Dirsekte ulnar nöropatide elektrodiagnostik bulgularla kol, omuz ve el sorunları anketinin korelasyonu

Year 2021, Volume: 12 Issue: 1, 15 - 22, 31.03.2021

İlker Öztürk , Halit Fidancı

https://doi.org/10.18663/tjcl.679752

Abstract

Amaç: Dirsekte ulnar nöropatide (DUN) elektrodiagnostik bulgular ile kol, omuz ve el sorunları (DASH) anketi arasında bir ilişki olup olmadığını bulmayı amaçladık.
Gereç ve Yöntemler: Klinik ve elektrodiagnostik bulguları DUN ile uyumlu olan hastalar bu retrospektif kohort çalışmasına dahil edildi. DUN hastaları nörofizyolojik sınıflandırmaya göre hafif, orta ve şiddetli DUN olarak ayrıldı. Tüm hastaların DASH-özürlülük / semptom (DASH-ÖS) skorları hesaplandı. Ayrıca bazı hastalara DASH iş modeli (DASH-İ) ve DASH yüksek performans sporları ve müzisyenler anketi uygulanmıştır.
Bulgular: Otuz dokuz DUN hastası çalışmaya dahil edildi. Yirmialtı hafif DUN, 8 orta DUN ve 5 şiddetli DUN hastası vardı. DUN’un nörofizyolojik sınıflandırması ile DASH-ÖS / DASH-İ skorları arasında pozitif bir korelasyon vardı (p = 0.002 r = 0.491, p = 0.012 r = 0.453). DASH-İ skorları ile ulnar sinir bileşik kas aksiyon potansiyeli / duyusal sinir aksiyon potansiyeli amplitüdleri arasında ters bir korelasyon bulundu (p = 0.036 r = -0.413, p = 0.006 r = 0.-492). Orta ve şiddetli UNE grubu tek bir grup olarak değerlendirildiğinde, hafif UNE hastalarının DASH-ÖS ve DASH-İ skorları orta-şiddetli UNE hastalarının skorlarından daha düşük bulundu (p = 0.001, p = 0.012).
Sonuç: Bu çalışma DUN’da DASH skorları ile nörofizyolojik sınıflandırma arasında pozitif bir korelasyon olduğunu göstermiştir. DASH-ÖS anketine ek olarak, DASH-İ anketinin kullanımı UNE'de faydalı olabilir.

Keywords

DASH anketi, elektrodiagnoz, ulnar nöropati

Correlation of electrodiagnostic findings and the disabilities of arm, shoulder and hand questionnaire in ulnar neuropathy at the elbow

Abstract

Aim: We aimed to find out whether there is a relationship between the electrodiagnostic findings and disabilities of arm, shoulder and hand (DASH) questionnaire in the ulnar neuropathy at the elbow (UNE).
Material and Methods: Patients whose clinical and electrodiagnostic findings were compatible with UNE were included in this retrospective cohort study. UNE patients were divided into mild, moderate and severe UNE according to the neurophysiological classification. DASH-disability / symptom (DASH-DS) scores of all patients were calculated. In addition, DASH work module (DASH-W) and DASH sports / performing arts module (DASH-SP) questionnaire were applied to some patients.
Results: Thirty-nine UNE patients were included in the study. There were 26 mild UNE patients, 8 moderate UNE patients, and 5 severe UNE patients. There was a positive correlation between neurophysiological classification of UNE and DASH-DS / DASH-W scores (p = 0.002 r = 0.491, p = 0.012 r = 0.453). An inverse correlation was found between DASH-W scores and ulnar nerve compound muscle action potential / sensory nerve action potential amplitudes (p = 0.036 r = -0.413, p = 0.006 r = 0.-492). When the moderate and severe UNE group was evaluated as a single group, DASH-DS and DASH-W scores of mild UNE patients were low in those of moderate-severe UNE patients (p = 0.001, p = 0.012).
Conclusion: This study showed a positive correlation between the DASH scores and the neurophysiological classification in the UNE. In addition to the DASH-DS questionnaire, the use of the DASH-W questionnaire can be useful in UNE.

