Median Nerve Conduction Velocity Research Articles

Effect of Forearm Supination and Pronation on Median & Ulnar Nerve Conduction Velocity Among Throwers, Archers, and Non-Athletes

ABSTRACT The distinct and specialized movements performed in different sports disciplines may significantly influence nerve performance, potentially affecting nerve responses and the overall function within the respective athletic activities. The purpose of this study is to find the effect of forearm supination and pronation across the elbow joint on ulnar and median nerve conduction velocity (NCV) in throwers, archers, and non-athletes. A total of 34 participants both male and females were recruited with a body mass index (BMI) between 18.5 and 24.9 kg/m2. Nerve conduction study (NeuroStim NS2 EMG/NCV/EP System) was used for measuring ulnar and median NCV across the elbow joint at different angles with the forearm in supination and pronation. Repeated measure analysis of variance (RMANOVA) revealed that there are statistically significant differences in mean values of forearm positions, angles, nerves and groups (p < .05). This study illuminates distinctive NCV variations across diverse athletic groups during forearm supination and pronation movements. Pronation consistently exhibited faster ulnar NCV compared to the median nerve across throwers, archers, and non-athletes, while in supination specific joint positions revealed notable differences within sports groups and nerve function.

Association of Anthropometry With Nerve Conduction Parameters of Median Nerve: A Cross-Sectional Study in a North Indian Medical University Hospital.

Background Nerve conduction studies ease the understanding of the various pathologies of the peripheral nervous system. It helps physicians to delineate between the two principal types of peripheral etiologies: axonal degeneration and demyelination. An increase in weight in the form of excessive fat deposition or obesity could have a worrisome effect on nerve conduction. So, to find the association of various anthropometric parameters (age, gender, height, weight, waist-hip ratio and body mass index) with motor and sensory median nerve conduction parameters (latency, amplitude and velocity) this cross-sectional study was conducted. Materials and method A total of 87 subjects were taken and their height, weight, waist-hip ratio and body mass index were measured using standard techniques. Motor and sensory nerve conduction parameters were measured on an electromyography machine. Data was stored, tabulated and analyzed. Results The average height of male and female subjects ± SD was 1.699 ± 0.072 m and 1.589 ± 0.067 m respectively. The average weight of male and female subjects ± SD was 64.089 ± 11.497 kg and 52.949 ± 8.404 kg, respectively. The average BMI of normal, underweight and overweight subjects ± SD was 21.668 ± 2.048 kg/m2, 17.074 ± 0.794 kg/m2 and 26.595 ± 0.915 kg/m2 respectively. Weight showed a significant (p = 0.0025) correlation with the latency of motor median nerve conduction. Waist-hip ratio showed a significant (p = 0.042 and p = 0.036) correlation with motor median nerve conduction velocity in both male and female subjects, respectively. BMI in the overweight category showed a significant (p = 0.0156 and p = 0.0290) correlation with latency and amplitude of motor median nerve conduction study, respectively. Conclusions This study exemplifies that an increase in BMI of our body can affect nerve conduction. This could serve as a preliminary study to assess the effect of obesity on peripheral nerve conduction, especially in the Indian population.

Exploring pathogenic pathways in carpal tunnel syndrome: sterile inflammation and oxidative stress.

