Peripheral neuropathies in the upper extremities of paraplegic wheelchair marathon racers

Abstract

In order to know if peripheral neuropathies in the upper extremities of paraplegic individuals are induced by participating in wheelchair marathon races, we performed nerve conduction studies bilaterally on the median, ulnar, and radial nerves of 10 male wheelchair marathon racers, and on 10 male sedentary paraplegic individuals. In five of 10 paraplegic racers, and in nine of 10 sedentary paraplegics there was a decrease of motor nerve conduction velocities and/or prolongation of motor or sensory nerve distal latencies. Abnormal results in all of the nerve conduction studies were 3.2% and 13.6% in paraplegic racers and sedentary paraplegics, respectively. Although paraplegic racers had fewer peripheral neuropathies in the upper extremities than did sedentary paraplegics, ulnar lesions due to involvement of the deep motor branch and at the elbow were a characteristic feature of nerve injuries, presumably caused by wheelchair marathon racing. It is suggested that although a wheelchair marathon is generally a safe sport, wearing gloves and handling a wheelchair in the correct way during the race are necessary to prevent nerve injuries.

Electrophysiologic and Ultrasonographic Assessment of Carpal Tunnel Syndrome in Wheelchair Basketball Athletes

“…Another study indicated prevalence of CTS of approximately 50% in wheelchair racers [21]. Dozono et al [22] reported similar prevalence of CTS in wheelchair marathon racers and other patients on wheelchair, which is approximately 10%. Likewise, our study findings also showed that the prevalence of CTS in WCB players and other paraplegic patients were not significantly different.…”

Neuromusculoskeletal Syndromes in Wheelchair Athletes

“…Differences in technique and definition of peripheral neuropathy are the most likely explanations for the discrepancy of prevalences in these two studies. Further, Dozono et al 20 found that 50% of WC road racers had peripheral neuropathy based on NCSs, but none had subjective complaints consistent with peripheral neuropathy. Thus, the limited available literature is still somewhat inconclusive.…”

“…Similarly, Jackson et al 19 reported that although only 30% of WC basketball players had symptoms of carpal tunnel syndrome (CTS), 52% had electrodiagnostic evidence of median neuropathy. Dozono et al 20 reported a 90% prevalence of peripheral neuropathies diagnosed by nerve conduction studies (NCSs), with the ulnar and radial nerves being most commonly affected in the WC nonathletes studied. Differences in technique and definition of peripheral neuropathy are the most likely explanations for the discrepancy of prevalences in these two studies.…”

“…As might be expected, the median, ulnar, and radial nerves are the most prone to sports-related overuse injury. 20,21 Most WC users must utilize repetitive flexion and extension of the wrist in order to propel the chair. In addition, some athletes, such as WC tennis and racquetball players, are further prone to overuse because of the additive effects of repetitive flexion and extension to propel the wheelchair coupled with repetitious racquet swinging motions.…”

“…The deep branch of the ulnar nerve may be injured by repetitive strokes to the palms, which corresponds to a type V lesion of Wu's classification. 20,38 Wrist pain can also arise from repetitive motion tendon injuries such as epicondylar tendinitis as seen arising from the backhand of racquet sports. De Quervain's tenosynovitis involving the first dorsal compartment of the wrist (containing the abductor pollicis longus [APL] and extensor pollicis brevis) may be seen in repetitive wrist motions associated with WC gripping techniques or bowling.…”