腕部位置和桡腕关节压迫对正中神经纵向活动性的影响。
The effects of wrist position and radioulnar wrist compression on median nerve longitudinal mobility.
机构信息
Soft Tissue Biomechanics Laboratory, Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China; Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, IL, USA.
Soft Tissue Biomechanics Laboratory, Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China; University of Michigan - Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, Shanghai, China.
出版信息
Clin Biomech (Bristol). 2022 Oct;99:105754. doi: 10.1016/j.clinbiomech.2022.105754. Epub 2022 Aug 29.
BACKGROUND
Carpal tunnel syndrome is an entrapment neuropathy at the wrist characterized by compromised median nerve mobility. The purpose of this study was to investigate the effect of wrist position on median nerve longitudinal mobility in healthy subjects and the effect of radioulnar wrist compression on the median nerve mobility under non-neutral wrist positions.
METHODS
Dynamic B mode ultrasound images captured longitudinal median nerve motion in the carpal tunnel in 10 healthy subjects at wrist neutral position, 30-degree flexion, and 30-degree extension. In each position, RWC of 0, 5, 10, and 15 N were applied. One-way repeated measure analysis of variance (ANOVA), Post-hoc Tukey's tests, and the Friedman Test were used to show the significant differences of median nerve longitudinal mobility at different wrist positions and force conditions.
FINDINGS
Median nerve longitudinal mobility was found to be significantly influenced by wrist position (P < 0.05). The mobility under wrist neutral position was 3.02 mm/s, 38% higher than under wrist flexion (2.18 ± 0.60 mm/s), and 32% higher than under wrist extension (2.29 ± 0.43 mm/s). The impaired median nerve mobility was significantly restored under 10 N radioulnar wrist compression (P < 0.05), by 34.4% under wrist flexion (3.03 ± 0.85 mm/s), and 38.9% under wrist extension (3.07 ± 0.79 mm/s).
INTERPRETATION
Non-neutral wrist positions compromise median nerve longitudinal mobility, but moderate radioulnar compressive forces are beneficial in the recovery of median nerve longitudinal mobility, and may help to prevent symptoms associated with carpal tunnel syndrome.
背景
腕管综合征是一种位于手腕处的神经嵌压症，其特征为正中神经活动受限。本研究旨在探讨健康受试者腕关节位置对正中神经纵向活动度的影响，以及非中立位时桡尺侧腕关节压迫对正中神经活动度的影响。
方法
本研究共纳入 10 名健康受试者，使用动态 B 型超声在腕中立位、30°掌屈和 30°背伸位下分别测量正中神经在腕管内的纵向运动。在每个位置下施加 0、5、10 和 15 N 的桡尺侧腕关节压力。采用单因素重复测量方差分析（ANOVA）、事后 Tukey 检验和 Friedman 检验，比较不同腕关节位置和力条件下正中神经纵向活动度的差异。
结果
腕关节位置显著影响正中神经纵向活动度（P<0.05）。腕中立位时正中神经的活动度为 3.02mm/s，比掌屈位时高 38%（2.18±0.60mm/s），比背伸位时高 32%（2.29±0.43mm/s）。10 N 的桡尺侧腕关节压迫可显著恢复正中神经活动度（P<0.05），在掌屈位时增加 34.4%（3.03±0.85mm/s），在背伸位时增加 38.9%（3.07±0.79mm/s）。
结论
非中立位腕关节会降低正中神经纵向活动度，但适度的桡尺侧腕关节压迫有助于恢复正中神经纵向活动度，可能有助于预防与腕管综合征相关的症状。
Zotero 插件