Greathouse David G, Root Tiffany M, Carrillo Carla R, Jordan Chelsea L, Pickens Bryan B, Sutlive Thomas G, Shaffer Scott W, Moore Josef F
Texas Physical Therapy Specialists, New Braunfels, Texas, USA.
US Army Med Dep J. 2011 Jan-Mar:70-81.
Dentists and dental hygienists have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. Unfortunately, previous research has not involved the impact of preventive dental specialist training on dental assistants. Therefore, the purpose of this study was to determine the presence of median and ulnar neuropathies in US Army dental assistants before and after training as preventive dental specialists.
Thirty-five US Army dental assistants (24 female, 11 male; age range 18-41 years) volunteered for the study. Twenty-eight preventive dental specialist students completed both the pretraining and posttraining data collections. Subjects were evaluated during the first and last weeks of their 12-week course. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities were obtained by performing motor, sensory, comparison (unilateral median to ulnar distal motor and sensory latencies), and F-wave nerve conduction studies (NCS). Descriptive statistics for subject demographics and pre to post physical examination and nerve conduction variables were calculated. Chi square (χ²) analysis was also conducted to determine if a significant shift in the prevalence of neuropathies occurred following dental training.
With the exception of comparison studies, pre-NCS and post-NCS electrophysiological variables were normal. Specifically, 9 subjects (26%) involving 14 hands (20%) were found to have meaningful (>1.0 millisecond) delayed median to ulnar distal motor latency comparisons in the pretraining assessment. Additionally, there was no statistically significant shift in the prevalence of electrodiagnostic abnormalities of the median nerve following the 12-week training program (χ²=0.280, P=.60).
The prevalence of clinical and electrodiagnostic abnormalities of the median nerve in this sample of US Army dental assistants closely mirrors the prevalence reported for other dental professionals. This study also demonstrates that, for this sample, the 12-week training program did not appear to affect the electrophysiologic status of the median or ulnar nerves.
据报道,牙医和牙科保健员上肢肌肉骨骼疾病的患病率较高,包括腕管综合征。遗憾的是,先前的研究未涉及预防性牙科专家培训对牙科助理的影响。因此,本研究的目的是确定美国陆军牙科助理在接受预防性牙科专家培训前后正中神经和尺神经病变的情况。
35名美国陆军牙科助理(24名女性,11名男性;年龄范围18 - 41岁)自愿参与本研究。28名预防性牙科专家学员完成了培训前和培训后的数据收集。在为期12周课程的第一周和最后一周对受试者进行评估。受试者填写病史表格、接受访谈并进行体格检查。通过进行运动、感觉、对比(单侧正中神经与尺神经远端运动和感觉潜伏期)以及F波神经传导研究(NCS)来获取双上肢正中神经和尺神经的神经传导状态。计算受试者人口统计学以及培训前到培训后体格检查和神经传导变量的描述性统计数据。还进行了卡方(χ²)分析,以确定牙科培训后神经病变患病率是否发生显著变化。
除对比研究外,培训前和培训后的神经传导研究电生理变量均正常。具体而言,在培训前评估中,发现9名受试者(26%)涉及14只手(20%)存在正中神经到尺神经远端运动潜伏期有意义的(>1.0毫秒)延迟。此外,经过12周培训计划后,正中神经电诊断异常的患病率没有统计学上的显著变化(χ² = 0.280,P = 0.60)。
在这个美国陆军牙科助理样本中,正中神经临床和电诊断异常的患病率与其他牙科专业人员报告的患病率相近。本研究还表明,对于这个样本,12周的培训计划似乎并未影响正中神经或尺神经的电生理状态。