Sila mišice abductor pollicis brevis pri pacientih s sindromom zapestnega prehoda : diplomsko delo

Bohinc, Žan (author), Leonardis, Lea (mentor), Jakovljević, Miroljub (reviewer)

Uvod: Sindrom zapestnega prehoda je najpogostejša oblika utesnitvene nevropatije, pri kateri se mediani živec utesni v zapestju. Simptomi in znaki sindroma zapestnega prehoda so neprijetno mravljinčenje, zmanjšana zaznava občutkov z medianim živcem oživčenih prstov, šibkost in atrofija tenarja ter bolečina. Težave se poslabšajo ponoči in v skrajnih legah zapestja. Sindrom zapestnega prehoda povzroči zmanjšanje sile palca, kar pomembno vpliva na posameznikovo učinkovitost v vsakdanjem življenju. Namen: Želeli smo ugotoviti ali je stopnja sindroma zapestnega prehoda povezana z nižjo silo mišice kratke odmikalke palca roke, ali je manjša sila kratke odmikalke palca roke povezana z nižjo amplitudo vala M in ali je sila mišice kratke odmikalke palca roke zdravih enaka sili preiskovancev, ki smo jim izmerili normalno amplitudo vala M in podaljšan končni čas prevajanja. Metode dela: Pri 51 pacientih smo za potrditev sindroma zapestnega prehoda opravili meritve prevodnosti po medianem in ulnarnem živcu ter, kadar je bila zakasnitev za mediani živec za 0,1 ms do 0,4 ms daljša od zakasnitve za ulnarni živec, še po radialnem živcu, ter z dinamometrom izmerili silo mišice kratke odmikalke palca roke. Parametre meritev prevodnosti smo uporabili za določitev stopnje sindroma zapestnega prehoda. Meritve sile mišice kratke odmikalke palca roke, amplitudo vala M, končni čas prevajanja in stopnjo sindroma zapestnega prehoda smo statistično analizirali. Podatki, vključeni v raziskavo, so bili anonimizirani. Statistično analizo smo opravili s programom SPSS. Rezultati: Stopnja sindroma zapestnega prehoda in sila mišice kratke odmikalke palca roke sta negativno povezani. Z večanjem stopnje sindroma zapestnega prehoda se sila mišice kratke odmikalke palca znižuje. Izračunali smo pozitivno povezanost med silo mišice kratke odmikalke palca roke in amplitudo vala M, to pomeni, da nižja amplituda vala M napoveduje nižjo silo mišice kratke odmikalke palca roke. V nasprotju s pričakovanji smo v svoji, raziskavi ugotovili, da se sila zdravih razlikuje od sile tistih, ki imajo normalno amplitudo vala M in podaljšan končni čas prevajanja. Razprava in zaključek: Z meritvami smo potrdili, da ima sindrom zapestnega prehoda pomemben vpliv na silo mišice kratke odmikalke palca.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, sindrom zapestnega prehoda, sila, mišica kratka odmikalka palca
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [Ž. Bohinc]
• Year: 2021
• Number of pages: 28 str., [1] str. pril.
• PID: 20.500.12556/RUL-131242
• UDC: 615.8
• COBISS.SI-ID: 78081795
• Publication date in RUL: 24.09.2021

Secondary language

• Language: English
• Title: Abductor pollicis brevis muscle strength in patients with carpal tunnel syndrome : diploma work

Abstract

Introduction: Carpal tunnel syndrome is the most common form of nerve entrapment in which the median nerve is compressed in the wrist. Symptoms include a reduced sensitivity in the area innervated by the median nerve, weakness, thenar atrophy, and pain. Carpal tunnel syndrome causes loss of strength and therefore influences activities of daily living as well as a psychological state of an individual. Purpose: The aim was to determine if a different carpal tunnel syndrome grade correlates with a lower strength of the abductor pollicis brevis if a lower abductor pollicis brevis strength correlates with a lower compound muscle action potential and if the strength of the abductor pollicis brevis in healthy patients is the same as in the patients with a normal compound muscle action potential and a higher latency. Methods: We included 51 patients for the nerve conduction studies of the median, ulnar, and, when the delay in the median nerve was 0.1 ms to 0.4 ms longer than the delay in ulnar nerve, radial nerve, and measured the strength of the abductor pollicis brevis. We used the results from the nerve conduction studies to grade carpal tunnel syndrome whilst latency, compound muscle action potential, abductor pollicis brevis strength and carpal tunnel syndrome grade were statistically analysed. All results in our research were used anonymously. Statistical analysis was made with SPSS. Results: Carpal tunnel syndrome grade and abductor pollicis brevis strength are negatively correlated, by increasing the grades of the carpal tunnel syndrome the strength of abductor pollicis brevis is lowering. We calculated a positive correlation between the compound muscle action potential and the abductor pollicis brevis strength, which means that a lower compound muscle action potential means a lower abductor pollicis brevis strength and vice versa. Contrary to expectations, we found statistically important differences in the strength of the abductor pollicis brevis of healthy patients and those with a normal compound muscle action potential and a higher latency. Discussion and conclusion: Measurements have confirmed that carpal tunnel syndrome indeed has an important influence on the strength of the abductor pollicis brevis.

• Keywords: diploma theses, physiotherapy, carpal tunnel syndrome, strength, musculus abductor pollicis brevis