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Nerve conduction velocity in median nerve of healthy adult population in Malwa region of Madhya Pradesh with respect to age, gender, and height along with the relation amongst them.

INTRODUCTION

Electrodiagnostic evaluation refers to the physiological expansion of the neurological assessment.[TM] We are already aware of the importance of these electrodiagnostic studies in evaluating patients with neuromuscular disorders. This evaluation is based on the principle of recording, displaying, and estimating action potentials originating from central nervous system (evoked potentials), peripheral nerves (nerve conduction assessments), and muscles (electromyography). [2]

Nerve conduction velocities (NCV) represent the most commonly used methods to study the peripheral nerves owing to their accuracy in diagnosing nerve-related conditions. It is beneficial in distinguishing between the true nerve disorder and conditions where muscles are affected by nerve injury. Some of the common disorders which can be diagnosed by NCV studies include peripheral neuropathy, carpal tunnel syndrome, ulnar neuropathy, and Guillain--Bare syndrome. Most importantly, its benefits are not only limited to diagnostic importance but also in planning therapeutic strategies.

Peripheral nerves, that is, median and ulnar nerves in upper extremity are commonly chosen for NCV as they are easily reachable. On stimulation of these nerves by a low-velocity electric current by electrodes that are placed on the skin at intervals causes a generation of nerve impulses. [3] These impulses are then recorded as motor NCV (MNCV) and compound muscle action potential (CMAP) distal to the point of stimulation.

Interestingly, NCV is affected by a number of physiological variables such as age, height, gender, and temperature along with diameter and myelination of the nerve fiber being assessed. [4] It has been reported in the previous studies that significant slowing of conduction velocities and sensory latencies occur with increasing age and more height. [5] Another study reported that the conduction velocity is 6 m/s faster in females. [6]

This goes to show that although a number of studies have been done in the past on the influence of anthropometrical parameters on NCV yet, none have been conducted in this semi-urban Malwa region of Indore district in Madhya Pradesh. This study was therefore conducted to find out the NCV in median nerve among the normal healthy adults from the local population and to evaluate the impact of anthropometric factors such as age, gender, and height on it along with relation among them.

The nerve conduction studies (NCS) comprised the following component: (a) Motor NCS (MNCS), (b) sensory NCS, (c) F-wave study, and (d) H-reflex study. [7]

Objectives

1. To establish the normal electrophysiological data NCV for the right median in normal healthy adult population

2. To study the effect of age, gender, and height on NCV in the right median nerve and relation among them

3. The objective of the present study was to determine a reference value for MNCV in young healthy adults.

MATERIALS AND METHODS

Study Population

This study was carried in Neurophysiology Laboratory of Physiology Department of Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh, India. It was a cross-sectional study which was approved by the Institutional Ethics Committee. The study had a sample size of 118 participants (95% confidence level) as calculated from Statistical Package for Social Sciences (SPSS), version 10, open source calculator.

Selection Criteria

Healthy individuals in different age groups (20-60) years, free of any neurological disorder, or any history of it.

Exclusion Criteria

1. Any individual of neurological disorder or neuromuscular transmission disorder

2. Any individual suffering from diabetes or renal disorder

3. Any individual suffering from weakness of upper limb or myopathy. [8]

The participants were divided into four groups of males and females based on their ages for a comparative assessment. Group 1 included ages between 20 and 30 years consisting of 51 participants; Group 2 included 31-40 years comprised 22 participants. Group 3 and Group 4 had ages between 41-50 and 51-60 years, respectively, consisting of 25 and 20 participants for the groups, consecutively.

Protocol

Informed consent had been obtained from the participants. The examination had been performed in a calm setting; the patient was thoroughly briefed about the procedure. Considerable gap was given between examination, so as to minimize discomforts to participant as well as to enhance their enthusiastic participation.

Electrophysiological Methods

All tests have been done on JAVA record management system (RMS) Aleron-201 series. The JAVA RMS Aleron-201 series is a clinically customized for a quick and flexible operation. Its software and hardware are particularly designed with the consideration of actual test being done in the field machine which can be totally customized for various test, nerve muscle and size with computer choice of amplifier, filter and sweep setting, and also analytical setting like marker.