The main objective of the current study was to find the association between oxidative stress, inflammatory markers, and electrophysiological profile with symptom severity in patients of carpal tunnel syndrome (CTS). Thirty-two carpal tunnel syndrome patients and 32 controls were included in the study. Boston CTS questionnaire along with plasma oxidative stress markers including superoxide dismutase, malondialdehyde, and nitric oxide and inflammatory markers including IL-6 and TNF-α were compared with the electrophysiological parameters derived from nerve conduction studies. Statistical significance of the levels between groups was calculated using unpaired-t test after checking for normality with D'Agostino & Pearson omnibus normality test. We found that the median nerve conduction velocity was prolonged, amplitude was decreased, while the levels of oxidative stress markers like malondialdehyde (MDA), superoxidase dismutase (SOD), and nitric oxide (NO) were increased in CTS patients compared to controls. Inflammatory markers like interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were also increased in CTS patients. We found that plasma SOD and TNF-α correlated well with the median motor amplitude. There was no other significant correlation between oxidative stress markers and inflammatory markers with nerve conduction studies or disease severity. Patients with mild disease also showed lesser levels of SOD, NO, IL-6, and TNF-α markers than patients with severe disease. CTS is probably a disease of sterile inflammation and disbalance of oxidative stress, with higher inflammatory and oxidative stress markers pointing to a more severe disease.

Clinical effect of acupuncture combined with medication on diabetic peripheral neuropathy and its influence on serum lipid metabolism

To observe the clinical effect on diabetic peripheral neuropathy (DPN) treated with acupuncture combined with medication and explore its effect mechanism. Sixty-two patients of DPN were randomly divided into a combined therapy group (31 cases) and a medication group (31 cases, 2 cases dropped out); besides, 20 healthy subjects were recruited as a normal group. On the base of routine intervention, in the medication group, thioctic acid capsules were administrated orally, 0.2 g each time, 3 times a day. In the combined therapy group, besides the medication as the medication group, acupuncture was performed on bilateral Quchi (LI 11), Waiguan (TE 5), Hegu (LI 4), Tianshu (ST 25), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) and the needles were retained for 30 min, acupuncture was delivered once daily, 6 times a week. The duration of treatment was 4 weeks in the two groups. The score of Toronto clinical scoring system (TCSS), the nerve conduction velocity of median nerve (MN) and common peroneal nerve (CPN) were observed before and after treatment in the two intervention groups; and the serum lipid metabolism was detected before and after treatment in the two intervention groups and the normal group. Compared with that before treatment, the scores of TCSS were reduced in the combined therapy group and the medication group (P<0.05) after treatment, and the score decrease in the combined therapy group was larger than that of the medication group (P<0.001). The motor nerve conduction velocity and the sensory nerve conductive velocity of MN and CPN after treatment all increased in the combined therapy group and the medication group compared with those before treatment (P<0.05), and the improvements in the combined therapy group were larger than those of the medication group (P<0.001). Before treatment DPN patients had 365 differential lipid metabolites, including sphingosine (SPH, d18:0), involved in the inositol phosphate metabolism, compared with the subjects of the normal group. There were 103 differential lipid metabolites in the medication group before and after treatment, including lysophosphatidyl ethanolamine (LPE, 18:1/0:0), participated in glycerophospholipid metabolism. In the combined therapy group, before and after treatment, there were 99 differential lipid metabolites, including lysophosphatidylcholine (LPC, 18:0/0:0), participated in the neuroactive ligand-receptor interaction. Acupuncture greatly affected 50 lipid metabolites such as lysophosphatidic acid (LPA, 0:0/22:6), LPA(0:0/18:2) and LPC(O-18:0), which was mainly involved in glycerophospholipid metabolism. Acupuncture combined with medication ameliorates the symptoms and the nerve conduction velocity in DPN patients, which may be related to the regulation of serum lipid metabolism.

Evaluation of Hand-Arm Vibration Syndrome Owing to Nerve Conduction Study and Cumulative Exposure Index-A 2.5-Year Cohort Study.

This study aims to clarify the relationship between peripheral neuropathy in hand-arm vibration syndrome and cumulative exposure index. 68 participants without symptoms were surveyed. The participants were divided into three groups based on past and current vibration exposure (VE). Comparison among groups according to past VE showed that the median and ulnar sensory nerve conduction velocities and median sensory nerve action potential (SNAP) amplitude were significantly lower in past high and low exposure groups than in the past nonexposure group. Comparison among groups according to current VE showed that the median and ulnar SNAP amplitudes were significantly lower in the current high exposure group than in the current low or nonexposure group. Vibration tool handlers have potential peripheral nerve lesions at a certain stage without subjective symptoms of the finger.