Keywords

DASH questionnaire, electrodiagnosis, ulnar neuropathy

References

• 1. Omejec G, Podnar S. Proposal for electrodiagnostic evaluation of patients with suspected ulnar neuropathy at the elbow. Clin Neurophysiol 2016; 127: 1961-7
• 2. Padua L, Aprile I, Mazza O et al. Neurophysiological classification of ulnar entrapment across the elbow. Neurol Sci 2001; 22: 11-6.
• 3. Beekman R, Van Der Plas JP, Uitdehaag BM, Schellens RL, Visser LH. Clinical, electrodiagnostic, and sonographic studies in ulnar neuropathy at the elbow. Muscle Nerve 2004; 30: 202-8.
• 4. Fidancı H, Savrun Y, Cengiz B, Kuruoğlu HR. The importance of arm-elbow velocity difference in the diagnosis of ulnar neuropathy at the elbow. Neurol Sci Neurophysiol 2019; 36: 16-21.
• 5. Omejec G, Podnar S. Precise of ulnar neuropathy at the elbow. Clin Neurophysiol 2015; 126: 2390-6.
• 6. Campbell WW, American Association of Electrodiagnostic Medicine. Guidelines in electrodiagnostic medicine. Practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow. Muscle Nerve Suppl 1999; 8: 171-205.
• 7. Visser LH, Beekman R, Franssen H. Short-segment nerve conduction studies in ulnar neuropathy at the elbow. Muscle Nerve 2005; 31: 331-8.
• 8. Kanakamedala RV, Simons DG, Porter RW, Zucker RS. Ulnar nerve entrapment at the elbow localized by short segment stimulation. Arch Phys Med Rehabil 1988; 69: 959-63.
• 9. Azrieli Y, Weimer L, Lovelace R, Gooch C. The utility of segmental nerve conduction studies in ulnar mononeuropathy at the elbow. Muscle Nerve 2003; 27: 46-50.
• 10. Onar MK, Bayrak AO, Türker H, Kasım D. Electrophysiologic Findings of Ulnar Neuropathy at the Elbow. Journal of Experimental and Clinical Medicine 2006; 23: 91-4.
• 11. Allahverdi E, Allahverdi TD. The superiority of the Anterior Transposition Surgical Method to Decompression Procedures in a Case of Secondary Cubital Entrapment Neuropathy. Middle Black Sea Journal of Health Science 2017; 3: 26-31
• 12. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disability of the arm, shoulder and hand). Am J Ind Med 1996; 30:372.
• 13. Duger T, Yakut E, Oksuz C, Yorukan S, Bilgutay BS, et al. Reliability and validity of the Turkish version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. Fizyoterapi Rehabilitasyon 2006; 17: 99-107.
• 14. Ebersole GC, Davidge K, Damiano M, Mackinnon SE. Validity and responsiveness of the DASH questionnaire as an outcome measur following ulnar nerve transposition for cubital tunnel syndrome. Plast Reconstr Surg 2013; 142: 81-90.
• 15. Ido Y, Uchitama S, Nakamura K, Itsubo T, Hayashi M, Hata Y, Imaeda T, Kato H. Postoperative improvement in DASH score, clinical findings, and nerve conduction velocity in patients with cubital tunnel syndrome. Sci Rep 2016; 6: 27497.
• 16. Omejec G, Podnar S. Normative values for short-segment nerve conduction studies and ultrasonography of the ulnar nerve at the elbow. Muscle Nerve 2015; 51: 370-7
• 17. Buschbacher RM. Ulnar nerve motor conduction to the abductor digiti minimi. Am J Phys Med Rehabil 1999; 78: 9–14.
• 18. Oh S. Clinical Electromyography: Nerve Conduction Studies. 3rd Ed. Philadelphia: Lippincott Williams Wilkins 2003; 217-8.
• 19. Chen S, Andary M, Buschbacher R et al. Electrodiagnostic reference values for upper and lower limb nerve conduction studies in adult populations. Muscle Nerve 2016; 54: 371-7.
• 20. Altun G, Kurtulmus T, Oltulu İ, Sağlam N. In Situ Decompression in the Treatment of Cubital Tunnel Syndrome. SDÜ Tıp Fak Derg 2018; 25: 132-8.
• 21. Beekman R, Schreuder AH, Rozeman CA, Koehler PJ, Uitdehaag BM. The diagnostic value of provacative clinical tests in ulnar neuropathy at the elbow is marginal. J Neurol Neurosurg Psychiatry 2009; 80: 1369-74.
• 22. Eliaspour D, Sedighipour L, Hedayati-Moghaddam MR et al. The pattern of muscle involvement in ulnar neuropathy at the elbow. Neurol India 2012; 60: 36-9.
• 23. Jabaley ME, Wallace WH, Heckler FR. Internal topography of major nerves of the forearm and hand: a current view. J Hand Surg Am 1980; 5: 1-18.
• 24. Halac G, Topaloglu P, Demir S, Cıkrıkcıoglu MA, Karadeli HH, Ozcan ME, Asil T. Ulnar nerve entrapment neuropathy at the elbow: relation between the electrophysiological findings and neuropathic pain. J Phys Ther 2015; 27: 2213-6.