The NCS was performed in a calm setting with a room temperature between 30[degrees]C and 31[degrees]C. Further participant was made comfortable with the laboratory setup, so as to completely relax. For median nerve, the active surface electrode should be put over the motor point of abductor pollicis brevis in the upper third of thenar eminence close to the 1st metacarpophalangeal joint and stimulating electrode was kept at the antecubital fossa proximally and wrist distally and ground electrode at the back of the palm.

For each participant, data of distal motor lat1, lat2, (MNCV), and CMAP from the distal stimulation were included from statistical analysis in this study. [9]

CMAP has the following component which is defined as:

i. Amplitude: It is measured from baseline to the positive peak

ii. Latency1: This is the time from the stimulus to the initial positive deflection off the baseline

iii. Latency2: Time taken for the 1st deflection of CMAP after stimulation at S2 (site)

iv. Duration: It correlates with the density of small fibers. It is measured from the onset to the positive peak

v. Area: The area comes from the difference between the lat1 and lat2. However, it needs computer analyses. [10]

In each participant, an orthodromic motor parameter of the nerve was measured. Surface electrodes were used. The recording electrodes were fixed to the participant's skin using adhesive tape. No special skin preparation was needed. The targeted nerve was supramaximally stimulated using a square wave current with duration 0.2 ms and the action potential was picked up by the recording electrode. The length of each nerve was estimated with a flexible measuring tape. For safety, a ground electrode was placed in between the stimulating and recording electrode. [8]

Principle of Motor Nerve Conduction

The motor nerve is stimulated at least at two points along its course. The pulse is adjusted to record a CMAP. It is important to ensure a supramaximal stimulation keeping the cathode close to the active recording electrode. This prevents hyperpolarization effect of anode and anodal conduction block. The surface recording electrode was commonly used and placed in belly-tendon montage, keeping the active electrode close to the motor point and reference to the tendon. A ground electrode was placed between stimulating and recording electrode. A biphasic action potential with initial negativity was thus recorded. Surface stimulation of healthy nerve requires a square wave pulse of 0.1 ms duration with an intensity of 5-40 mA. Filter setting for MNCS was 20 Hz to 3 KHz and sweep speed was 10 ms/division.

The measurements for MNCS include the onset latency, duration, and amplitude of CMAP and NCV. The latency is the time in millisecond from the stimulus artifact to the first positive deflection CMAP for better visualization of the take off; the latency should be measured at a higher gain than the one used for CMAP amplitude measurement.

The latency is a measure of conduction in the fastest conducting motor fibers. It also includes neuromuscular transmission time and the propagation time along the muscle membrane from the baseline to the positive peak. The amplitude correlates with the number of nerve fibers. The duration of CMAP was measured from the onset to the positive peak. Duration correlates with the density of small fibers. The area under CMAP was also measured. However, it was a computer-generated analysis. [9]

MNCV was calculated by measuring the distance in millimeter between two points of stimulation, which is divided by the latency difference in millisecond. The NCV was expressed as m/s.

Conduction velocity: [D/PL-DL] m/[s.sup.3]

Where PL is the proximal latency (lat1) and DL is the distal latency (DL) (lat2) and D is the distance between the proximal and DL. [3]

Recording procedure

MNCS variables

Estimator with water soaked felt tips were placed at the right median nerve which was recorded.

Right median nerve

Median nerve is a mixed nerve derived from C5 to T1, roots through medial and lateral cords of brachial plexus. It supplies most forearm flexors and thenar muscles and provides sensory innervations to the lateral aspect of palm and dorsal surfaces of terminal phalanges along with the palmer surface of thumb, index, middle, and half of ring fingers.

Position

This study was performed in the supine position (Figure 1).

1. Active electrode: Placement was half way between the mid-point of distal wrist crease and first metacarpophalangeal joint [8]

2. Reference electrode: Placement was slightly distal to the first metacarpophalangeal joint [8]

3. Ground electrode: Placement was on the dorsum of the hand. If stimulus artifact interferes with the recording, the ground may be placed near the active electrode, between the electrode and the cathode [8]

4. Stimulation point (S1): The cathode was placed 8 cm proximal to the active electrode in a line measured first to the mid-point of the distal wrist crease and then to a point slightly ulnar to the tendon of the flexor carpi radials. The anode was proximal [8]

5. Stimulation point (S2): The cathode was placed medial to the brachial artery pulse in the antecubital region. The anode was proximal [8]

6. Nerve fiber tested: C8 and T1 nerve root through the lower trunk of the anterior division and medial cord of the brachial plexus [8]

7. Machine setting: Sensitivity - 10 mv/division, low-frequency filter-20H2 and high-frequency filter--3 KHz, and sweep speed - 10 ms/division.