Changes in ulnar and median nerve conduction velocity after reverse total shoulder arthroplasty: Correlation with distalization and lateralization

PurposeThe purpose of this study was to assess ulnar and median nerve injury after reverse total shoulder arthroplasty (RSA) by measuring the sensory nerve conduction velocity (SCV). The secondary objective was to evaluate the impact of lateralization and/or distalization on SCV changes. MethodsTwenty consecutive cases were prospectively included and retrospectively reviewed. SCV of the ulnar and median nerves as well as humeral lateralization/distalization quantified by plain radiography were evaluated pre-operatively and at 1 week post-operatively. Changes in SCV were tested using the paired t-test, and correlations between humeral lateralization/distalization and SCV changes were tested using Kendall's rank correlation coefficient and maximal information coefficient (MIC). ResultsThe SCV of the ulnar nerve was delayed from 55.4 ​m/s pre-operatively to 53.0 ​m/s post-operatively (p ​= ​0.021), whereas there was no significant change in the median nerve (p ​= ​0.17). There was a weak to moderate correlation between ulnar nerve SCV delay and lateralization (τ ​= ​−0.38; p ​= ​0.021; MIC ​= ​0.70) but no significant correlation with distalization (p ​= ​0.65; MIC ​= ​0.56). ConclusionsFollowing RSA, a small but significant delay in SCV of the ulnar nerve was observed. A negative correlation was found between lateralization and SCV delay of the ulnar nerve.

Effectiveness of manual therapy to the Cervical Spine on clinical outcomes and electrodiagnostic tests in people with carpal tunnel syndrome: A randomized controlled trial

ObjectiveTo determine if cervical spine manual therapy (CMT) plus conventional physical therapy (PT) optimizes clinical objective and self-reported outcomes, compared to PT alone, in people with carpal tunnel syndrome (CTS). MethodForty-eight patients with the diagnosis of CTS were randomly divided into conventional PT (control group) and conventional PT plus cervical spine manual therapy (intervention group). All patients received 10 sessions of supervised conventional physical therapy (wrist splint, electrotherapy and wrist joint mobilization). Patients in the cervical spine manual therapy group also had manual therapies techniques given to their neck. Visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), the disabilities of the arm, shoulder, and hand (DASH) questionnaire, median nerve motor distal latency (mMDL), and median sensory nerve conduction velocity (mSNCV) were assessed at three points: baseline, post-intervention, and six months later. ResultsThe cervical spine manual therapy group showed significantly greater improvement in VAS, DASH score, mMDL, and mSNCV in post-intervention and follow-up compared to the conventional group. There was no significant difference in two subscales of BCTQ at post-intervention for two groups, whereas these two subscales showed a significant difference in favor of the cervical manual therapy group at follow-up. ConclusionThe analysis of results showed that conventional CMT combined with PT could be more effective in improving the clinical outcomes and electrodiagnostic findings of patients with CTS compared to conventional PT only in the long term. Therefore, it can be suggested as a proper therapeutic method in CTS.

Steroid versus placebo injections and wrist splints in patients with carpal tunnel syndrome: a systematic review and network meta-analysis.

A network meta-analysis of randomized controlled trials compared the effectiveness of corticosteroid injections with placebo injections and wrist splints for carpal tunnel syndrome, focusing on symptom relief and median nerve conduction velocity. Within 3 months of the corticosteroid injection, there was a modest statistically significant difference in symptom relief compared to placebo injections and wrist splints, as measured by the Symptom Severity Subscore of the Boston Carpal Tunnel Questionnaire; however, this did not meet the minimum clinically important difference. Pain reduction with corticosteroids was slightly better than with wrist splints, but it also failed to reach clinical significance. Electrodiagnostic assessments showed transient changes in distal motor and sensory latencies in favour of corticosteroids at 3 months, but these changes were not evident at 6 months. The best current evidence suggests that corticosteroid injections provide minimal transient improvement in nerve conduction and symptomatology compared with placebo or wrist splints.

Effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers.

To compare the effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers with symptomatic neck pain and asymptomatic office workers. A total of 40 participants, both male and female office workers, with symptomatic neck pain (n = 20) and asymptomatic (n = 20), were recruited. Pain intensity, ulnar nerve conduction velocity, median nerve conduction velocity, and muscle activity were determined before and after 1 hour of computer use. There was a significant increase in pain intensity in the neck area in both groups (P < .001). The symptomatic neck pain group revealed a significant decrease in the sensory nerve conduction velocity of the ulnar nerve (P = .008), whereas there was no difference in the median nerve conduction velocity (P > .05). Comparing before and after computer use, the symptomatic neck pain group had less activity of the semispinalis muscles and higher activity of the anterior scalene muscle than the asymptomatic group (P < .05). The trapezius and wrist extensor muscles showed no significant differences in either group (P > .05). This study found signs of neuromuscular deficit of the ulnar nerve, semispinalis muscle, and anterior scalene muscle after 1hour of computer use among office workers with symptomatic neck pain, which may indicate the risk of neuromuscular impairment of the upper extremities. The recommendation of resting, and encouraging function and flexibility of the neuromuscular system after 1hour of computer use should be considered.

Perineural 5% dextrose versus corticosteroid injection in non-surgical carpal tunnel syndrom treatment.

<p>We aimed to investigate the difference of clinical and electrophysiological improvement between perineural corticosteroid injection therapy (PCIT) and perineural 5% dextrose injection therapy (5%PDIT) in carpal tunnel syndrome (CTS).</p>. <p>Total of 92 wrists that were diagnosed as mild-to-moderate idiopathic CTS and completed their follow-up were included in our study. The severity of pain, symptom severity and functional status were asses&shy;sed by visual analog scale (VAS) and the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores for treatment effectiveness. Randomized wrists were administered PCIT or 5%PDIT accompanied by ultrasound guidance. VAS, BCTQ scores and the electro&shy;physiological study repeated before and after treatment at the 1st and 6th months after perineural injection therapies (PITs) were recorded.</p>. <p>Compared with baseline data, within groups there was significant improvement in VAS, BCTQ severity and function scores at 1st and 6th months follow-up (all p &lt; 0.001). Considerable advance were detected in the median sensory nerve conduction velocity (SNCV) when pretreatment values were compared with posttreatment first month in both groups (p = 0.01; p &lt; 0.001, respectively). No significant change occurred in median distal motor latency (DML) values between the 1st and 6th months in the groups (p = 0.095; p = 0.113, respectively). No significant difference was observed bet&shy;ween 5%PDIT and PCIT groups.</p>. <p>Clinical and electrophysiologic improvement in CTS began from 1st month after PCIT and 5%PDIT. At the 6th month follow-up of the patients, 5%PDIT and PCIT had similar therapeutic effects. As a result, we can consider the replacement of PCIT with 5%PDIT in mild-to-moderate CTS patients especially in those who are hesitant because of the corticosteroid&rsquo;s adverse effects.</p>.

Efficacy and safety of Buyang Huanwu decoction for diabetic peripheral neuropathy: a systematic review and Metaanalysis.

