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美国陆军医疗司令部乐队成员的正中神经和尺神经病变

Median and ulnar neuropathies in U.S. Army Medical Command Band members.

作者信息

Shaffer Scott W, Koreerat Nicholas R, Gordon Lindsay B, Santillo Douglas R, Moore Josef H, Greathouse David G

机构信息

Clinical Electrophysiology Services, Texas Physical Therapy Specialists, 1324 Common Street, Suite 307, New Braunfels, TX 78130, USA. Tel 210-705-3441, fax 830-625-3228.

出版信息

Med Probl Perform Art. 2013 Dec;28(4):188-94.

Abstract

PURPOSE

Musicians have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. The purpose of this study was to determine the presence of median and ulnar neuropathies in U.S. Army Medical Command (MEDCOM) Band members at Fort Sam Houston, Texas.

METHODS

Thirty-five MEDCOM Band members (30 males, 5 females) volunteered to participate. There were 33 right-handed musicians, and the mean length of time in the MEDCOM Band was 12.2 yrs (range, 1-30 yrs). Subjects completed a history form, were interviewed, and underwent a physical examination of the cervical spine and bilateral upper extremities. Nerve conduction studies of the bilateral median and ulnar nerves were performed. Electrophysiological variables served as the reference standard for median and ulnar neuropathy and included distal sensory latencies, distal motor latencies, amplitudes, conduction velocities, and comparison study latencies.

RESULTS

Ten of the 35 subjects (29%) presented with abnormal electrophysiologic values suggestive of an upper extremity mononeuropathy. Nine of the subjects had abnormal median nerve electrophysiologic values at or distal to the wrist; 2 had bilateral abnormal values. One had an abnormal ulnar nerve electrophysiologic assessment at the elbow. Nine of these 10 subjects had clinical examination findings consistent with the electrophysiological findings.

CONCLUSIONS

The prevalence of mononeuropathies in this sample of band members is similar to that found in previous research involving civilian musicians (20-36%) and far exceeds that reported in the general population. Prospective research investigating screening, examination items, and injury prevention measures in musicians appears to be warranted.

摘要

目的

据报道,音乐家上肢肌肉骨骼疾病的患病率较高,包括腕管综合征。本研究的目的是确定德克萨斯州萨姆休斯顿堡美国陆军医疗司令部(MEDCOM)乐队成员中正中神经和尺神经病变的情况。

方法

35名MEDCOM乐队成员(30名男性,5名女性)自愿参与。有33名右利手音乐家,在MEDCOM乐队的平均时长为12.2年(范围1 - 30年)。受试者完成病史表格,接受访谈,并对颈椎和双侧上肢进行体格检查。对双侧正中神经和尺神经进行神经传导研究。电生理变量作为正中神经和尺神经病变的参考标准,包括远端感觉潜伏期、远端运动潜伏期、波幅、传导速度和对比研究潜伏期。

结果

35名受试者中有10名(29%)出现提示上肢单神经病变的异常电生理值。其中9名受试者在腕部或其远端正中神经电生理值异常;2名双侧异常。1名受试者肘部尺神经电生理评估异常。这10名受试者中有9名临床检查结果与电生理结果一致。

结论

该乐队成员样本中单神经病变的患病率与先前涉及平民音乐家的研究结果相似(20 - 36%),且远高于一般人群的报道。对音乐家的筛查、检查项目和损伤预防措施进行前瞻性研究似乎很有必要。

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