Measurement of longitudinal tibial nerve excursion during ankle joint dorsiflexion: an in-vivo...
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ORAL PRESENTATION Open Access Measurement of longitudinal tibial nerve excursion during ankle joint dorsiflexion: an in- vivo investigation with ultrasound imaging Matthew Carroll 1,2* , Janet Yau 2 , Keith Rome 1,2 , Wayne Hing 1,3 From 3rd Congress of the International Foot and Ankle Biomechanics Community Sydney, Australia. 11-13 March 2012 Background A key mechanical function of peripheral nerves is their ability to slide in relation to the surrounding tissues. This function is of paramount importance to maintain ideal neural function [1]. Advances in ultrasound ima- ging and the development of specific software (cross- correlation analysis) have made it possible to analyse real-time ultrasound images, allowing for quantification of in-vivo peripheral nerve movement [2]. Cross-correla- tion analysis has been utilised in numerous upper extre- mity in-vivo neural investigations [3-5]. No study has investigated in-vivo longitudinal nerve excursion at the ankle joint. The aims of this study were to quantify the degree of longitudinal tibial nerve excursion as the ankle moved from dorsiflexion to plantarflexion and assess the between session intra-rater reliability of the ultrasound imaging technique. Materials and methods A sample of sixteen participants (10 male, 6 female; mean [SD] age 34.7 [9.3] years old) were recruited. A three second video loop of the tibial nerve was captured by ultrasound imaging as the ankle moved from 20° plantarflexion to 10° dorsiflexion. The tibial nerve was imaged on two occasions with a 5 minute interval between measurement sessions. Foot and ankle position was standardised on a measurement platform. Video loops were analysed to determine the degree of longitu- dinal nerve excursion. Intraclass correlation coefficients (ICC), with 95% confidence intervals (CI), standard error of the measurement (SEM) and the smallest real difference (SRD) were calculated as an indication of reliability and measurement error. Results Results demonstrated mean [SD] longitudinal excursion of 3.01 [0.97] mm. The between session intra-rater relia- bility was excellent (ICC=0.93; 95% CI, 0.70-0.96), with SEM, 0.26mm and a mean SRD of 0.75mm. Conclusions Ultrasound imaging in conjunction with cross correla- tion analysis presents a reliable technique to quantify in- vivo tibial nerve movement during ankle joint dorsiflexion. Author details 1 Health and Rehabilitation Research Institute, AUT University, Auckland, 0627, New Zealand. 2 Department of Podiatry, AUT University, Auckland, 0627, New Zealand. 3 Department of Physiotherapy, AUT University, Auckland, 0627, New Zealand. Published: 10 April 2012 References 1. Shacklock M: Clinical Neurodynamics: A new system of musculoskeletal treatment. Edingburgh: Elsevier; 2005. 2. Dilley A, et al: The use of cross-sectional analysis between high- frequency ultrasound images to measure longitudinal median nerve movement. Ultrasound Med Biol 2001, 27:1211-1218. 3. Erel E, et al: Longitudinal sliding of the median nerve in patients with carpal tunnel syndrome. J Hand Surg Br 2003, 28:439-443. 4. Dilley A, et al: Quantitative in vivo studies of median nerve sliding in response to wrist, elbow, shoulder and neck movements. Clin Biomech (Bristol, Avon) 2003, 18:899-907. 5. Dilley A, Summerhayes C, Lynn B: An in vivo investigation of ulnar nerve sliding during upper limb movements. Clin Biomech (Bristol, Avon) 2007, 22:774-779. * Correspondence: [email protected] 1 Health and Rehabilitation Research Institute, AUT University, Auckland, 0627, New Zealand Full list of author information is available at the end of the article Carroll et al. Journal of Foot and Ankle Research 2012, 5(Suppl 1):O37 http://www.jfootankleres.com/content/5/S1/O37 JOURNAL OF FOOT AND ANKLE RESEARCH © 2012 Carroll et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Transcript of Measurement of longitudinal tibial nerve excursion during ankle joint dorsiflexion: an in-vivo...
