Ultrasonographic median nerve changes under tendon gliding exercise in patients with carpal tunnel syndrome and healthy controls.

ABSTRACT

STUDY DESIGN: Case control study. PURPOSE OF THE STUDY To evaluate the ultrasonographic median nerve changes under tendon gliding exercise in patients with carpal tunnel syndrome (CTS) and healthy controls. METHODS: Seventy-three patients with CTS and 53 healthy volunteers were consecutively recruited. Each subject underwent a physical examination, nerve conduction studies and ultrasonographic examinations of the median nerve during tendon gliding exercises. RESULTS: Significant changes in the cross-sectional area of the median nerve were found while moving from the straight position to the hook position and from the hook position to the fist position. There were also significant changes in the flattening ratio when moving from the hook position to the fist position. CONCLUSIONS: Ultrasonography revealed that the median nerve was compressed in the fist position in both CTS patients and healthy volunteers. Thus, forceful grasping should be avoided during tendon gliding exercises performed in the fist position. LEVEL OF EVIDENCE 3b.