Abstract
Objective
Individuals with spinal cord injury (SCI) often present signs and symptoms of median
nerve (MN) pathology. Preclinical signs identification of MN pathology might facilitate
early intervention to prevent or delay carpal tunnel syndrome in SCI. We assessed
if ultrasound parameters changed in response to upper extremity (UE) circuit training
exercise in individuals with paraplegia and able-bodied individuals.
Design
Case-control study.
Participants
Adults (N=32) with paraplegia (n=16) and age- and sex-matched able-bodied controls
(n=16).
Intervention
Circuit training exercise.
Main Outcome Measures
MN ultrasound evaluation at the pisiform and radius before and after UE exercise.
Ultrasound parameters included cross-sectional area (CSA), and gray scale (GS). Data
presented as mean ± SD.
Results
Pre-exercise CSAs were larger in SCI at the radius (12.0±2.9 vs 9.0±2.1; P=.003), but not the pisiform (9.8±3.1 vs 9.1±1.7; P=.431). There were no statistical differences in MN response to exercise between groups
(all P≥.293). Across participants, CSA changes were inversely associated with their pre-exercise
values at the pisiform (r=–0.648; P<.001) and the radius (r=–0.366; P=.043). Participants with pre-exercise CSA values ≥10.00 mm2 at the pisiform responded to exercise with decreases in CSA (mean change ± SD, –2.0±1.5;
P=.002) and GS (–2.8±6.2; P=.029). Participants with pre-exercise CSA ≤9.99 mm2 at the pisiform responded to exercise with no change in CSA (mean change ± SD, 0.7±2.5;
P=.002) and increased GS (3.2±7.2; P=.029).
Conclusions
CSA exercise response was more strongly related to pre-exercise MN values than presence
or absence of SCI.
Keywords
List of abbreviations:
ABP (able-bodied population), BMI (body mass index), CSA (cross-sectional area), CTS (carpal tunnel syndrome), GLM (general linear model), GS (gray scale), IQR (interquartile range), MN (median nerve), NCS (nerve conduction study), SCI (spinal cord injury), SSS (symptom severity scale), TTV (total training volume), UE (upper extremity), UP (ultrasound parameter)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 22, 2020
Footnotes
Supported by the Miami Project to Cure Paralysis.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
