Median Nerve Mobility Research Articles

Median Nerve Mobility Measurement using a Motion Tracking Analysis Program: A Reliability Study

Objective: To evaluate relative and absolute reliability and repeatability in assessing median nerve mobility at the level of the wrist and distal upper arm of the right upper extremity during wrist extension. Methods: Six healthy participants participated in the study. Median nerve mobility was captured three times at both sites using Sonocyte Turbo by two sonologists for a total of 72 video clips (36 for each site and 18 by each sonologist). Longitudinal movement was measured using Motion Tracking Analysis Program (MTAP) by the two assessors who were rehabilitation medicine residents. After one month, the assessors remeasured the longitudinal excursion of the median nerve of the previous video clips. Results: There was moderate agreement between the two sonologists of the median nerve mobility at the level of the distal upper arm and the wrist respectively. There was a moderate to almost perfect agreement between the two assessors’ readings in the mobility of the nerve at level of the distal upper arm and wrist for the first and second readings. Repeatability testing showed that there was variable agreement at the level of the distal upper arm and at the wrist. Conclusion: MTAP using fast template tracking with an adaptive template is a reliable tool that can be employed in the accurate assessment of median nerve mobility at the distal upper arm and wrist.

Attitudes toward Death Anxiety and Dying Among Respiratory Therapy Students: A Pilot Study

Objective: To evaluate relative and absolute reliability and repeatability in assessing median nerve mobility at the level of the wrist and distal upper arm of the right upper extremity during wrist extension. Methods: Six healthy participants participated in the study. Median nerve mobility was captured three times at both sites using Sonocyte Turbo by two sonologists for a total of 72 video clips (36 for each site and 18 by each sonologist). Longitudinal movement was measured using Motion Tracking Analysis Program (MTAP) by the two assessors who were rehabilitation medicine residents. After one month, the assessors remeasured the longitudinal excursion of the median nerve of the previous video clips. Results: There was moderate agreement between the two sonologists of the median nerve mobility at the level of the distal upper arm and the wrist respectively. There was a moderate to almost perfect agreement between the two assessors’ readings in the mobility of the nerve at level of the distal upper arm and wrist for the first and second readings. Repeatability testing showed that there was variable agreement at the level of the distal upper arm and at the wrist. Conclusion: MTAP using fast template tracking with an adaptive template is a reliable tool that can be employed in the accurate assessment of median nerve mobility at the distal upper arm and wrist.

Assessing the efficacy of Mettler Release Technique (MRT) and Neural Mobilization Technique (Butler) on Median Nerve Mobility

The aim of this study was to compare the effects of Mettler's Release Technique (MRT) with Butler's Neural mobilization in subjects (n=20 each) showing positive signs when subjected to ULTT 1 (modified). All the subjects were Right handed dominant people, in whom affected side was the Right UL & the Left UL was treated as the control limb. Results showed that Butler's technique is 62.8% more effective in comparison to MRT which is 38.2% effective, (p<0.001). However, when the same subjects were re-evaluated within a week's time, the reversal of the effects obtained was observed more in subjects who underwent Butler's Neural Tissue Mobilisation. Both the techniques showed improvements, thus proving that both structures are important for the optimal functioning of the body. Thus, a combined treatment program will be more beneficial.

Ultrasonography of median nerve mobility in the diagnosis of carpal tunnel syndrome

Abstract Background Few studies on median nerve mobility in carpal tunnel were reported. The purpose of this study was to observe median nerve mobility in the carpal tunnel dynamically with ultrasound during wrist and fingers flexion and extension and define the abnormality between normal people and patients with carpal tunnel syndrome. Materials and Methods Thirty-two persons without symptoms of carpal tunnel syndrome and 18 patients with symptoms of carpal tunnel syndrome (10 patients confirmed by nerve conduction velocity/electromyography) were evaluated by high-resolution ultrasound (the SonoSite Titan high-resolution ultrasound; transducer: 5–10 MHz, 38-mm broadband linear array) with wrist and fingers in flexion and extension positions. The motions of median nerve and flexor tendons were observed. Result In our observation, median nerve will move from the volar side of the flexor tendons to the dorsal side of the flexor tendons smoothly through the tract between flexor pollicis longus and flexor digitorum superficialis of index when wrist and fingers flexed. In patients with carpal tunnel syndrome, the normal mobility of median nerve was absent. In 18 patients with carpal tunnel syndrome symptoms, there were 17 patients (94%) with positive findings in ultrasound examination. In 32 persons without the symptom of carpal tunnel syndrome, there were four cases with positive findings. Conclusions Median nerve has mobility in the carpal tunnel. In patients with carpal tunnel syndrome, the mobility was absent. Ultrasonography of median nerve mobility is helpful in diagnosing carpal tunnel syndrome. Its reliability and sensitivity should be further evaluated.

Ultrasound features of carpal tunnel syndrome: a prospective case-control study

The purpose of the study was to examine the most adequate cut-off point for median nerve cross-sectional area and additional ultrasound features supporting the diagnosis of carpal tunnel syndrome (CTS). Forty wrists from 31 CTS patients and 63 wrists from 37 asymptomatic volunteers were evaluated by ultrasound. All patients were women. The mean age was 49.1 years (range: 29-78) in the symptomatic and 45.1 years (range 24-82) in the asymptomatic group. Median nerve cross-sectional area was obtained using direct (DT) and indirect (IT) techniques. Median nerve echogenicity, mobility, flexor retinaculum measurement and the anteroposterior (AP) carpal tunnel distance were assessed. This study was IRB-approved and all patients gave informed consent prior to examination. In CTS the median nerve cross-sectional area was increased compared with the control group. Median nerve cross-sectional area of 10 mm(2) (DT) and 9 mm(2) (IT) had high sensitivity (85% and 88.5%, respectively), specificity (92.1% and 82.5%) and accuracy (89.3% and 82.5%) in the diagnosis of CTS. CTS patients had an increased carpal tunnel AP diameter, flexor retinaculum thickening, reduced median nerve mobility and decreased median nerve echogenicity. Ultrasound assists in the diagnosis of CTS using the median nerve diameter cut-off point of 10 mm(2) (DT) and 9 mm(2) (IT) and several additional findings.