To evaluate the efficacy and safety of Buyang Huanwu decoction (BYHWD) in treating diabetic peripheral neuropathy (DPN). Eight electronic databases, including China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, Chinese Biomedical Literature Database, Cochrane Library, Embase, Web of Science, and PubMed, were searched for randomized controlled trials (RCTs) of BYHWD to treat DPN. We identified all RCTs related to BYHWD and those on the treatment of DPN with the combination of mecobalamin. RevMan software was used for the statistical analysis. Twentyone RCTs with a total of 1945 patients were included. The methodological quality of the literature included was low. Metaanalysis showed that the efficacy of the treatment group was significantly better than that of the control group in the treatment of DPN with BYHWD [risk ratio () = 0.33, 95% (0.27, 0.40), 11.25, 0.000 01]. The median nerve of median motor nerve conduction velocity (MNCV) [mean difference () = 4.16, 95% (1.35, 6.98)] and median sensory NCV (SNCV) [(= 3.28, 95% (2.35, 4.22)] were improved in the treatment group. The MNCV in the common peroneal nerve [(= 1.63, 95% (0.39, 2.87)] and SNCV [(= 4.56, 95% (3.16, 5.97)] were significantly higher than those in the control group ( 0.01). Plasma viscosity [(= －0.15, 95% (－0.20, －0.09), 5.17, 0.01)], whole blood high shear [(= 0.83, 95% (1.56, －0.11), 2.26, 0.02)]and whole blood low shear [(= 1.61, 95% (2.28, 0.94), 4.68, 0.01)] decreased significantly after treatment. There was no significant difference in fasting blood glucose [(= 0.42, 95% ( 0.89, 0.05), 1.76, 0.08)] between the treatment and control groups; postprandial blood glucose [(= 0.62, 95% ( 1.19, 0.05), 2.12, 0.03)] decreased significantly. No significant difference was found in the blood lipid levels between the treatment and control groups, including triglycerides [(= 0.21, 95% (0.52, 0.10), 1.34, 0.18)] and cholesterol [(= 0.13, 95% ( 0.27, 0.00), 1.92, 0.06)]. Of the 21 RCTs, only five reported adverse reactions, and four studies reported the length of followup. No serious adverse events were reported. None of the studies reported the quality of life and economic conditions. Our study suggests that BYHWD has a significant therapeutic effect on DPN. Highquality, largescale RCTs are needed to provide more reliable evidence.

Survey of body mass index (BMI) on median motor nerve conduction velocity (NCV) in normal population of Malwa region

: Nerve conduction studies reveal technique to work on peripheral nerve being capable in revealing nerve-related issue. It aids in distinguishing from a nerve injury to situation where muscles are affected due to a nerve lesion. While, in that respect much dissimilarity persist in use of Nerve Conduction Velocity (NCV) in different nerves with regard to place, sex, mass &amp; other ethnographical facts i.e. Span of life. This has been viewed in performing nerve conduction studies while ethnograpical part differs for different geological region.: The purpose of present work is to do the Nerve Conduction Variables (NCV) studies in rt. median nerve in usual well young of Malwa region and to study the outcome of B.M.I on it. : A total 110 healthy participants from the periods of 20 and 50 years, with none nerve lesion, being examined at IMCHRC, Indore. All trial were completed on JAVA RMSAleron-201 series. Scrutiny on SPSS 10.0 series. : The mean of NCV firstly rises among periods of 20-30 yrs, 31-40 yrs &amp; 40-50years, preceded by a fall in the mean NCV of elbow–wrist segment which significantly fall while the mean of B.M.I rises with increasing length of life. It is to be noted that NCV was inversely related to an increase in B.M.I in the volunteer the mean NCV of Set 1 &amp;#62; Set2, Set3, Set 4 with P &amp;#60; 0.05 that toply relevant.Usual parameter for conduction in peripheral nerves to be used in the test of peripheral nerve lesion. B.M.I has a definitive effect on NCV. So, this factor has been put into concern during interpretation of results during nerve conduction studies. Therefore, it should also be used for research purposes &amp; in prognosis approach.

