Electrophysiological Changes Based on the Palmaris Longus

Study Overview
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Brief Summary
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One of the most important causes of carpal tunnel syndrome is increased pressure in the canal. With the loading of the palmaris longus at 20 degrees of wrist extension, the pressure within the canal increases more than the load exerted on other flexor tendons. Several studies have shown the association of carpal tunnel syndrome with the presence of palmaris longus. In this study, our aim is to investigate how the presence or absence of palmaris longus changes EMG measurements in the median nerve. Individuals with a diagnosis of carpal tunnel syndrome or entrapment neuropathy will be given the Schaffer test, a standardized test to test the presence of the palmaris longus muscle. The result will be noted, EMG examination will be requested and the electrophysiological properties of the median nerve will be recorded.

Detailed Description
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One of the most important causes of carpal tunnel syndrome(CTS) is the pressure increase in the canal. With the loading of the palmaris longus at 20 degrees of wrist extension, the pressure within the canal increases more than the load exerted on other flexor tendons. Several studies have shown the association of carpal tunnel syndrome with the presence of palmaris longus. Our aim in this study is to investigate how the presence or absence of the palmaris longus changes the EMG measurements in the median nerve. Individuals with a diagnosis of carpal tunnel syndrome or entrapment neuropathy will be given the Schaffer test, a standardized test to test the presence of the palmaris longus muscle. The result will be noted, EMG examination will be requested, and the electrophysiological properties of the median nerve will be recorded. If the Schaffer test that detects the presence of palmaris longus is negative, 4 different tests that will prove the absence of palmaris longus will be performed by the same practitioner. These 4 tests are Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's two-finger sign method. Routine median nerve conduction studies are valuable in CTS. Prolonged distal latency in motor and sensory nerves can be found in most cases of CTS. If routine studies are insufficient, more sensitive methods are needed. These; Comparison of mixed latencies in the wrist recording of the sensory responses of the median and ulnar nerves with palmar stimulation, median and ulnar sensory latencies with orthodromic or antidromic recording from the 4th finger, median and ulnar motor latencies with recording from the second lumbrical and second interosseous muscle, median and radial sensory latencies with thumb recording It is based on determining the compression point by centrifugation method by performing segmental sensory nerve conduction examination.

Official Title
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Electrophysiological Changes in the Median Nerve in the Presence and Absence of the Palmaris Longus

Conditions
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Palmaris Longus Muscle, Absence of, Carpal Tunnel Syndrome, EMG Syndrome

Intervention / Treatment
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* Diagnostic Test: EMG
* Diagnostic Test: Palmaris Longus Test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Applying to the electrophysiology laboratory for an EMG examination for entrapment neuropathy. The examination should be requested by a doctor. Exclusion Criteria: Having a disease affecting the orthopedic, neurological or rheumatological skeletal and neurological system; Those who do physical activity so heavy that they cause muscle pain or neurological damage; Those who have an operation in the area to be evaluated

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: palmaris longus and carpal tunnel<br>EMG measurements of median and ulnar nerves will be made in patients with palmaris longus muscle. | Diagnostic Test: EMG<br>* Electromyography (EMG) is an electrodiagnostic medicine technique for evaluating and recording the electrical activity produced by skeletal muscles.<br>Diagnostic Test: Palmaris Longus Test<br>* Schaffer test will be done to understand the presence of palmaris longus. 4 different tests will be done to prove its absence.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Median Nerve Conduction Velocity | right and left median nerve conduction velocity will be assessed with EMG, (m/s) | 1st day | 
| Median Nerve Peak Latency | right and left median nerve peak latency will be assessed with EMG,0 (ms) | 1st day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ulnar Nerve Conduction Velocity | right and left ulnar nerve conduction velocity will be assessed with EMG, (m/s) | 1st day | 
| Ulnar Nerve Peak Latency | right and left ulnar nerve peak latency will be assessed with EMG,0 (ms) | 1st day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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carpal tunnel syndrome, palmaris longus, median nerve, carpal tunnel