Strict actions of the human wrist flexors: A study with an electrical neuromuscular stimulation method.

In order to elucidate strict actions of the human wrist flexors, motion and force produced by electrical neuromuscular stimulation (ENS) to each of musculus (m.) flexsor carpi radialis (FCR) and m. flexsor carpi ulnaris (FCU) with the prone, semiprone, and supine forearm were studied in ten healthy human subjects. Abduction, extension, adduction, and flexion directions were represented by, respectively, 0°, 90°, 180°, and 270°. ENS to FCR and FCU produced motion in direction of, respectively, 273° (mean) and 265° with the prone, 249° and 232° with the semiprone, and 242° and 229° with the supine forearm to the maximal range. Direction/strength (Nm) of force by ENS to FCR and FCU were, respectively, 298°/1.16 and 239°/1.70 with the prone, 279°/1.30 and 241°/1.62 with the semiprone, and 267°/1.24 and 227°/2.04 with the supine forearm. ENS to FCR exhibited force of 20-29% of maximal flexion and 7-15% of maximal abduction or 1-4% of maximal adduction and that to FCU force of 24-28% of maximal flexion and 15-25% of maximal adduction. The force study results suggest that FCU is a flexor rather than an adductor with every forearm position. FCR should be a flexor rather than an abductor with the prone and semiprone and a flexor with the supine forearm. The action of FCR as the abductor should diminish with supinating the forearm.

Strict actions of the human wrist extensors: A study with an electrical neuromuscular stimulation method.

Motion and force produced by electrical neuromuscular stimulation (ENS) to each of the extensor carpi radialis longus (ECRL) and brevis (ECRB), and extensor carpi ulnaris (ECU) with the prone (P), semiprone (SP), and supine forearm (S) were studied in ten normal human subjects. Abduction (AB), extension (E), adduction (AD), and flexion (F) directions were represented by, respectively, 0°, 90°, 180°, and 270°. ENS to ECRL, ECRB, and ECU produced motion in direction of, respectively, 60° (mean), 87°, and 205° with P, 66°, 83°, and 166° with SP, and 47°, 66°, and 116° with S to maximal range. Direction/strength (Nm) of force by ENS to ECRL, ECRB, and ECU were, respectively, 54°/1.75, 74°/1.78, and 184°/1.49 with P, 34°/1.65, 63°/1.66, and 152°/1.43 with SP, and 32°/1.66, 70°/1.49, and 147°/1.25 with S. ENS to ECRL exhibited force of 15-20% of maximal E (15-20%Max-E) and 19-29%Max-AB, that to ECRB 24-32%Max-E, and that to ECU 17-30%Max-AD. The force study results suggest that ECRL is an abductor and extensor and ECRB is an extensor rather than an abductor. ECU should be an adductor rather than an extensor with SP and S and an adductor with P. The data must contribute to reconstruct motor functions of paralyzed hands.

The long-term follow-up of surgical treatment for cervical myelopathy with severe nape and upper arm pain caused by the anomalous vertebral artery: case report.

STUDY DESIGN: A case of cervical myelopathy with a severe nape and upper arm pain caused by anomalous bilateral vertebral arteries is reported. OBJECTIVE: To report over six and a half years results of a microsurgical decompression for high cervical myelopathy with a severe pain of nape and upper arm resulting from spinal cord compression by the anomalous vertebral arteries. SUMMARY OF BACKGROUND DATA: Although symptomatic cases of anomalies of vertebral artery (VA), such as fenestration or elongation, leading to severe cervical pain, cervical myelopathy, or accessory nerve palsy have been reported, no long-term results of microsurgical decompression for those cases have been reported. METHODS: The clinical features of the case and over 6(1/2) years results of microsurgical decompression by retracting the arteries with silicon tapes and a dural patch are reported. An etiology and the treatment of the cases are discussed with a review of the previous documented cases. RESULTS: The cord compression was relieved surgically, and the patient's symptoms have improved after surgery throughout the follow-up period. CONCLUSION: Anomalous vertebral arteries should be included in the differential diagnosis of the upper cervical lesion of unknown origin. The microsurgical decompression with presented technique has relieved the symptoms for over 6(1/2) years.