Article

OBJECTIVE: To investigate the immediate effects of bilateral upper-extremity
sanding exercises on conduction and morphologic characteristics of the median and
ulnar nerves at the wrist in hemiparetic subjects and control subjects. DESIGN:
Case control study using a pretest-post-test design. SETTING: Inpatient
rehabilitation department affiliated with a teaching hospital. PATIENTS (OR
PARTICIPANTS): Thirty hemiparetic subjects and 21 matched control subjects who
met our inclusion criteria and had no history of diseases that may have
predisposed them to peripheral neuropathies were recruited for this study.
METHODS: Bilateral nerve conduction tests and ultrasonographic evaluations were
performed on each subject before and immediately after a 30-minute bilateral
sanding exercise with a frequency of 5 repetitions per minute. MAIN OUTCOME
MEASUREMENTS: The effects of exercises on bilateral median and ulnar wrist nerves
were assessed with the use of sensory and motor nerve conduction velocity tests
and by width/thickness ratios in ultrasonographic evaluations. RESULTS: In the
hemiparesis group, the pre-exercise amplitude of the motor component for the
median and ulnar nerves were respectively lower than the corresponding values in
the control group (P < .05), whereas the pre-exercise amplitude and velocity of
the sensory component were lower than the corresponding values in the control
group (P < .01). After the exercise, the assessments for the affected side showed
reductions in the conduction velocity of the sensory component and an increase in
the width/thickness ratio for the median nerve (P < .05). CONCLUSIONS: The median
and ulnar nerves at the wrist in hemiparetic subjects before sanding exercises
showed different conduction characteristics compared with control subjects. Their
affected side also demonstrated significant conduction and morphologic changes
after the exercises. These subclinical findings may be attributed to different
mechanisms such as overuse, spasticity, and demyelinating changes. Prevention of
these subclinical changes is recommended to enhance exercise safety in
hemiparetic patients.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS