بررسی تأثیر دو وضعیت مفصل شانه (وضعیت 90 و صفر درجه‌ی Abduction) حین عمل بای‌پس عروق کرونر بر سرعت هدایت اعصاب در بیماران مبتلا به دیابت

نوع مقاله : مقاله کوتاه

نویسندگان

1 استادیار، گروه فیزیوتراپی، مرکز تحقیقات ارتقای سلامت، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

2 دانشجوی کارشناسی ارشد، گروه فیزیوتراپی، دانشکده‌ی توان‌بخشی و کمیته‌‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشیار، گروه قلب، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 استادیار، گروه فیزیوتراپی، دانشکده‌ی توان‌بخشی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: هدف از انجام این مطالعه، بررسی تأثیر وضعیت شانه حین عمل بای‌پس عروق کرونر بر علایم بالینی و سرعت هدایت عصبی اعصاب اندام فوقانی در افراد مبتلا به دیابت بود.روش‌ها: در این کارآزمایی بالینی، 20 نفر بیمار مبتلا به دیابت که کاندیدای عمل قلب باز بودند، به صورت تصادفی به دو گروه شاهد و مورد تقسیم شدند. در گروه مورد، دست در حین عمل در حالت باز (90 درجه) و در گروه شاهد دست در کنار بدن (صفر درجه) قرار می‌گرفت. آزمون‌های الکترودیاگنوزیس شامل بررسی دامنه‌ی موج و سرعت هدایت حسی و حرکتی اعصاب Median، Radial و Ulnar دست چپ بود. معاینات بالینی شامل بررسی کرختی و پارستزی (خواب رفتگی) هر دو دست بود.یافته‌ها: مقایسه‌ی میانگین تغییرات آمپلی‌تود و سرعت هدایت عصبی اعصاب Median، Radial و Ulnar در گروه شاهد بعد از مداخله برای همه‌ی متغیرها تغییر معنی‌داری نشان داد (050/0 > P). میانگین تغییرات آمپلی‌تود و سرعت هدایت اعصاب Median، Radial و Ulnar در گروه مورد، به جز سرعت هدایت حرکتی Radial و آمپلی‌تود حسی Ulnar، تغییر معنی‌داری را نشان دادند (050/0 > P). مقایسه‌ی بین گروهی میانگین آمپلی‌تود و سرعت هدایت عصبی بعد از عمل، تنها در آمپلی‌تود حسی Ulnar تغییر معنی‌داری را نشان داد (050/0 > P).نتیجه‌گیری: وضعیت 90 درجه‌ی Abduction شانه حین عمل بای‌پس عروق کرونر، باعث کاهش آسیب اکسونال فیبرهای حسی عصب Ulnar می‌شود

کلیدواژه‌ها


عنوان مقاله [English]

Effects of Zero- and 90-Degree Abduction of Glenohumeral Joint on the Upper Extremity Nerve Conduction Velocity (NCV) in Patients with Diabetes Undergoing Coronary Artery Bypass Graft Surgery

نویسندگان [English]

  • Mohammad Hosseinifar 1
  • Zeinolabedin Mojahed 2
  • Mohsen Mirmohammad-Sadeghi 3
  • Hamid Azadeh 4
1 Assistant Professor, Department of Physiotherapy, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
2 MSc student, Department of Physiotherapy, School of Rehabilitation Sciences AND Student Research Committee, Isfahan University of Medical sciences, Isfahan, Iran
3 Associate Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Assistant Professor, Department of Physiotherapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: The aim of this study was to evaluate the effect of arm position during coronary artery bypass surgery on neuropathic symptoms and nerve conduction velocity (NCV) of the upper extremity nerves in patients with diabetes.Methods: In this clinical trial, 20 patients with diabetes, who were candidates for open-heart surgery, were divided randomly into control and experimental group. During the operation, patient’s arm was positioned at 90 degree abduction and at the sides of the body in the experimental and control group, respectively. Electrodiagnostic tests including assessing amplitude and conduction velocity of sensory and motor nerves of radial, median and ulnar of left hand was performed. Physical examination was also done for checking the numbness and Paresthesia in both hands.Findings: The Comparison of the changes for mean of amplitude and NCV of radial, median and ulnar nerves showed significant change in the control group after operation (P < 0.050). The Comparison of the changes for mean of amplitude and NCV of radial, median and ulnar nerves showed significant change except in radial motor NCV and sensory amplitude of ulnar nerve in the test group after operation (P < 0.050). The comparison of mean values after operation between groups showed no significant changes except in sensory amplitude of ulnar nerve.Conclusion: Arm abduction at 90 degrees reduces the axonal injury of the ulnar sensory fibers during coronary artery bypass graft surgery.

کلیدواژه‌ها [English]

  • Diabetes
  • Nerve conduction velocity (NCV)
  • Coronary Artery Bypass
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