Care should be taken to concomitantly stimulate the ulnar nerve. The direction of thumb twitch would help in making sure that only median nerve was stimulated. [8]

Applied

Entrapment of median nerve leads to three important syndromes. [9]

i. Carpal tunnel syndrome

ii. Anterior interosseous syndrome

iii. Pronator teres syndrome.

Statistical Methods

Analysis was done using SPSS 10.0 version. Values obtained were expressed in the form of mean and standard deviation. P value was taken as significant if it was found to be <0.05. The test used was z-test with two sample mean. [10]

RESULTS

Gender

A total of 118 normal adults participants with mean age of 35.4 [+ or -] 12.7 in males and 33.8 [+ or -] 13.7 years in females were recruited in our study (Table 1). The gender distribution was 68% males and 32% females. The average height of the males was 168.6 [+ or -] 5.02 cm and of the females was 161.9 [+ or -] 11.2 cm. It revealed statically significant differences between the two genders (P = 0.001). Tables 2 and 3 reveal a significant difference in the NCV of the right median nerve between males and females.

The average amplitude of median nerve has been observed to be greater in males than the females in the elbow region, but it was inversed in the wrist region (Tables 2 and 3). Mean duration of the median nerve in females is observed to be slightly less as compared to the males. The latency periods were of a comparable duration in both elbow and wrist regions. The amplitude of median nerve in wrist region was higher in females than males, but the inverse was true in the elbow region.

Table 1 shows that

1. Age: The mean age of male is more than that of female with P = 0.542 which is non-significant. The age range is between 20 and 60 years.

2. Height: The mean height of male is more than that of female with P = 0.001 which is significant. The range of height is 132-180 cm.

3. NCV right median nerve of elbow--wrist segment: The mean NCV elbow--wrist of male is more than that of female with P = 0.038 which is found to be highly significant. Its range is between 29.67 and 98.36 m/s.

Height

Table 4 reveals a significant decrease in NCV of elbow--wrist segment with an increase in mean height.

Tables 5 and 6 show the following result for the different biological parameter as:

1. Age: The mean for age increases with increasing age

2. Height: There is a significant increase in mean height with the increasing age

3. NCV right median nerve elbow--wrist segment: The mean NCV of elbow--wrist segment significantly decreases with the increasing age.

Age

The results of the comparative data of the different age groups (Figure 2) showed an increase in NCV initially between the ages of 20-30 years and 31-40, followed by a significant decrease in the mean NCV of elbow--wrist segment with the increasing age.

Tables 7 and 8 shows the following result on comparing the different biological parameters of Group 1 versus Group 2, Group 3, and Group 4:

1. Age: The mean age for the age Group 2 (30-40), age Group 3 (40-50), and age Group 4 (50-60) is more than that of age Group 1 (20-30) with P < 0.05 which is found to be statistically significant.

2. Height: The mean height for age Group 2 > age Group 1 with P = 0.111 which is non-significant while mean height for age Group 3 and age Group 4 > age Group 1, with P = 0.023 and 0.004, respectively, which is statistically significant.

3. NCV of right median nerve elbow--wrist segment: The mean NCV of age Group 1 > age Group 2, age Group 3, and age Group 4 with P < 0.05 which is highly significant.

DISCUSSION

Our study had aimed at obtaining the normative data for NCV in the right median nerve in normal healthy adults with respect to age, gender, and height on it, in Malwa region of Indore district of Madhya Pradesh. We studied a total of 118 healthy individuals and observed a strong correlation to biological factors, that is, age, gender, and height.

Age

A thorough literature review showed that age affects electrodiagnostic studies only in extremes of age. The effect of age is most significant from birth to 1 year when myelination is incomplete. In the newborn, NCV is approximately 50% of adult values. By 1 year of age, the velocities reach 75%, and by 3-5 years, myelination is complete, and NCV is comparable with adult normative data. [2] NCV decreases with age owing to decreased number of nerve fiber, a reduction in fiber diameter, and changes in the fiber membrane. [11] However, the values normally change by less than 10 m/s by the 60th year or even the 80th year. [12]

On comparing our study for the adults between 20 and 60 years, the NCV for elbow--wrist segment found to be less than that of Chouhan [13] but more than that of Ginzberg et al. [14] and Kimura et al. [15] (Table 5).