A Pilot Study In to the Effects of Cervical Manual Therapy Plus Conventional Physical Therapy on Clinical Outcomes and Electrodiagnostic Findings in People With Carpal Tunnel Syndrome.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that has a significant impact on patients' quality of life. Current physical therapy treatment options show limited effects or low-quality evidence, especially in the long term. To date, there has been little research to look at the effects of treating the cervical spine on decreasing symptoms distally to the carpal tunnel. This study aimed to evaluate the effects of cervical manual therapy plus conventional physical therapy on patients with carpal tunnel syndrome. This pilot pretest/posttest and six-month follow-up clinical study included 15 adult patients with CTS. For two weeks, each patient received 10 sessions of supervised intervention treatment. The efficacy of the therapies was assessed at baseline (T0), immediately after treatment (T1), and six months after treatment (T2). The visual analog scale (VAS), a symptom severity scale, the functional capacity scale of the Boston Carpal Tunnel Questionnaire (BCTQ), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, median nerve motor distal latency (mMDL), and median sensory nerve conduction velocity (mSNCV) were outcome measures. There were significant improvements in all measures between the baseline values at T0 and those recorded immediately after the treatment at T1 or six months later at T2 (p<.05). This pilot study indicates that cervical manual therapy plus conventional physical therapy applied for two weeks improves clinical outcomes and electrodiagnostic findings in people with CTS.

DIAGNOSTIC VALUE OF MEDIAN NERVE CONDUCTION VELOCITY ACROSS WRIST AMONG PATIENTS WITH SUSPECTED CARPAL TUNNEL SYNDROME

Background: Carpal Tunnel Syndrome (CTS) is the most prevalent type of compressive neuropathy. At present, electrodiagnosis is considered the gold standard in diagnosing CTS. However, no clear cutoff point has been established regarding the diagnostic value of the median nerve conduction velocity, across the carpal tunnel area, among patients with CTS.&#x0D; Objectives: This study aimed to determine the cutoff point for patients’ median nerve conduction velocity (NCV), to diagnose CTS among suspected patients, which is determined using electrical stimulations conducted across the carpal tunnel area. The present study also aimed to determine the diagnostic value of the median nerve conduction velocity across the carpal tunnel area, compared with the standard method.&#x0D; Methods: This cross-sectional study was conducted among 56 participants (106 wrists) suspected of CTS. Motor and sensory NCV across the carpal tunnel was investigated to yield diagnostic value of CTS compared with the standard technique.&#x0D; Results: The optimal cutoff point in diagnosing CTS using the wrist to midpalm conduction velocity, was 40 m/s (with a sensitivity of 87.04% and specificity of 87.18%) for the sensory nerve conduction study, and 35 m/s (with a sensitivity of 88.06% and specificity of 89.74%) for the motor nerve conduction study.&#x0D; Conclusion: Our study determined that the optimal cutoff conduction velocities for CTS diagnosis, using the wrist-to-midpalm electrical stimulation method, was 40 m/s for the sensory nerve, and 35 m/s for the motor nerve.

Genotypic And Phenotypic Features of Patients with GJB1 Mutations: Single Center Experience (P11-8.003)

<h3>Objective:</h3> To describe the clinical and genetic characteristics of patients with <i>GJB1</i> mutations in Turkey. <h3>Background:</h3> <i>GJB1</i> mutations are the most common cause of X-linked Charcot-Marie-Tooth (CMT) disease. Typical manifestation includes distal muscle weakness and atrophy in the lower limbs. On the other hand, additional clinical features, such as stroke-like episodes, vocal cord paralysis, and hearing loss, can be observed. <h3>Design/Methods:</h3> Herein, we evaluated the clinical and genetic features of 29 patients from 23 unrelated families with <i>GJB1</i> mutation at the Neuromuscular Unit of the Istanbul Faculty of Medicine, Istanbul University. <h3>Results:</h3> Eight patients were female. The mean age of onset was 19.0 ± 12.0 (between 3 and 53 years). Females (27.3 ± 13.2) had later disease onset than males (15.4 ± 11.4). The most common presenting symptom was distal muscle weakness and foot deformities (21 patients), followed by foot pain (4 patients) and hand tremor (3 patients). Family history was absent in six patients. Two patients had immunosuppressive treatment for a misdiagnosis of inflammatory neuropathy. In neurological examination, all but two female patients had distal weakness in the lower extremities, and 24 had upper extremity weakness. The most frequent skeletal deformity was pes cavus (25 patients), followed by hammer toes (16 patients). Nine patients had hand tremor, and one had vocal cord paralysis. One patient had a history of stroke-like episodes, and one had multiple-sclerosis like cranial and spinal cord MRI lesions. In a mean disease duration of 22.5 ± 14.6 years all patients were ambulatory. The mean median motor nerve conduction velocity was 36.5 ± 8.2, consistent with intermediate-type CMT disease. Eighteen different mutations were identified in the <i>GJB1</i> gene. <h3>Conclusions:</h3> Our patients exhibited diverse phenotypic features regarding the disease onset and additional symptoms. Moreover, genotypic features were also heterogeneous, considering the identified mutations were scattered throughout the gene. <b>Disclosure:</b> Dr. Parman has nothing to disclose. Arman Cakar has nothing to disclose. Ayse Candayan has nothing to disclose. Dr. Durmus has nothing to disclose. Esra Battaloglu has nothing to disclose.

