Correlation between muscle electrophysiology and strength after fibular nerve injury

Won, Yu Hui; Kim, Kang-Won; Choi, Jun Tak; Ko, Myoung-Hwan; Park, Sung-Hee; Seo, Jeong-Hwan

doi:10.1007/s10072-016-2584-z

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…[21] Won et al reported that the amplitude of CMAP, compared to the uninjured side of patients with common peroneal nerve injury, showed a correlation with dorsiflexion muscle strength and the ratio of MMT and amplitude (T grade of 0.13, P grade of 0.35, F grade of 0.61, and G grade of 0.77 compared to the unaffected side). [22] In the current study, a significant change in the CMAP amplitude of each motor nerve was observed according to the degree of injury, as demonstrated by the degree of muscle strength reduction. Among them, TA and GCM CMAP amplitudes of the peroneal and tibial nerves, respectively, showed a stronger correlation with isometric strength than the EDB and AH CMAP amplitudes.…”

Section: Tablesupporting

confidence: 53%

“…Seo et al [21] reported that the amplitude and area of CMAP in patients with common peroneal and tibial nerve injuries showed a linear correlation with maximal isometric muscle strength in dorsiflexion ( r = 0.690, P < .001) and plantarflexion ( r = 0.670, P < .001). Won et al [22] suggested that the amplitude of CMAP showed a linear correlation with dorsiflexion isometric strength only in the peroneal nerve ( r = 0.790, P < .001). In this study, correlation coefficients were higher than the values reported by Seo et al in both the peroneal and tibial nerves but, were lower than the values by Won et al in the peroneal nerve.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of lower extremity strength by nerve conduction study in cauda equina syndrome

et al. 2022

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An electrodiagnostic test is more useful than the lower extremity isometric strength test for objectively determining the degree of nerve damage and prognosis in cauda equina syndromes (CES). This study evaluated the correlation between nerve conduction study (NCS) parameters and the lower extremity isometric strength and manual muscle test (MMT) grades. The isometric strengths of knee extension (KE), ankle dorsiflexion (ADF), and ankle plantarflexion (APF) were measured. NCS parameters, MMT, and isometric strength of femoral, peroneal, and tibial nerves were evaluated, including their correlations with each other. A regression equation between the isometric strength and compound muscle action potential (CMAP) amplitudes was derived and cutoff values were used to confirm boundary values of strength and amplitude between the MMT grades. KE isometric strength and femoral nerve CMAP amplitude were significantly correlated (r = 0.738, P < .001). ADF isometric strength and peroneal nerve CMAP amplitude were significantly correlated (tibialis anterior, r = 0.707, P < .001). KE (r = 0.713, P < .001), ADF (r = 0.744, P < .001), and APF (r = 0.698, P < .001) isometric strengths were correlated with the MMT grades. For the regression curve, the second-order curve was more reasonable than the first-order curve. Cutoff femoral nerve CMAP amplitude and isometric strength cutoff values were ≥2.05 mV and 17.3, respectively, for MMT grades 2 to 3 and 2.78 ± 1.08 and 20.8 ± 9.33, respectively, for grade 3. The isometric strengths of the KE, ADF, and APF and the CMAP amplitude of the electrophysiologic parameters were correlated in CES patients and a significant correlation with MMT grade was also identified. Accordingly, it is possible to identify the precise neurological condition, objectively evaluate the degree of paralysis and disability, and determine the quantitative muscle strength from MMT in order to establish an appropriate rehabilitation treatment plan.

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Section: Tablesupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Prediction of lower extremity strength by nerve conduction study in cauda equina syndrome

et al. 2022

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“…Isometric dynamometry [ 17 ] was used to objectively measure ankle dorsiflexion strength. Active and passive ankle dorsiflexion range of motion [ 18 ] were measured, using a goniometer, with the patient’s knee flexed and extended.…”

Section: Methodsmentioning

confidence: 99%

A randomized controlled trial comparing conservative versus surgical treatment in patients with foot drop due to peroneal nerve entrapment: results of an internal feasibility pilot study

