Reliability, reference values and predictor variables of the ulnar sensory nerve in disease free adults.

OBJECTIVE: The purposes of this descriptive and exploratory study were to examine electrophysiological measures of ulnar sensory nerve function in disease free adults to determine reliability, determine reference values computed with appropriate statistical methods, and examine predictive ability of anthropometric variables. METHODS: Antidromic sensory nerve conduction studies of the ulnar nerve using surface electrodes were performed on 100 volunteers. Reference values were computed from optimally transformed data. Reliability was computed from 30 subjects. Multiple linear regression models were constructed from four predictor variables. RESULTS: Reliability was greater than 0.85 for all paired measures. Responses were elicited in all subjects; reference values for sensory nerve action potential (SNAP) amplitude from above elbow stimulation are 3.3 µV and decrement across-elbow less than 46%. No single predictor variable accounted for more than 15% of the variance in the response. CONCLUSION: Electrophysiologic measures of the ulnar sensory nerve are reliable. Absent SNAP responses are inconsistent with disease free individuals. Reference values recommended in this report are based on appropriate transformations of non-normally distributed data. No strong statistical model of prediction could be derived from the limited set of predictor variables. SIGNIFICANCE: Reliability analyses combined with relatively low level of measurement error suggest that ulnar sensory reference values may be used with confidence.

Test-retest reliability of the ulnar F-wave minimum latency in normal adults.

BACKGROUND AND PURPOSE: The purpose of this study was to measure the test-retest reliability of the ulnar F-wave minimum latency (Fmin) in normal adults. A reliable Fmin measure allows clinicians to ascribe changes in latency to true changes in a subject and not merely random daily variation. SUBJECTS AND METHODS: Fmin in the Abductor Digiti Minimi muscle was measured bilaterally in 49 healthy adults (n = 98) with a three day separation between tests. RESULTS: The Fmin reliability estimate as measured by intraclass correlation coefficient (3,1) was 0.59 with a standard error of measurement (SEM) of 1.3 msec. A paired t-test showed no significant difference (t = 1.7, df = 97, p > 0.05) between the mean scores from the two testing sessions. DISCUSSION AND CONCLUSIONS: We found moderate reliability and relatively low precision (high SEM) in Fmin scores taken from healthy individuals on two separate days. Strict adherence to our protocol and an acceptable overall precision of measurements (as measured by mean scores) suggest the contributions of rater and instrument error were low in our study. We conclude that 1) valid clinical interpretation of minimum F-wave latency findings is questionable because the Fmin measurement appears to have only moderate reliability, and 2) the lability of the phenomenon itself is the most likely contributor to variability in the Fmin latencies. Further research is warranted before electrophysiologists may be justified in attributing small changes in the Fmin to actual changes in the subject.