In adult, NCV decreases with age; it starts to decline at a rate of 1.5%/s, more in the upper limb than the lower limb. This was related to gradual loss of neuron with aging. A similar observation was made by Flack and Stalberg [16] for MNCV. Tong et al. [17] in their study on the effect of aging on motor nerve noted that the rate of change in parameter was significantly greater in the median nerve than the ulnar nerve.

Gender

In contrast to this study, Thakur et al. [18] found an increase in all components of CMAP for male as compared to female and was statistically significant for antecubital fossa and right popliteal fossa. While this study showed a decrease in all NCV variables, that is, CMAP except duration but they were nonsignificant. In this study, area was also calculated because of computer analysis. Thakur et al. [18] did not calculate area and NCV for the gender of upper and lower limb.

Soudmand et al. [19] reported that NCV is not influenced much by gender. Gender difference in nerve conduction parameter could also be due to the difference in height.

While the work of Kimura et al. [15] reveals that gender-related amplitude differences persist despite adjustment of height. As male has thicker subcutaneous tissue which provides greater distance between digital nerve and surface ring electrode as compared to female. Garg et al. [20] found that male had a higher CMAP and longer latencies and duration than the females.

Height

The present study showed the effect of height on NCV in different age groups as for Group 2 was more than that of Group 1. Again the mean of height of Group 3 was more than that of Group 1, while Group 4 was again more than that of Group 1. While comparing height of Group 1 versus Group 2, we get P = 0.11 which is nonsignificant. While Group 1 versus Group 3 P = 0.0130 and Group 1 versus Group 4 P = 0.004 are both significant. The present study revealed a decrease in NCV as height increases with advancing age which is supported by Robinson et al. [21]

In favor of the present study, Awang et al. [22] found the slowing of NCV with increasing age in the median nerve. Many studies had shown the effect of age on NCV for motor nerve was relatively slower in taller participants. While it was also estimated that the NCV decreases by 2.3 m/s/100mm in height as reported by Flack and Stalberg, [16] which was later confirmed by Shehab et al. [23]

An inverse relationship exists between the height of the individual and the velocity of nerve conduction as reported by Campbell et al. [24] This is because the shorter nerves conduct faster than the longer nerve of the same age group. In tall participant, distal conduction slowing occurs due to a greater axonal tapering and lesser myelination. Tall individual is also subjected to more loss of large sized axon with aging because of higher metabolic stress related to supplying the more distal axon reported by Soudmand et al. [19]

Height is the most important factor in F wave and H--reflex studies described by Cornwall and Nelson. [25] Logically, taller participants have longer conduction time of late response because of longer conduction distance reported by Huang et al. [26]

CONCLUSION

In conclusion, the normative conduction parameter of commonly tested peripheral motor nerve in upper limb had been established in our neurophysiology laboratory of the department of physiology of our institute. The present study might be used for the evaluation of peripheral nerve disorder and also for the comparative studies as the anthropometrical factors, that is, age, gender, and height had shown strong correlation among them. The diagnostic conclusion could also be derived from the NCS data. The study data created preliminary normative information of our population in this Malwa region, abet in a limited sample. A study with larger sample size will definitely add more strength. The present study concluded high NCV as compared to other workers. The probable explanation could be true differences among population and small sample sizes; the normative data could be used as preliminary working reference while reporting clinical NCS finding. In this way, these studies hold a great strength.

REFERENCES

[1.] Mendell JR, Kissel JT, Cornbath DR. Diagnosis and Management of Peripheral Nerve Disorders. Oxford: Oxford University Press; 2001. p. 30-7.

[2.] Weiss L, Silver JK, Weiss J. Easy EMG. Philadelphia, PA: Elsevier; 2004. p. 17-24, 111-9.

[3.] Mishra UK, Kalita J. Clinical neurophysiology - Nerve conduction. Electromyography and Evoked Potentials. 2nd ed. New Delhi: B.I. Churchill Livingstone; 1999.

[4.] Stalberg E. Nerve conduction studies. J Neurol Sci. 2000;17(2):1302-664.

[5.] Falco FJ, Hennessey WJ, Goldberg G, Braddom RL. Standardized nerve conduction studies in the lower limb of the healthy elderly. Am J Phys Med Rehabil. 1994;73(3):168-74.