Oosterbos,

Rummens,

Bogaerts

et al. 2023

Pilot Feasibility Stud

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Background Based on the lack of literature to support any treatment strategy in patients with foot drop due to peroneal nerve entrapment, a prospective study randomizing patients between surgery and conservative treatment is warranted. Since studies comparing surgery to no surgery are often challenging, we first examined the feasibility of such a randomized controlled trial. Methods/design An internal feasibility pilot study was conducted to assess several aspects of process, resource, management, and scientific feasibility. The main objective was the assessment of the recruitment rate. The criterion to embark on a full study was the recruitment of at least 14 patients in 6 participating centers within 6 months. Cross-over rate, blinding measures, training strategies, and trial assessments were evaluated. The trial was entirely funded by the KCE Trials public funding program of the Belgian Health Care Knowledge Centre (ID KCE19-1232). Results The initial duration was prolonged due to the COVID-19 pandemic. Between April 2021 and October 2022, we included 19 patients of which 15 were randomized. Fourteen patients were treated as randomized. One drop-out occurred after randomization, prior to surgery. We did not document any cross-over or accidental unblinding. Training strategies were successful. Patients perceived the quality of life questionnaire as the least relevant assessment. Assessment of ankle dorsiflexion range of motion was prone to interobserver variability. All other trial assessments were adequate. Discussion Recruitment of the anticipated 14 patients was feasible although slower than expected. The Short-Form Health Survey (SF-36) and assessment of ankle dorsiflexion range of motion will no longer be included in the full-scale FOOTDROP trial. Conclusion The FOOTDROP study is feasible. Trial registration ClinicalTrials.gov, identifier NCT04695834. Registered 4 January 2021.

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“…Electrophysiological measurement is an established and sensitive method (23,24) which can differentiate between a lesion of the long tracts, a radiculopathy and a peripheral nerve injury. Information about the location and severity/type of nerve lesion can be obtained (eBox 2).…”

Section: Electrophysiological Measurementmentioning

confidence: 99%

The Interdisciplinary Management of Foot Drop

Carolus¹,

Becker²,

Cuny³

et al. 2019

Deutsches Ärzteblatt International

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Background: Foot drop can be caused by a variety of diseases and injuries. Although it is a common condition, its overall incidence has not been reported to date. Foot drop markedly restricts the everyday activities of persons suffering from it. There is, therefore, a need for an optimized strategy for its diagnosis and treatment that would be standardized across the medical specialties encountering patients with this problem.Methods: This article consists of a review on the basis of pertinent publications retrieved by a search in the Pubmed/MEDLINE and Cochrane databases, as well as a description of the authors' proposed strategy for the diagnosis and treatment of foot drop.Results: Foot drop can be due to a disturbance at any central or peripheral location along the motor neural pathway that terminates in the dorsiflexor muscles of the foot, or at multiple locations in series. Optimal localization of the lesion(s) is a prerequisite for appropriate treatment and a successful outcome. The most common causes are L5 radiculopathy and peroneal nerve injury. An operation by a neurosurgeon or spinal surgeon is a reasonable option whenever there is a realistic chance that the nerve will recover. In our opinion, any patient with a subjectively disturbing foot drop and a clinically suspected compressive neuropathy of the peroneal nerve should be informed about the option of surgical decompression of the nerve at the fibular head, which can be performed with little risk. In case of a permanent foot drop, some patients can benefit from muscle-transfer surgery. For spastic foot drop, the option of botulinum toxin injections should be evaluated. Conclusion:The care of patients with foot drop could be optimized by interdisciplinary foot-drop clinics involving all of the relevant specialists. The goals of treatment should always be improved mobility in everyday life and the prevention of falls, pain, and abnormal postures.

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Correlation between muscle electrophysiology and strength after fibular nerve injury

Cited by 8 publications

References 6 publications

Prediction of lower extremity strength by nerve conduction study in cauda equina syndrome

Prediction of lower extremity strength by nerve conduction study in cauda equina syndrome

A randomized controlled trial comparing conservative versus surgical treatment in patients with foot drop due to peroneal nerve entrapment: results of an internal feasibility pilot study

The Interdisciplinary Management of Foot Drop

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