Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 27 , ISSUE 2 ( June, 2016 ) > List of Articles

RESEARCH ARTICLE

Prevalence of Upper Limb Neuropathy in Rehabilitated Spinal Cord Injured Patients in South India

Ahana Chatterjee, Rohit Bhide

Citation Information : Chatterjee A, Bhide R. Prevalence of Upper Limb Neuropathy in Rehabilitated Spinal Cord Injured Patients in South India. Indian J Phy Med Rehab 2016; 27 (2):34-40.

DOI: 10.5005/ijopmr-27-2-34

Published Online: 00-06-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Paraplegics with spinal cord injury, independent in activities of daily living (ADL) are known to have upper limb neuropathy due to constant use for mobility and transfers. Additionally architectural barriers, disabled unfriendly public transport, diffi cult terrains and sociocultural barriers in a developing country like India, further adds strain on the upper limbs. Hence, it is important to know the effects of these increased demands in terms of prevalence of peripheral neuropathies in rehabilitated spinal cord injured population from developing countries. In this study we tried to find prevalence of upper limb neuropathy in SCI population in South India.

Methods

Patients with spinal cord injury with a neurological level T2 and below, not having any other associated complication of upper limb due to any other disease apart from SCI were recruited in the study. Total 51 patients (45 male and 6 female) out of 183 patients screened, met key inclusion criteria. All the subjects who were recruited in the study underwent electrodiagnostic studies for the median, ulnar and radial nerves (both sensory and motor). The baseline demographic parameters such as time since injury, age, sex, American Spinal Injury Association scale (AIS), vocation, comorbidities and current mode of indoor and outdoor mobility were recorded. The final diagnosis based on electrodiagnostic study of median/ulnar/radial nerve was graded in scale of 0-2 with 0 being normal, 1 being neuropathy of one hand and 2 being involvement of both the hands.

Results

The scores from demographic data and electrodiagnostic data were accessed and categorical comparison was made between different types of mobility aids and neuropathy (CTS/ulnar/radial). The study showed an overall prevalence of 80% for median neuropathy, 24% for ulnar neuropathy and 16% for radial neuropathy. However, no statistical correlation was found between the use of any particular mobility aid, time since injury, vocation and neuropathy.

Conclusions

We found high prevalence of upper limb compressive neuropathy in the spinal injured population studied, however, due to the small sample size, no statistical signifi cance could be found. We also found carpal tunnel syndrome to be the commonest neuropathy amongst the population especially in the groups that use wheelchair and elbow crutches for mobility.


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  1. Upper extremity neuropathies in patients with spinal cord injuries. J Spinal Cord Med 1995;18:95-7.
  2. Prevalence and risk factors for upper extremity entrapment neuropathies in polio survivors. J Rehabil Med 2009;41:26-31.
  3. Carpal tunnel syndrome in paraplegic patients. Paraplegia 1985;23:182-6.
  4. Compressive mononeuropathies of the upper extremity in chronic paraplegia. Paraplegia 1991;29:17-24.
  5. Electrodiagnosis in spinal cord injured persons with new weakness or sensory loss: central and peripheral etiologies. Arch Phys Med Rehabil 1999;80:904-9.
  6. Late complications of the weight-bearing upper extremity in the paraplegic patient. Clin Orthop 1988;233:132-5.
  7. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 2002;25:918-22.
  8. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 1993;43:2406-9.
  9. Recent trends in mortality and causes of death among persons with spinal cord injury. Arch Phys Med Rehabil 1999;80:1411-9.
  10. Prevalence and impact of wrist and shoulder pain in patients with spinal cord injury. J Spinal Cord Med 1995;18:9-13.
  11. Upper extremity peripheral nerve entrapments among wheelchair athletes: prevalence, location, and risk factors. Arch Phys Med Rehabil 1994;75:519-24.
  12. Electrodiagnostic study of carpal tunnel syndrome in wheelchair basketball players. Clin J Sport Med Off J Can Acad Sport Med 1996;6:27-31.
  13. Median nerve compression in the carpal tunnel--functional response to experimentally induced controlled pressure. J Hand Surg 1982;7:252-9.
  14. Carpal tunnel syndrome in manual wheelchair users with spinal cord injury: a cross-sectional multicenter study. Am J Phys Med Rehabil Assoc Acad Physiatry 2009;88:1007-16.
  15. Reduced motor conduction velocity of the ulnar nerve in spinal cord injured patients. Paraplegia 1980;18:21-4.
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