[6.] Lang HA, Puusa A, Hynninen P, Kuusela V, Jantti V, Sillanpaa M. Evolution of nerve conduction velocity in later childhood and adolescence. Muscle Nerve. 1985;8(1):38-43.

[7.] Pal GK. Textbook of Practical Physiology. 3rd ed. New Delhi: JP Medical Ltd.; 2011.

[8.] Kumar A, Roohi F, Prasad A. Study of nerve conduction velocity in median nerve of healthy male and female of different age groups. Int J Recent Sci Res. 2014;5(12):2250-5.

[9.] Kumar A, Prasad A, Dutta A, Roohi F. Study of nerve conduction velocity in tibial nerve of healthy male and female of different age groups. Int J Recent Sci Res. 2015;6(6):4477-82.

[10.] Kumar A, Prasad A. Nerve conduction velocity in median nerve and tibial nerve of healthy adult population with respect to gender. Natl J Physiol Pharm Pharmacol. 2016;6(5):368-75.

[11.] Jagga M, Lehri A, Verma SK. Effect of aging and anthropometric measurements on nerve conduction properties - A review. J Exerc Sci Physiother. 2011;7(1):1.

[12.] Kimura J. Electrodiagnosis in Diseases of Nerve and Muscles: Principles and Practice. New York: Oxford; 2001. p. 27-36, 64-90, 112-3, 887-92.

[13.] Chouhan S. Motor nerve conduction studies of median nerve in young adult group. Indian J Biol Med Res. 2011;3(2):1751-3.

[14.] Ginzburg M, Lee M, Ginzburg J, Alba A. Median and ulnar nerve conduction determinations in the Erb's point - Axilla segment in normal subjects. J Neurol Neurosurg Psychiatry. 1978;41(5):444-8.

[15.] Kimura J, Murphy MJ, Varga V. Electrophysiological study of anomalous innervations of intrinsic hand muscles. Neurology. 1973;51:1387-427.

[16.] Flack B, Stalberg E. Clinical motor nerve conduction studies. Method Clin Nerurophysiol. 1993;4(1):61-80.

[17.] Tong HC, Werner RA, Franzblan A. Effect of aging on motor nerve conduction study parameter. J Muscle Nerve. 2004;29(5):716-20.

[18.] Thakur D, Pandel BH, Bajaj BK, Jha CB. Nerve conduction study in healthy individual: A gender based study. Health Renaiss. 2010;8(3):169-75.

[19.] Soudmand R, Ward LL, Swift TR. Effect of height on nerve conduction velocity. J Acta Neurol. 1982;32(2):407-10.

[20.] Garg R, Bansal N, Kaur H, Arora KS. Nerve conduction studies in the upper limb in the Malwa region-normative data. J Clin Diagn Res. 2013;7(2):201-4.

[21.] Robinson LR, Rubner DE, Wahl PW, Fujimoto WY, Stolov WC. Influences of height and gender on normal nerve conduction studies. Arch Phys Med Rehabil. 1993;74(11):1134-8.

[22.] Awang MS, Abdullah JM, Abdullah MR, Tharakan J, Prasad A, Husin ZA, et al. Nerve conduction study among healthy Malays. The influence of age, height and body mass index on median, ulnar, common peroneal and sural nerve. Malays J Med Sci. 2006;13(2):19-23.

[23.] Shehab DK. Normative data of nerve conduction studies in the upper limb in Kuwait; Age they different from the western data? Med Princ Pract. 1998;7(2):203-8.

[24.] Campbell WW Jr, Ward LC, Sift TR. Nerve conduction velocity varies inversely with height. Muscle Nerve. 1981;4(6):520-3.

[25.] Cornwall MW, Nelson C. Median nerve F-wave conduction studies in healthy subjects. J Am Phys Ther Assoc. 1984;64:1679-83.

[26.] Huang CR, Chang WN, Chang HW, Tsai NW, Lu CH. Effects of age, gender, height, and weight on late responses and nerve conduction study parameters. Acta Neurol Taiwan. 2009;18(4):242-9.

How to cite this article: Kumar A, Dutta A, Prasad A, Daniel A. Nerve conduction velocity in median nerve of healthy adult population in Malwa region of Madhya Pradesh with respect to age, gender and height along with the relation amongst them. Natl J Physiol Pharm Pharmacol 2017;7(6):608-615.