Median Nerve Conduction Velocity in Throwers, Archers, and Non-Athletes: Influence of Forearm and Elbow Joint Positions

Median Nerve Conduction Velocity in Throwers, Archers, and Non-Athletes: Influence of Forearm and Elbow Joint Positions

Clinical phenotypic diversity of NOTCH2NLC-related disease in the largest case series of inherited peripheral neuropathy in Japan

BackgroundNOTCH2NLC GGC repeat expansions have been associated with various neurogenerative disorders, including neuronal intranuclear inclusion disease and inherited peripheral neuropathies (IPNs). However, only a few NOTCH2NLC-related disease studies in IPN...

Use of Iontophoresis with Corticosteroid in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis.

Carpal tunnel syndrome is a neuropathy that affects the median nerve. The aim of this review is to synthesize the evidence and perform a meta-analysis on the effects of iontophoresis in people with carpal tunnel syndrome. The search was carried out using PubMed, Web of Science, Scopus, CINHAL Complete, Physiotherapy Evidence Database, and SciELO. The methodological quality was evaluated using PEDro. A standardized or mean difference meta-analysis (Hedge's g) using a random-effects model was calculated. Seven randomized clinical trials using iontophoresis for electrophysiological, pain, and functional outcomes were included. The mean of PEDro was 7/10. No statistical differences were obtained for the median sensory nerve conduction velocity (SMD = -0.89; p = 0.27) or latency (SMD = -0.04; p = 0.81), motor nerve conduction velocity (SMD = -0.04; p = 0.88) or latency (SMD = -0.01; p = 0.78), pain intensity (MD = 0.34; p = 0.59), handgrip strength (MD = -0.97; p = 0.09), or pinch strength (SMD = -2.05; p = 0.06). Iontophoresis only seemed to be superior in sensory amplitude (SMD = 0.53; p = 0.01). Iontophoresis did not obtain an enhanced improvement compared to other interventions, but no clear recommendations could be made due to the limited number of included studies and the heterogeneity found in the assessment and intervention protocols. Further research is needed to draw sound conclusions.

Systematic review and Meta-analysis of efficacy and safety of Tangmaikang Granules in treatment of diabetic peripheral neuropathy

