RESUMO
OBJECTIVE: To investigate the optimal sonographic method for diagnosing carpal tunnel syndrome (CTS) in patients with diabetic sensorimotor polyneuropathy (DSP). METHODS: A total of 190 participants were divided into four groups based on DSP history and electrodiagnostic results of CTS. The absolute parameters were measured at baseline and the relative values were calculated: maximal cross-sectional area (CSA) of the median nerve throughout the carpal tunnel (Mmax), median nerve CSA at the forearm level (Mf), ulnar nerve CSA at the pisiform level (Upi), difference between Mmax and Mf (∆MM), and difference between Mmax and Upi (∆MU). Then, the optimal ultrasonographic parameters for diagnosing CTS, according to the presence of DSP, using absolute and relative cutoff values were analyzed. RESULTS: Median and ulnar nerve CSAs were significantly larger in the DSP group than in the control group. In the DSP participants, the mean Mmax, ∆MM, and ∆MU values were significantly larger in patients with both DSP and CTS than in patients with DSP only. The Mmax thresholds of 9.5 mm2 in the control group and 11.5 mm2 in the DSP group showed the greatest sensitivity and specificity for diagnosing CTS. The ∆MM thresholds of 2.5 mm2 and ∆MU thresholds of 4.5 mm2 had the greatest sensitivity and specificity in both the DSP and control groups. CONCLUSION: Measurement of Mmax, ∆MM and ∆MU is an optimal ultrasonographic evaluation method for diagnosing CTS in patients with DSP.
RESUMO
BACKGROUND: Microcurrent electrical neuromuscular stimulation (MENS) has been suggested to improve muscle function and restore damaged muscle. However, current evidence is insufficient to determine the effectiveness of this therapy in age-dependent muscle weakness. Therefore, a prospective, randomized, double-blinded, sham-controlled clinical trial was designed to evaluate the effects of short-term MENS on muscle function in the elderly. METHODS: A total of 38 healthy elderly participants aged 65 years and above were enrolled and randomly divided into 2 stimulation groups: real or sham MENS group. Real or sham MENS were applied to the 8 anatomical points of the dominant arm and leg during the course of 40 minutes. We performed muscle function tests at baseline and after the intervention: the handgrip strength tests (HGS, kg), the root mean square values (RMS, µV), and the single leg heel-rise tests (HRT) to determine changes in the strength, activity, and endurance of the elderly muscle, respectively. RESULTS: In the real MENS group, the mean values of the HGS and the number of plantar flexions were significantly increased, but the RMS value of the electromyography signal was significantly decreased after the real intervention (Pâ<â.05). However, the sham MENS group showed a significant decrease in the number of plantar flexions and the total time for HRT after the sham stimulation (Pâ<â.05). The mean difference in the RMS value was significantly lower, but the number of plantar flexions and the total time for HRT was significantly higher in the real MENS group than in the sham MENS group (Pâ<â.05). CONCLUSION: The findings suggest that short-term application of MENS may play a partial role in enhancing physical activities of the elderly, as it can improve some muscle function.