Source of Support: Nil, Conflict of Interest: None declared.

Abhishek Kumar (1), Abhilasha Dutta (1), Anjali Prasad (2), Amol Daniel (3)

(1) Department of Physiology, Index Medical College, Hospital and Research Centre, Indore, Madhya Pradesh, India, (2) Department of Anatomy, Index Medical College, Hospital and Research Centre, Indore, Madhya Pradesh, India, (3) Department of Surgery, Christian Hospital, Indore, Madhya Pradesh, India

Correspondence to: Abhishek Kumar, E-mail: abhi83feb22@gmail.com

Received: February 02, 2017; Accepted: February 18, 2017

DOI: 10.5455/njppp.2017.7.0202618022017
Table 1: Comparison of mean age, height, and NCV for male and female

Parameter               Range                        Male (n=80)

Age                      20-60 years                  35.4[+ or -]12.7
Height                  132-180 cm                   168.65[+ or -]5023
NCV of right             29.67-93.36 m/s              69.1[+ or -]29.8
median nerve
(elbow--wrist segment)

Parameter              Female (w=38)               Statistical analysis

Age                     33.8[+ or -]13.7           P=0.542
                                                   Df=68
                                                   Non-significant
Height                 161.9[+ or -]11.2           P=0.001
                                                   7=3.52
                                                   Significant
NCV of right            55.9[+ or -]32.4           7=2.22
median nerve                                       P=0.038>0.05
(elbow--wrist                                      Df=67
segment)                                           Highly significant

NCV: Nerve conduction velocities

Table 2: Effect of gender on MNCV CMAP of elbow region

CMAP                       Elbow (males)          Elbow (females)

Lat1 (ms)                   8.34                   8.79
Lat2 (ms)                  21.87                  21.1
Duration                   13.5                   12.5
Amplitude (mV)              4.63                   4.19
Area                       19.3                   16.6

MNCV: Motor nerve conduction velocities, CMAP: Compound muscle action
potential

Table 3: Effect of gender on MNCV CMAP of wrist region

CMAP                    Wrist (males)           Wrist (females)

Lat1 (ms)                3.06                    3.76
Lat2 (ms)               18.55                   16.62
Duration                15.38                   12.86
Amplitude (mV)           2.31                    2.9
Area                    23.8                    22.1

MNCV: Motor nerve conduction velocities, CMAP: Compound muscle action
potential

Table 4: Variation in NCV with different heights

Mean height (in cm)     NCV of right median nerve (elbow- wrist segment)
                        in m/s

164.1[+ or -]1.05       29.67-98.36 m/s (71.2[+ or -]21.2)
167.43[+ or -]6.84      31.85-61.25 (55.5[+ or -]22.8)
168.2[+ or -]4.98       30.93-57.15 (53.5[+ or -]16.5)
169.15[+ or -]4.98      43.29-77.92 (52.0[+ or -]14.4)

NCV: Nerve conduction velocities

Table 5: Height and NCV of right median nerve of elbow--wrist segment
of different age groups

Parameter        Range                Number       Mean[+ or -]SD
                 (age group)          of cases

Age               20-30 years         51            22.057[+ or -]2.125
height           142-180 cm           51           164.1[+ or -]1.05
NCV of right      29.67-98.36 m/s     51            71.2[+ or -]21.2
median nerve
(elbo- wrist
segment)

Parameter        Range                 Number       Mean[+ or -]SD
                                       of cases

Age               31-40 years          22            34.739[+ or -]2.24
height           147-180 cm            22           167.43[+ or -]6.84
NCV of right      31.85-61.25 m/s      22            55.5[+ or -]22.8
median nerve
(elbo- wrist
segment)

Parameter        Range                Number        Mean[+ or -]SD
                                      of cases

Age               41-50 years          25            45.880[+ or -]2.205
height           156-176 cm            25           168.24[+ or -]4.98
NCV of right      30.93-57.15 m/s      25            53.5[+ or -]16.5
median nerve
(elbo- wrist
segment)

Parameter        Range                Number        Mean[+ or -]SD
                                      of cases

Age               51-60 years          20            56.000[+ or -]3.293
height           160-178 cm            20           169.15[+ or -]4.98
NCV of right      43.29-77.92 m/s      20            52.0[+ or -]14.4
median nerve
(elbo- wrist
segment)

