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The effects of wrist position and radioulnar wrist compression on median nerve longitudinal mobility

  • Author Footnotes
    1 These authors contribute equally.
    Kewei Song
    Footnotes
    1 These authors contribute equally.
    Affiliations
    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
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  • Author Footnotes
    1 These authors contribute equally.
    Yu Wang
    Footnotes
    1 These authors contribute equally.
    Affiliations
    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
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  • Rongxi Yi
    Affiliations
    Soft Tissue Biomechanics Laboratory, Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
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  • Kishor Lakshminarayanan
    Affiliations
    Department of Sensors and Biomedical Engineering, School of Electronics Engineering, Vellore Institute of Technology, Tamil Nadu, India
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  • Guoning Zhang
    Correspondence
    Corresponding authors at: Room 228, Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, China.
    Affiliations
    Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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  • Yifei Yao
    Correspondence
    Corresponding authors at: Room 228, Med-X Research Institute, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, China.
    Affiliations
    Soft Tissue Biomechanics Laboratory, Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contribute equally.

      Highlights

      • Non-neutral wrist positions compromise median nerve longitudinal mobility.
      • 10 N radioulnar wrist compression restored nerve mobility at non-neutral position.
      • Moderate radioulnar compressive forces may help prevent carpal tunnel syndrome.

      Abstract

      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.

      Keywords

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