The Effect of Local Cooling at the Elbow on Nerve Conduction Velocity and Motor Unit Behaviour: An Exploration of a Novel Neurological Assessment.

BACKGROUND: This study aimed to determine the effects of a standard therapeutic cooling protocol using crushed ice on the elbow to explore if changes in the motor unit (MU) firing rates in the first dorsal interosseous (FDI) muscle are comparable to known changes in sensory and motor nerve conduction velocity (NCV) due to a regional temperature drop around a peripheral nerve. METHODS: Twelve healthy individuals were assessed before cooling, immediately after cooling, and 15 min of rewarming. Assessments included two standard non-invasive nerve conduction velocity tests and a non-invasive investigation of the MU firing rates using surface electromyography decomposition (dEMG). RESULTS: Repeated ANOVAs showed significant differences in the MU firing rates and NCV between time points (p = 0.01 and p < 0.001). All measures showed significant differences between pre and post cooling and between pre-cooling and 15 min of passive re-warming, however, no changes were seen between post cooling and rewarming except in the sensory NCV, which increased but did not return to the pre-cooled state. CONCLUSIONS: This current study showed a significant, temporary, and reversible reduction in ulnar NCV across the elbow in healthy subjects, which was associated with a significant decrease in mean MU firing rates in the FDI muscle.

Fluid Containing Structures in the tips of the fingers and toes delineated by Ultrasound Imaging before and after Induced Skin Wrinkling.

This Ultrasound study identified spaces within the pulp of distal phalanx of the fingers and toes that halve in area after Water Induced Skin Wrinkling. These spaces appeared as fluid filled sacculi between connective tissue compartments accountable for distending digital pulp under normal circumstances and skin wrinkling after water immersion. Whilst studying conditions related to sympathetic nerve function with WISW ultrasound imaging is a valuable adjunct to the visual assessment.

Diagnostic value of the muscle fiber conduction velocity for evaluation of muscle hypotrophy.

AIM: To find an objective method of evaluation of the thigh muscle hypothrophy in gonarthrosis. MATERIAL AND METHODS: The subjects of the study were 24 patients with gonarthrosis (mean age 58.4 +/- 2.6 years). Of these 8 (33%) were males and 16 (67%) females. The following methods of examination were used: computed tomography (CT) of the thigh musculature--linear measurement and area of the cross-section of the vastus medialis muscle; electromyography--muscle fiber conduction velocity; and measurement of thigh girth. RESULTS: Significant reduction of the cross-section area and linear measurement of the vastus medialis muscle and significant delay of the muscle fiber conduction velocity was found in the symptomatic side compared with the asymptomatic side. No correlation was found between the tape measure of the thigh and cross-section area of the muscle. A significant correlation was found between the cross-section area of the muscle and the fast fiber conduction velocity as well as between the linear measurement of the vastus medialis muscle cross-section and fast fiber conduction velocity. CONCLUSION: The correlation between the macromorphological changes of the vastus medialis muscle assessed by computed tomography and the functional changes detected by electromyography allows the conclusion that the muscle fiber conduction velocity can be used as an objective method of evaluation of muscle atrophy in degenerative joint diseases.