Dimensional changes of the carpal tunnel and the median nerve during manual mobilization of the carpal bones
Dimensional changes of the carpal tunnel and the median nerve during manual mobilization of the carpal bones
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DOI：
10.1016/j.msksp.2018.04.002
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发表时间：
2018-08-01
影响因子：
2.3
通讯作者：
Jimenez-del-Barrio, Sandra
中科院分区：
文献类型：
--
作者：
Bueno-Gracia, Elena;Ruiz-de-Escudero-Zapico, Alazne;Jimenez-del-Barrio, Sandra
简介：腕管是临床上重要的正中神经和相关肌腱的纤维骨导管。它是机械动态的，因此隧道和正中神经的尺寸随着机械装置的位置、运动和外加力的施加而变化。看似移动和改变隧道形状的治疗手动技术是临床实践的一部分。因此，本研究的目的是通过手动活动腕骨来测量腕管和正中神经尺寸的变化。材料和方法：设计了一项由 18 名志愿者受试者和总共 33 条记录组成的分析描述性研究。在手腕的解剖位置和腕骨松动技术期间，对腕管和正中神经的横截面积 (CSA)、前后径 (APD)、横径 (TD)、周长、扁平率和圆度进行超声测量。结果：在松动技术期间，隧道 (p = 0.003) CSA 显着增加。隧道的 APD 也显着增加 (< 0.001)，而 TD 则减少。正中神经显示出与隧道相似且显着的变化（p < 0.001）。然而，由于获得的一些差异小于先前研究中获得的 SDD，因此这些差异被认为是无关紧要的。结论：手动松动腕骨会导致腕管尺寸发生显着变化。
Introduction: 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.Material and methods: 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.Results: 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.Conclusions: Manual mobilization of the carpal bones produced significant changes in the dimensions of the carpal tunnel.