Publication: Effect of hand size on the stimulation intensities required for median and ulnar sensory nerve conduction studies
Issued Date
2013-05-01
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1532821X
00039993
00039993
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2-s2.0-84876678742
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Mahidol University
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SCOPUS
Bibliographic Citation
Archives of Physical Medicine and Rehabilitation. Vol.94, No.5 (2013), 925-929
Suggested Citation
Thanitta Thanakiatpinyo, Gulapar Srisawasdi Effect of hand size on the stimulation intensities required for median and ulnar sensory nerve conduction studies. Archives of Physical Medicine and Rehabilitation. Vol.94, No.5 (2013), 925-929. doi:10.1016/j.apmr.2012.11.029 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/31814
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Title
Effect of hand size on the stimulation intensities required for median and ulnar sensory nerve conduction studies
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Abstract
Objectives: To examine the effect of hand size on median and ulnar sensory nerve conduction study (NCS) stimulation intensities and pain scores. Design: Prospective, single group design to compare main outcomes by using a standard distance of 14cm versus the proximal wrist crease in 3 different hand sizes. Setting: Electrodiagnostic laboratory in a department of rehabilitation medicine. Participants: Healthy volunteers (N=25) aged 20 to 30 years. Interventions: Hand size was determined, based on the distance between the proximal wrist crease and the base of the long finger, resulting in 3 groups (≤11cm, >11-12cm, >12cm) with 12 hands per group. Antidromic median and ulnar sensory NCSs were performed. The nerves were randomly stimulated at the proximal wrist crease and 14cm from the recording electrode. Main Outcome Measures: Supramaximal stimulation intensities and 10-cm visual analog scale (VAS) pain scores at each stimulating site were recorded and compared. Results: Thirty-six hands from 25 young healthy volunteers were studied. There was no correlation between the body mass index (BMI) and stimulation intensity, and BMI and VAS (r<0.3) in both median and ulnar nerves. Overall analysis showed that the stimulation intensity and VAS at 14cm were significantly greater than at the proximal wrist crease. Subgroup analysis showed the same result in all groups for the median sensory NCS, but in only the small hand group for the ulnar sensory NCS. Conclusions: When the same distance is used for NCSs regardless of patient size, smaller individuals required greater stimulation and reported greater discomfort. This may reflect greater nerve depth and suggests that one size fits all may not be the best approach with NCSs.