RESUMEN
This study aims were twofold: (1) to evaluate the construct validity of the Repetitive Movement Test (RMT) a novel test developed for Wheelchair Rugby classification which evaluates arm coordination impairment at five joints - shoulder, elbow, forearm, wrist and fingers - and (2), pending sufficiently positive results, propose objective minimum impairment criteria (MIC). Forty-two WR athletes with an eligible coordination impairment, and 20 volunteers without impairment completed the RMT and two clinically established coordination tests: the finger-nose test (FNT) and the spiral test (ST). Coordination deduction (CD), an ordinal observational coordination scale, currently used in WR classification, was obtained. Spearman-rank correlation coefficients (SCC) between RMT and ST (0.40 to 0.67) and between RMT and CD (0.31 to 0.53) generally supported RMT construct validity, SCC between RMT and FNT were lower (0.12-0.31). When the scores on ST, FNT and RMT from the sample of WR players were compared with the scores from volunteers without impairment, 93.5% to 100% of WR players had scores > 2SD below the mean of volunteers without impairment on the same test. In conclusion, RMT at the elbow, forearm, wrist and fingers have sufficient construct validity for use in WR. MIC were recommended with ST and RMT.
Asunto(s)
Brazo/fisiopatología , Ataxia/fisiopatología , Fútbol Americano/fisiología , Articulaciones/fisiopatología , Deportes para Personas con Discapacidad/fisiología , Adolescente , Adulto , Ataxia/clasificación , Rendimiento Atlético , Estudios de Casos y Controles , Estudios Transversales , Articulación del Codo/fisiopatología , Femenino , Articulaciones de los Dedos/fisiopatología , Fútbol Americano/clasificación , Antebrazo , Humanos , Masculino , Persona de Mediana Edad , Paratletas , Desempeño Psicomotor/fisiología , Rango del Movimiento Articular/fisiología , Reproducibilidad de los Resultados , Articulación del Hombro/fisiopatología , Deportes para Personas con Discapacidad/clasificación , Estadísticas no Paramétricas , Articulación de la Muñeca/fisiología , Adulto JovenRESUMEN
OBJECTIVE: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. A local corticosteroid injection at the carpal tunnel inlet is often given to reduce the signs and symptoms. The long term effect of a local corticosteroid injection is not known yet. The aims of the study were to assess the long term effect of a local corticosteroid injection and the rognostic factors. METHODS: Assessment of 419 consecutive patients, seen between November 2004 and November 2007 at our Neurology out-patient clinic. After confirmation of the diagnosis CTS the treating neurologist decided on the patients eligibility for a local corticosteroid injection, containing 40 mg methylprednisolone. RESULTS: Local corticosteroid injection was given to 273 of the 419 patients with CTS (65%), 122 (29%) were treated surgically and 24 (6%) were treated by another therapy. Of the 273 patients long term follow-up was available for 211 (77%) patients. A beneficial effect of more than 6 months was seen in 132 patients (63%), longer than 12 months in 102 patients (48%), and longer than 18 months in 71 patients (34%). Only severity of electrodiagnostic testing was a predictor of outcome. The median time until treatment failure was 15 months for mild, 5 months for moderate and 4.5 months for severe CTS (logrank test p=0.02). CONCLUSION: Patients with an electrodiagnostically mild CTS (i.e., abnormal comparative tests or prolonged median DSL>3.5 ms but normal median DML) are good candidates for a local steroid injection with 50% having a good long term effect for more than 15 months. SIGNIFICANCE: This study shows that the EMG severity of CTS is an important prognostic factor for the long term effect of a local steroid injection.