This study aimed to explore the efficacy and safety of Tangmaikang Granules in the treatment of diabetic peripheral neuropathy(DPN). PubMed, Cochrane Library, EMbase, SinoMed, CNKI, Wanfang and VIP were retrieved for randomized controlled trial(RCT) of Tangmaikang Granules in the treatment of DPN. Cochrane handbook 5.3 was used to evaluate the quality of the inclu-ded studies, and RevMan 5.4.1 and Stata 15.1 were employed to analyze data and test heterogeneity. GRADEpro was used to assess the quality of each outcome index. Clinical effective rate was the major outcome index, while the improvement in numbness of hands and feet, pain of extremities, sluggishness or regression of sensation, sensory conduction velocity(SCV) and motor conduction velocity(MCV) of median nerve and peroneal nerve, fasting blood glucose(FBG), 2 h postprandial blood glucose(2hPBG), and glycated hemoglobin(HbA1c) and incidence of adverse reactions were considered as the minor outcome indexes. A total of 19 RCTs with 1 602 patients were eventually included. The Meta-analysis showed that the improvements in clinical effective rate(RR=1.45, 95%CI[1.32, 1.61], P&lt;0.000 01), pain of extremities(RR=1.70, 95%CI[1.27, 2.27], P=0.000 3), MCV of peroneal nerve(MD=4.08, 95%CI[3.29, 4.86], P&lt;0.000 01) and HbA1c(SMD=-1.23, 95%CI[-1.80,-0.66], P&lt;0.000 1) of Tangmaikang Granules alone or in combination in the experimental group were better than those in the control group. Compared with the conditions in the control group, numbness of hands and feet(RR=1.42, 95%CI[1.12, 1.80], P=0.003), sluggishness or regression of sensation(RR=1.41, 95%CI[1.05, 1.91], P=0.02), SCV of median nerve(MD=4.59, 95%CI[0.92, 8.27], P=0.01), SCV of peroneal nerve(MD=4.68, 95%CI[3.76, 5.60], P&lt;0.000 01) and MCV of median nerve(MD=5.58, 95%CI[4.05, 7.11], P&lt;0.000 01) of Tangmaikang Granules in combination in the experimental group were improved by subgroup analysis. The levels of FBG(MD=-0.57, 95%CI[-1.27, 0.12], P=0.11) and 2hPBG(MD=-0.69, 95%CI[-1.70, 0.33], P=0.18) in the experimental group were similar to those in the control group after treatment with Tangmaikang Granules alone or in combination. There was no difference in the safety(RR=1.28, 95%CI[0.58, 2.82], P=0.54) of Tangmaikang Granules in the treatment of DPN between the experimental group and the control group. Tangmaikang Granules could significantly increase clinical effective rate and nerve conduction velocity as well as improve symptoms of peripheral nerve and blood glucose level, and no serious adverse reactions were identified yet. Further validation was needed in future in large-sample, multicenter, high-quality RCTs.

Effect of backpack load on nerve conduction velocity and risk of peripheral neuropathy in upper extremities of undergraduate medical students carrying backpack

Background: Prolonged load carriage can potentially affect hand and upper limb use through compression of the nerves, reduction in blood flow, and muscle fatigue. Backpacks of undergraduate medical student are not much different from their syllabus. They carry heavy backpacks on regular basis and many times they wear it incorrectly. Aims and Objectives: We aimed to see the effect of backpack load on motor nerve conduction velocity and hand grip strength in the upper extremities. Materials and Methods: The present study included 31 undergraduate medical students between the age of 18 and 25 years. The procedure is conducted in three phases on different days. In each phase, participants were asked to walk for 5 min with load. In Phase 1, nerve conduction velocity and grip strength weere measured in unloaded condition and after carrying load &lt;10% of body weight. To limit the effect of fatigue, participants are instructed to return to laboratory in next consecutive weeks to repeat the procedure for Phase 2 and 3 as in Phase 1 by increasing load to 10–20% and 20–30% of their body weight respectively. Results: Values of median and ulnar motor nerve conduction velocity obtained without and with increasing % of backpack load after 5 min walk were decreased non-significantly as load increased. There was significant (P&gt;0.001) difference in grip strength of medical students carrying backpack with increasing load after 5 min walk. Conclusion: In this study, we aimed at quantifying the effects of load carriage on overall upper limb performance, with a focus on conduction velocity of motor nerves. This has implications for occupations such as soldiers, firefighters, paramedics, and others who may be required to operate machinery, equipment, tools, or systems that require precise motor control.