Kim Do Kyun, Kim Beom Suk, Kim Min Je, Kim Ki Hoon, Park Byung Kyu, Kim Dong Hwee
Department of Physical Medicine & Rehabilitation, College of Medicine, Korea University, Seoul, Korea.
Department of Physical Medicine and Rehabilitation, Army Hospital, Daejeon, Korea.
Ann Rehabil Med. 2017 Feb;41(1):58-65. doi: 10.5535/arm.2017.41.1.58. Epub 2017 Feb 28.
To investigate the contributing factors of carpal tunnel syndrome (CTS), electrodiagnostic and ultrasonographic findings of median nerve, and median nerve change after exercise in wheelchair basketball (WCB) players.
Fifteen WCB players with manual wheelchairs were enrolled in the study. Medical history of the subjects was taken. Electrodiagnosis and ultrasonography of both median nerves were performed to assess CTS in WCB players. Ultrasonographic median nerves evaluation was conducted after wheelchair propulsion for 20 minutes.
Average body mass index (BMI) and period of wheelchair use of CTS subjects were greater than those of normal subjects. Electrodiagnosis revealed CTS in 14 of 30 hands (47%). Cross-sectional area (CSA) of median nerve was greater in CTS subjects than in normal subjects at 0.5 cm and 1 cm proximal to distal wrist crease (DWC), DWC, 1 cm, 2 cm, 3 cm, and 3.5 cm distal to DWC. After exercising, median nerve CSAs at 0.5 cm and 1 cm proximal to DWC, DWC, and 3 cm and 3.5 cm distal to DWC were greater than baseline CSAs in CTS subjects; and median nerve CSAs at 1 cm proximal to DWC and DWC were greater than baseline CSAs in normal subjects. The changes in median nerve CSA after exercise in CTS subjects were greater than in normal subjects at 0.5 cm proximal to DWC and 3 cm and 3.5 cm distal to DWC.
BMI and total period of wheelchair use contributed to developing CTS in WCB players. The experimental exercise might be related to the median nerve swelling around the inlet and outlet of carpal tunnel in WCB athletes with CTS.
探讨腕管综合征（CTS）的影响因素、正中神经的电诊断和超声检查结果，以及轮椅篮球（WCB）运动员运动后正中神经的变化。
15名使用手动轮椅的WCB运动员纳入本研究。记录受试者的病史。对双侧正中神经进行电诊断和超声检查，以评估WCB运动员的CTS情况。在轮椅推进20分钟后进行正中神经超声评估。
CTS受试者的平均体重指数（BMI）和轮椅使用时间均高于正常受试者。电诊断显示30只手中有14只（47%）存在CTS。在腕横纹近端0.5 cm和1 cm、腕横纹处、腕横纹远端1 cm、2 cm、3 cm和3.5 cm处，CTS受试者正中神经的横截面积（CSA）大于正常受试者。运动后，CTS受试者在腕横纹近端0.5 cm和1 cm、腕横纹处、腕横纹远端3 cm和3.5 cm处的正中神经CSA大于基线CSA；正常受试者在腕横纹近端1 cm和腕横纹处的正中神经CSA大于基线CSA。CTS受试者运动后正中神经CSA在腕横纹近端0.5 cm、腕横纹远端3 cm和3.5 cm处的变化大于正常受试者。
BMI和轮椅总使用时间是WCB运动员发生CTS的影响因素。实验性运动可能与患有CTS的WCB运动员腕管入口和出口周围的正中神经肿胀有关。
