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01-12-2011 | Methodology article | Uitgave 1/2011 Open Access

Journal of Foot and Ankle Research 1/2011

Clinical utility of tibial motor and sensory nerve conduction studies with motor recording from the flexor hallucis brevis: a methodological and reliability study

Tijdschrift:
Journal of Foot and Ankle Research > Uitgave 1/2011
Auteurs:
Kathleen M Galloway, Mark E Lester, Rachel K Evans
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-4-14) contains supplementary material, which is available to authorized users.
Kathleen M Galloway, Mark E Lester and Rachel K Evans contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

KG carried out the nerve conduction studies. KG performed statistical analysis. All authors participated in the design and coordination of the study. All authors helped draft the manuscript, and have read and approved the final manuscript.

Abstract

Background

Standard tibial motor nerve conduction measures are established with recording from the abductor hallucis. This technique is often technically challenging and clinicians have difficulty interpreting the information particularly in the short segment needed to assess focal tibial nerve entrapment at the medial ankle as occurs in posterior tarsal tunnel syndrome. The flexor hallucis brevis (FHB) has been described as an alternative site for recording tibial nerve function in those with posterior tarsal tunnel syndrome. Normative data has not been established for this technique. This pilot study describes the technique in detail. In addition we provide reference values for medial and lateral plantar orthodromic sensory measures and assessed intrarater reliability for all measures.

Methods

Eighty healthy female participants took part, and 39 returned for serial testing at 4 time points. Mean values ± SD were recorded for nerve conduction measures, and coefficient of variation as well as intraclass correlation coefficients (ICC) were calculated.

Results

Motor latency, amplitude and velocity values for the FHB were 4.1 ± 0.9 msec, 8.0 ± 3.0 mV and 45.6 ± 3.4 m/s, respectively. Sensory latencies, amplitudes, and velocities, respectively, were 2.8 ± 0.3 msec, 26.7 ± 10.1 μV, and 41.4 ± 3.5 m/s for the medial plantar nerve and 3.2 ± 0.5 msec, 13.3 ± 4.7 μV, and 44.3 ± 4.0 msec for the lateral plantar nerve. All values demonstrated significant ICC values (P ≤ 0.007).

Conclusion

Motor recording from the FHB provides technically clear waveforms that allow for an improved ability to assess tibial nerve function in the short segments used to assess tarsal tunnel syndrome. The reported means will begin to establish normal values for this technique.

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Extra materiaal
Authors’ original file for figure 1
13047_2010_341_MOESM1_ESM.pdf
Literatuur
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