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Biomedical subjects

K D Meadows

Publications and source records attributed to K D Meadows.

At least 19 recordsLinked to original sources

Effects of an aerobic exercise program on median nerve conduction and symptoms associated with carpal tunnel syndrome.

Carpal tunnel syndrome is associated with greater body mass index and less physical activity. To determine the effect of aerobic exercise on median nerve conduction and symptoms suggestive of carpal tunnel syndrome, 30 symptomatic volunteers (30 to 64 years old) with abnormal median nerve conduction studies participated in a 10-month program of supervised aerobic exercise. Changes in percentage of body fat, body mass index, peak oxygen consumption, 14-cm median sensory latency, and hand/wrist symptoms were assessed. A decrease in 14-cm sensory median latency correlated with a decrease in percentage of body fat (R = 0.52, P = 0.004) and was predicted by an increase in peak oxygen utilization (partial R = 0.52, P = 0.005) and a decrease in body mass index (partial R = 0.47, P = 0.014). There was also a tendency for a set of symptoms sometimes associated with carpal tunnel syndrome (pain, tightness, and clumsiness) to be relieved by the exercise program. These results suggest that an aerobic exercise program can be beneficial to median nerve function and may be associated with a reduction in hand symptoms.

Adult↗

Natural history of median nerve sensory conduction in industry: relationship to symptoms and carpal tunnel syndrome in 558 hands over 11 years.

We evaluated the natural history of median nerve sensory conduction, hand/wrist symptoms, and carpal tunnel syndrome (CTS) in an 11-year longitudinal study of 289 workers from four industries. Twenty hands which had carpal tunnel release surgery were excluded, leaving 558 hands for the primary study group. Overall, the trend was for mean sensory latencies and prevalence of slowing to increase, the prevalence of symptoms to decrease, and the prevalence of CTS to remain unchanged. Among individual hands, nerve conduction abnormalities tended to persist (82% 11-year persistence), while symptoms fluctuated widely (13% 11-year persistence). There was a strong, direct linear correlation between initial severity of slowing and subsequent development of CTS; however, most workers who developed de novo slowing did not develop symptoms or CTS. We conclude that changes in conduction status of the median nerve occur naturally with increasing age and do not necessarily lead to symptoms and CTS.

Adult↗

Tobacco, caffeine, alcohol, and carpal tunnel syndrome in American industry. A cross-sectional study of 1464 workers.

We investigated the effects of three legal drugs (tobacco, caffeine, and alcohol) on the prevalence of carpal tunnel syndrome (CTS) confirmed by nerve conduction studies (definite CTS) in two groups of American industrial workers: 656 nonclaimant workers and 808 working patients referred for upper extremity symptoms. Comparing workers with definite CTS to workers without definite CTS revealed 26% greater current use of tobacco, 19% greater lifetime use of tobacco, 5% greater current use of caffeine, 14% lesser current use of alcohol, and 75% greater history of alcohol abuse in the workers with definite CTS. All these differences were statistically significant. Those who currently used alcohol but not tobacco or caffeine were at the lowest risk for slowing, symptoms, and definite CTS. Those who currently used caffeine alone or in combination with tobacco were at the highest risk. In female workers, current smoking, current caffeine use, and current coffee consumption independently predicted 5.0% of the explainable risk for definite CTS. In male workers, history of alcohol abuse and current beer consumption independently predicted 3.0% of the explainable risk for definite CTS. Prevalence of slowing, symptoms, and definite CTS in 12 specific job categories correlated directly with current tobacco use. We conclude that the use of legal drugs affects the prevalence of median nerve slowing, symptoms, and carpal tunnel syndrome, but the effects of the drugs independently explain only a small portion of the total risk. Nevertheless, legal drug use or abuse may serve as a marker for increased CTS risk.

Adult↗

Outcome study of ulnar nerve compression at the elbow treated with simple decompression and an early programme of physical therapy.

Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper limb. This paper presents the experience of treating cubital tunnel syndrome with simple decompression in 131 patients (164 ulnar nerves) over the past 12 years. 85% of these patients had mild or moderate ulnar nerve disease. In 146/164 ulnar nerves (89%), simple decompression resulted in good or excellent immediate post-operative relief of symptoms. After an average follow-up of 4.3 years (range, 0.8-12.0 years), 130/164 (79%) still reported good or excellent relief. The independent predictors of a better long-term outcome were absence of post-operative subluxation, greater body weight, normal pre-operative two-point discrimination (2-PD), and a more recent date of operation. A physical therapy rehabilitation program generally began on the day after surgery. Active participation in this predicted a rapid return to work or activities of daily living. The average time to return to work with simple decompression was 20 workdays.

Adult↗

Slowing of sensory conduction of the median nerve and carpal tunnel syndrome in Japanese and American industrial workers.

As part of a continuing study of the causes of carpal tunnel syndrome (CTS) in industry, we measured sensory conduction of the median nerve in 101 Japanese furniture factory workers. We used the maximum latency difference (MLD) with a critical value of > or = 0.40 msec to indicate abnormal slowing of nerve conduction. The prevalence of slowing in the Japanese workers was 17.8%, while the prevalence of probable CTS (based on symptoms only) was 2.5%, and the prevalence of definite CTS (probable CTS confirmed by slowing) was 2.0%. The most important factor predicting the MLD was the body mass index. The MLD was the most important factor predicting probable CTS. The prevalence of slowing in the Japanese workers was not significantly different from the prevalence of slowing in 316 American workers from four industries (22.0%), but the prevalences of probable CTS and definite CTS were much lower in the Japanese. The meaning of these findings is discussed.

Adolescent↗

Predictive value of nerve conduction measurements at the carpal tunnel.

We compared the predictive values of three measurements of sensory conduction of the median nerve at the carpal tunnel (maximum latency difference [MLD], 8-cm latency [S8], and 14-cm latency [S14]) in 2334 hands of industrial workers, workers' compensation patients, and students. The MLD was determined by the centimetric technique. The MLD was the most sensitive and efficient measurement for predicting carpal tunnel syndrome (CTS). An MLD > or = 0.40 ms correctly identified 86.3% of 753 hands with CTS. The MLD correlated best with CTS and with the primary diagnostic category (CAT). MLD was the second factor selected in stepwise regression analysis for CAT (numbness was first and S8 was third). The MLD was the most important factor for predicting persistent or de novo CTS in a 5-year follow-up of 630 hands. Thus, the MLD was the most reliable nerve conduction study measurement for predicting current or future CTS in these subjects' hands.

Adult↗