PDF(Pubmed)
Abstract：
The current literature studied the median nerve (MN) at specific locations during joint motions. As only a few particular parts of the nerve are depicted, the relevant information available is limited. This experiment investigated the morphological and biomechanical properties of the MN. The effects of the shoulder and wrist motions on MN were explored as well. Eight young healthy female individuals were tested with two-dimensional ultrasound and shear wave elastography (SWE). The morphological and biomechanical properties were examined in limb position 1, with the wrist at the neutral position, the elbow extended at 180°, and the shoulder abducted at 60°. In addition, the experiment assessed the differences among the wrist, forearm, elbow, and upper arm with Friedman\'s test and Bonferroni post hoc analysis. Two groups of limb positions were designed to explore the effects of shoulder movements (shoulder abducted at 90° and 120°) and wrist movements (wrist extended at 45° and flexed at 45°) on the thickness and Young\'s modulus. Differences among the distributions of five limb positions were tested as well. The ICC3, 1 values for thickness and Young\'s modulus were 0.976 and 0.996, respectively. There were differences among the MN thicknesses of four arm locations in limb position 1, while Young\'s modulus was higher at the elbow and wrist than at the forearm and upper arm. Compared to limb position 1, only limb position 4 had an effect on MN thickness at the wrist. Both shoulder and wrist motions affected MN Young\'s modulus, and the stiffness variations at typical locations all showed a downward trend proximally in all. The distributions of MN thickness and Young\'s modulus showed fold line patterns but differed at the wrist and the pronator teres. The MN in the wrist is more susceptible to limb positions, and Young\'s modulus is sensitive to nerve changes and is more promising for the early diagnosis of neuropathy.
摘要：
当前文献研究了关节运动过程中特定位置的正中神经（MN）。因为只描绘了神经的几个特定部分，可用的相关信息有限。本实验研究了MN的形态和生物力学特性。还探讨了肩膀和手腕运动对MN的影响。用二维超声和剪切波弹性成像（SWE）对8名年轻健康女性进行了测试。在肢体位置1，手腕在中立位置检查形态学和生物力学特性，弯管以180°延伸，肩膀外展成60°.此外,实验评估了手腕之间的差异，前臂,弯头,和上臂进行弗里德曼测试和Bonferroni事后分析。设计了两组肢体位置，以探讨肩部运动（肩部以90°和120°外展）和腕部运动（腕部以45°伸展并以45°弯曲）对厚度和杨氏模量的影响。还测试了五个肢体位置的分布之间的差异。厚度和杨氏模量的ICC3,1值分别为0.976和0.996。肢体位置1的四个手臂位置的MN厚度之间存在差异，而肘部和腕部的杨氏模量高于前臂和上臂。与肢体位置1相比，只有肢体位置4对腕部的MN厚度有影响。肩部和腕部运动都影响MN杨氏模量，典型位置的刚度变化均呈下降趋势。MN厚度和杨氏模量的分布显示出折线图案，但在腕部和旋前柱处有所不同。腕部的MN更容易受到肢体位置的影响，杨氏模量对神经变化敏感，对神经病变的早期诊断更有希望。
