Bueno-Gracia Elena, Ruiz-de-Escudero-Zapico Alazne, Malo-Urriés Miguel, Shacklock Michael, Estébanez-de-Miguel Elena, Fanlo-Mazas Pablo, Caudevilla-Polo Santos, Jiménez-Del-Barrio Sandra
Department of Physiatry and Nursery, Faculty of Heath Sciences, University of Zaragoza, C/Domingo Miral s/n, CP: 50009. Zaragoza, Spain.
Department of Physiatry and Nursery, Faculty of Heath Sciences, University of Zaragoza, C/Domingo Miral s/n, CP: 50009. Zaragoza, Spain.
Musculoskelet Sci Pract. 2018 Aug;36:12-16. doi: 10.1016/j.msksp.2018.04.002. Epub 2018 Apr 4.
The carpal tunnel is a clinically important fibro-osseous conduit for the median nerve and associated tendons. It is mechanically dynamic, such that the dimensions of the tunnel and median nerve change with position, movement and application of externally applied force with mechanical devices. Therapeutic manual techniques that appear to move and change tunnel shape are part of clinical practice. The aim of this study was therefore to measure changes in dimensions of the carpal tunnel and median nerve with manual mobilization of the carpal bones.
An analytical descriptive study with 18 volunteer subjects and a total of 33 records was designed. Ultrasound measurements of the cross-sectional area (CSA), anteroposterior diameter (APD), transverse diameter (TD), perimeter, flattening ratio and circularity of the carpal tunnel and of the median nerve, were measured, both in the anatomical position of the wrist and during mobilization techniques of the carpal bones.
During the mobilization technique, the tunnel (p = 0.003) CSA significantly increased. APD also increased significantly for the tunnel (<0.001) while TD decreased. The median nerve showed similar and significant (p < 0.001) changes than the tunnel. However, because several of the obtained differences where smaller than the SDD obtained in a previous study, these differences were considered as irrelevant.
Manual mobilization of the carpal bones produced significant changes in the dimensions of the carpal tunnel.
腕管是正中神经及相关肌腱的一个临床上重要的纤维骨性管道。它具有力学动态性，使得该管道和正中神经的尺寸会随着位置、运动以及使用机械设备施加外力而发生变化。那些似乎能移动和改变管道形状的治疗手法是临床实践的一部分。因此，本研究的目的是测量通过手动活动腕骨时腕管和正中神经尺寸的变化。
设计了一项分析性描述性研究，有18名志愿者受试者，共33份记录。在腕关节的解剖位置以及腕骨活动技术过程中，测量腕管和正中神经的横截面积（CSA）、前后径（APD）、横径（TD）、周长、扁平率和圆形度的超声测量值。
在活动技术过程中，腕管的CSA显著增加（p = 0.003）。腕管的APD也显著增加（<0.001），而TD减小。正中神经显示出与腕管相似且显著（p < 0.001）的变化。然而，由于获得的几个差异小于先前研究中获得的最小可检测差异（SDD），这些差异被认为是不相关的。
手动活动腕骨会使腕管尺寸产生显著变化。
