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COMMON SPORT SPECIFIC WRIST POSITIONS CAN INDUCE CHANGES IN “FUNCTIONAL” EMG RECORDING OF THE MEDIAN NERVE – IMPLICATIONS FOR DIAGNOSIS AND TREATMENT.

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Introduction: Conventional nerve conduction studies localize the lesion of a nerve and can disclose the degree of focal conduction block or pinpoint the region of focal slowing, giving complementary information about the character of the lesion. In a group of active population transient disturbances during physical efforts are commonly observed.

Aim: To precise the evolution with time of EMG recordings of the median nerve in common sport-specific positions.

Material and methods: 20 healthy volunteers and 12 symptomatic patients (persons with a conduction block were excluded from the study). Conventional EMG of median nerve was performed, than a “reversed Phalen” position kept for 30 min, and consequent measurements in 5 min periods were performed.

Results: In 20% of asymptomatic patients a significant decrease of sensory nerve action potential was recorded after 20 min of observation, while 100% of symptomatic in daily living and negative in conventional EMG studies developed a severe decrease of conduction and blocks after 15 min. These symptoms recuperated after 5 min in functional wrist position. We proposed to these patients a neuromobilisation physiotherapy program, that clinically diminished their complaints.

Conclusions: EMG shows a 97–100% diagnostic specificity and sensitivity. It might be a functional test helping to distinguish a group of risk of development of carpal tunnel syndrome with exercises. This method is useful among patients with functional disturbances due to joint instability or repetitive motions in sports.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.