ORAL PRESENTATION Open Access
Measurement of longitudinal tibial nerveexcursion during ankle joint dorsiflexion: an in-vivo investigation with ultrasound imagingMatthew Carroll1,2*, Janet Yau2, Keith Rome1,2, Wayne Hing1,3
From 3rd Congress of the International Foot and Ankle Biomechanics CommunitySydney, Australia. 11-13 March 2012
BackgroundA key mechanical function of peripheral nerves is theirability to slide in relation to the surrounding tissues.This function is of paramount importance to maintainideal neural function [1]. Advances in ultrasound ima-ging and the development of specific software (cross-correlation analysis) have made it possible to analysereal-time ultrasound images, allowing for quantificationof in-vivo peripheral nerve movement [2]. Cross-correla-tion analysis has been utilised in numerous upper extre-mity in-vivo neural investigations [3-5]. No study hasinvestigated in-vivo longitudinal nerve excursion at theankle joint. The aims of this study were to quantify thedegree of longitudinal tibial nerve excursion as the anklemoved from dorsiflexion to plantarflexion and assess thebetween session intra-rater reliability of the ultrasoundimaging technique.
Materials and methodsA sample of sixteen participants (10 male, 6 female;mean [SD] age 34.7 [9.3] years old) were recruited. Athree second video loop of the tibial nerve was capturedby ultrasound imaging as the ankle moved from 20°plantarflexion to 10° dorsiflexion. The tibial nerve wasimaged on two occasions with a 5 minute intervalbetween measurement sessions. Foot and ankle positionwas standardised on a measurement platform. Videoloops were analysed to determine the degree of longitu-dinal nerve excursion. Intraclass correlation coefficients(ICC), with 95% confidence intervals (CI), standarderror of the measurement (SEM) and the smallest real
difference (SRD) were calculated as an indication ofreliability and measurement error.
ResultsResults demonstrated mean [SD] longitudinal excursionof 3.01 [0.97] mm. The between session intra-rater relia-bility was excellent (ICC=0.93; 95% CI, 0.70-0.96), withSEM, 0.26mm and a mean SRD of 0.75mm.
ConclusionsUltrasound imaging in conjunction with cross correla-tion analysis presents a reliable technique to quantify in-vivo tibial nerve movement during ankle jointdorsiflexion.
Author details1Health and Rehabilitation Research Institute, AUT University, Auckland, 0627,New Zealand. 2Department of Podiatry, AUT University, Auckland, 0627, NewZealand. 3Department of Physiotherapy, AUT University, Auckland, 0627, NewZealand.
Published: 10 April 2012
References1. Shacklock M: Clinical Neurodynamics: A new system of musculoskeletal
treatment. Edingburgh: Elsevier; 2005.2. Dilley A, et al: The use of cross-sectional analysis between high-
frequency ultrasound images to measure longitudinal median nervemovement. Ultrasound Med Biol 2001, 27:1211-1218.
3. Erel E, et al: Longitudinal sliding of the median nerve in patients withcarpal tunnel syndrome. J Hand Surg Br 2003, 28:439-443.
4. Dilley A, et al: Quantitative in vivo studies of median nerve sliding inresponse to wrist, elbow, shoulder and neck movements. Clin Biomech(Bristol, Avon) 2003, 18:899-907.
5. Dilley A, Summerhayes C, Lynn B: An in vivo investigation of ulnar nervesliding during upper limb movements. Clin Biomech (Bristol, Avon) 2007,22:774-779.
* Correspondence: [email protected] and Rehabilitation Research Institute, AUT University, Auckland, 0627,New ZealandFull list of author information is available at the end of the article
Carroll et al. Journal of Foot and Ankle Research 2012, 5(Suppl 1):O37http://www.jfootankleres.com/content/5/S1/O37
JOURNAL OF FOOTAND ANKLE RESEARCH
© 2012 Carroll et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.
doi:10.1186/1757-1146-5-S1-O37Cite this article as: Carroll et al.: Measurement of longitudinal tibialnerve excursion during ankle joint dorsiflexion: an in-vivo investigationwith ultrasound imaging. Journal of Foot and Ankle Research 2012 5(Suppl1):O37.
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Carroll et al. Journal of Foot and Ankle Research 2012, 5(Suppl 1):O37http://www.jfootankleres.com/content/5/S1/O37
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