm; P=.089). Mean nerve/tendon excursion ratios were significantly greater in controls (.32±.07) than patients (.23±.06), with the elbow extended (P<.001), and flexed (controls, .36±.06; patients, .28±.10; P=.019). Discriminant analysis identified that 11 (58%) of the 19 patients and 3 (8%) of the 37 controls showed a nerve/tendon excursion ratio of .25 or less when tested with the elbow in extension. Conclusions Reduced longitudinal excursion of the median nerve at the carpal tunnel was identified in a substantial proportion of patients with CTS. Further studies are merited to determine if reduced median nerve excursion at the carpal tunnel is clinically relevant in CTS, and can be influenced by movement-based interventions.

KW - Carpal tunnel syndrome

KW - Median nerve

KW - Rehabilitation

KW - Ultrasonography, Doppler

M3 - Article

VL - 88

SP - 569

EP - 576

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 5

ER -