NCV: Nerve conduction velocities, SD: Standard deviation

Table 6: Height and NCV of the right median nerve of elbow--wrist
segment of different age groups

Parameter       Group 1       Group 2        Group 3        Group 4

Age              22.057        34.739         45.88          56
Height          164.1         167.43         168.24         169.15
NCV-e-w          71.2          53.6           53.5           52

NCV: Nerve conduction velocities

Table 7: Comparison of different biological parameters of Group 1
versus Group 2, Group 1 versus Group 3, and Group 1 versus Group 4
along with statistical analysis

Parameter                                       Group 1 versus Group 2
                     Number of cases            Group 1
                                                Mean[+ or -]SD

Age                   51 (20-30 years)           22.057[+ or -]2.0125
                     /22 (31-40 years)
Height                51 (142-180 cm)           164.1[+ or -]10.5
                     /22 (147-185 cm)
NCV of right          51 (29.67-98.36 m/s)       71.2[+ or -]21.2
median nerve         /22 (33.85-61.25 m/s)
(elbow--wrist
segment)

Parameter            Group 1 versus Group 2       Group 1 versus Group 3
               Group 2               Statistical    Number of cases
               Mean[+ or -]SD        analysis

Age             34.739[+ or -]2.240  P<0.05         51 (20-30 years)
                                     Significant   /25 (41-50 years)
Height         167.43[+ or -]6.84    T=1.62         51 (142-180 cm)
                                     P=0.111       /25 (156-176 cm)
                                     Non-
                                     significant
NCV of right    55.5[+ or -]22.8     T=2.78         51 (29.67-98.36 m/s)
median nerve                         P=0.008       /25 (30.93-57.15 m/s)
(elbow--wrist                        Df=39
segment)                             Highly
                                     significant

Parameter                   Group 1 versus Group 3
                     Group 1                       Group 3
                     Mean[+ or -]SD                Mean[+ or -]SD

Age                    22.057[+ or -]2.0125         45.880[+ or -]2.205
Height                164.1[+ or -]10.5            168.24[+ or -]4.98
NCV of right          71.2[+ or -]21.2             53.4[+ or -]16.5
median nerve
(elbow--wrist
segment)

Parameter         Group 1 versus Group 3        Group 1 versus Group 4
                  Statistical                   Number of cases
                  analysis

Age               P<0.05                         51 (20-30 years)
                  Significant                   /20 (51-60 years)
Height            T=12.23                        51 (142-180 cm)
                  P=0.023                       /20 (160-178 cm)
                  Non-
                  significant
NCV of right      T=3.96                         51 (29.67-98.36 m/s)
median nerve      P=0.001                       /20 (43.28-77.92 m/s)
(elbow--wrist     Df=59
segment)          Highly
                  significant

Parameter                     Group 1 versus Group 4
                     Group 1                     Group 4
                     Mean+SD                     Mean[+ or -]SD

Age                   22.057[+ or -]2.0125        56.00[+ or -]3.293
Height               164.1[+ or -]10.5           169.15[+ or -]3.88
NCV of right         71.2[+ or -]21.2            52.01[+ or -]14.4
median nerve
(elbow--wrist
segment)

Parameter                                      Group 1 versus Group 4
                                                Statistical
                                                analysis

Age                                             P<0.05
                                                Significant
Height                                          T=2.94
                                                P=0.004
                                                Non-
                                                significant
NCV of right                                    T=4.36
median nerve                                    P=0.001
(elbow--wrist                                   Df=50
segment)                                        Non-
                                                significant

SD: Standard deviation

Table 8: Comparison of different parameters of Group 1 versus Group 2,
Group 1 versus Group 3, Group 1 versus Group 4 along with mean NCV of
elbow--wrist of same age group

Group         Age           Height         NCV--e--w

1             22.06         164.1          71.2
2             34.74         167.43         55.5
1             22.06         164.1          71.2
3             45.88         168.24         53.4
1             22.06         164.1          71.2
4             56.00         169.15         52.01

NCV: Nerve conduction velocities
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Title Annotation:RESEARCH ARTICLE
Author:Kumar, Abhishek; Dutta, Abhilasha; Prasad, Anjali; Daniel, Amol
Publication:National Journal of Physiology, Pharmacy and Pharmacology
Date:Jun 1, 2017
Words:5074
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