Clinical quality measures for electrodiagnosis in suspected carpal tunnel syndrome.

Extensive research has documented that medical care in the United States is not of optimal quality, meaning that well-established care processes are not consistently provided to the patients who would benefit from them. To assess and improve quality of care, specific measures are needed. The objective of this study was to develop quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome (CTS).

Iatrogenic axillary neuropathy after intramuscular injection of the deltoid muscle.

A previously healthy 26-yr-old male presented for an electrodiagnostic evaluation with complaints of significant right deltoid muscle atrophy and shoulder abduction weakness after receiving an intramuscular (IM) deltoid injection of an antiemetic 4 wk earlier. Electrodiagnostic evaluation confirmed an acute axillary neuropathy. We hypothesize that direct mechanical trauma to the anterior branch of the axillary nerve resulted in axillary mononeuropathy with axonal loss, although chemically induced nerve injury cannot be excluded.

Impact of a home-based activity and dietary intervention in people with slowly progressive neuromuscular diseases.

Objective: To determine whether a home-based activity and dietary intervention can increase activity level, reduce caloric intake, and impact positively components of metabolic syndrome in a disabled population.

Design: Testing occurred at 3 points during the 6-month intervention period (baseline, 3mo, 6mo) and at 6 months postintervention. Each test point included laboratory testing of anthropometric and metabolic variables and 3 days of home-based activity and dietary monitoring.

Body composition and water compartment measurements in boys with Duchenne muscular dystrophy.

Objective: Duchenne muscular dystrophy (DMD) patients have a lower percentage of total body water and higher extracellular water to intracellular water (ECW/ICW) ratio compared with normal subjects. However, it is not known whether this is due to increased fat mass or a decreased amount of ICW in muscle cells in DMD patients. The purpose of this study was to (1) determine the effect of increased fat mass and decreased lean mass on the ECW to ICW ratio in DMD patients and to (2) determine the validity of multifrequency bioelectrical impedance analysis (MFBIA) in assessing body composition in DMD patients.

Metabolic syndrome in neuromuscular disease.

Objectives: To test the hypotheses that (1) people with neuromuscular disease (NMD) have multiple risk factors for cardiovascular disease and diabetes and (2) these risk factors worsen over time.

Design: Longitudinal testing with average 2.5-year follow-up.

Response to aerobic exercise training in humans with neuromuscular disease.

There have been few studies examining the response of persons with neuromuscular disease and postpolio syndrome to cardiopulmonary testing and aerobic exercise training. In persons with neuromuscular disease that directly involves the cardiac and respiratory systems, deficits in performance may be primarily due to these limitations, along with loss of functional muscle tissue from the disease process. In the more slowly progressive disorders, deconditioning may play an important role in limiting aerobic exercise performance and may be amenable to training.

Response to resistive strengthening exercise training in humans with neuromuscular disease.

The role of strengthening exercise to potentially improve weakness and the functional abilities of persons with neuromuscular diseases is controversial. There are questions about the ability of diseased skeletal muscle to respond to resistance exercise, particularly in light of concerns about weakness induced by exercise. Numerous studies show promising results of strength training, although methodologic issues limit conclusions.

Electrodiagnosis in carpal tunnel syndrome.

There is currently no gold standard to definitively diagnose carpal tunnel syndrome. It remains a clinical diagnosis supported by characteristic electrodiagnostic abnormalities. Properly performed electrodiagnostic studies should provide the hand surgeon with information regarding severity, progression if a previous study was performed, and a reasonable assurance that concomitant peripheral nervous system abnormalities are not present.

Assessment of pain and health-related quality of life in slowly progressive neuromuscular disease.

Few studies have examined the effect of pain on the quality of life of individuals with slowly progressive neuromuscular disease (NMD). The purpose of this study was to determine the frequency and extent to which subjects with slowly progressive NMD report pain and the association between pain and health-related quality of life in persons with NMD. The study design was a descriptive, nonexperimental survey.