The Effects of Ankle Joint Position on Deep Peroneal Nerve Latencies
-
Mohamed Hussein El-Gendy
,
Mahmoud Salah Abd El- Fattah
,
Mohamed Magdy ElMeligie
,
Efrem Kentiba
,
Yasser Ramzy Lasheen
Abstract
Purpose: Joint positioning can impact nerve function. Few studies have explored the effects of ankle positions on deep peroneal nerve conduction. This cross-sectional study aimed to investigate the influence of different ankle joint positions on distal motor and sensory onset latencies of the deep peroneal nerve.
Materials and Methods: Thirty one healthy adults (23.4 ±3.9 years) underwent deep peroneal nerve conduction study. Distal motor and sensory onset latencies were measured at neutral (0°), dorsiflexion (20°), and plantarflexion (40°) ankle positions.
Results: Changing ankle position significantly affected distal motor (p=0.001) and sensory onset latencies (p=0.001). Latencies were shortest in dorsiflexion (motor: 3.8±0.46 ms; sensory: 2.4±0.2 ms), followed by neutral (motor: 4.2±0.5 ms; sensory: 2.6±0.3 ms), and longest in plantarflexion (motor: 5±0.6 ms; sensory: 3.3±0.2 ms).
Conclusion: Ankle position impacts deep peroneal nerve conduction. Dorsiflexion and neutral positions reduced distal motor and sensory latencies compared to plantarflexion. These findings provide preliminary evidence that may help optimize ankle positioning in electrodiagnostic testing. Further blinded research with larger, more diverse samples is warranted.
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2. Yao Y, Grandy E, Evans PJ, Seitz Jr WH, Li ZM. Location‐dependent change of median nerve mobility in the carpal tunnel of patients with carpal tunnel syndrome. Muscle Nerve. 2020;62(4):522-527.
3. Schiefer MA, Freeberg M, Pinault G, et al. Selective activation of the human tibial and common peroneal nerves with a flat interface nerve electrode. J Neural Eng. 2013;10(5):056006.
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6. Padua L, Coraci D, Erra C, et al. Prolonged phone-call posture causes changes of ulnar motor nerve conduction across elbow. Clin Neurophysiol. 2016;127(8):2728-2732.
7. Chowet AL, Lopez JR, Brock-Utne JG, Jaffe RA. Wrist hyperextension leads to median nerve conduction block: implications for intra-arterial catheter placement. Anesthesiology. 2004;100(2):287-291.
8. Broadhurst PK, Robinson LR. Effect of hip and knee position on nerve conduction in the common fibular nerve. Muscle Nerve. 2017;56(3):519-521.
9. Bruni JE, Montemurro DG. Human neuroanatomy: a text, brain atlas, and laboratory dissection guide. New York: Oxford University Press, USA; 2009.
10. Rydevik BL, Kwan MK, Myers RR, et al. An in vitro mechanical and histological study of acute stretching on rabbit tibial nerve. J Orthop Res. 1990;8(5):694-701.
11. Driscoll PJ, Glasby MA, Lawson GM. An in vivo study of peripheral nerves in continuity: biomechanical and physiological responses to elongation. J Orthop Res. 2002;20(2):370-375.
12. Voller T. Surgical anatomy and biomechanics of the foot. Orthop Trauma. 2022;36(4):239-243.
13. Greening J, Dilley A. Posture‐induced changes in peripheral nerve stiffness measured by ultrasound shear‐wave elastography. Muscle Nerve. 2017;55(2):213-222.
14. Joshua AM, Misri Z. Peripheral Nerve Disorders. In: Physiotherapy for Adult Neurological Conditions. Springer; 2022. p. 621-729.
15. Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH. The carpal tunnel syndrome: A study of carpal canal pressures. J Bone Joint Surg Am. 1981;63(3):380-383.
16. Cherni Y, Desmyttere G, Hajizadeh M, Bleau J, Mercier C, Begon M. Effect of 3D printed foot orthoses stiffness on muscle activity and plantar pressures in individuals with flexible flatfeet: A statistical non-parametric mapping study. Clin Biomech. 2022;92:105553.
17. Khamis NK, Md Deros B, Nuawi MZ, Schramm D. Pattern of Muscle Contraction in Car Pedal Control. Jurnal Kejuruteraan. 2018;30(1):23-29.
18. DiDomenico LA, Masternick EB. Anterior tarsal tunnel syndrome. Clin Podiatr Med Surg. 2006;23(3):611-620.
19. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361-374.
20. Mathis S, Ciron J, Du Boisgueheneuc F, Godenèche G, Hobeika L, Larrieu D, Neau J-P. Study of accessory deep peroneal nerve motor conduction in a population of healthy subjects. Clin Neurophysiol. 2011;41(1):29-33.
21. Huber J, Leszczyńska K, Wincek A, Szymankiewicz-Szukała A, Fortuna W, Okurowski S, Tabakow P. The role of peripheral nerve electrotherapy in functional recovery of muscle motor units in patients after incomplete spinal cord injury. Appl Sci. 2021;11(20):9764.
22. Sorenson EJ. Sensory Nerve Conduction Studies and Sensory Nerve Action Potentials. In: Clinical Neurophysiology. 2021. p. 292-311.
23. Tankisi H, Burke D, Cui L, de Carvalho M, Kuwabara S, Nandedkar SD, Rutkove S, Stålberg E, van Putten MJ, Fuglsang-Frederiksen A. Standards of instrumentation of EMG. Clin Neurophysiol. 2020;131(1):243-258.
24. Aminoff MJ. Aminoff’s Electrodiagnosis in Clinical Neurology E-Book: Expert Consult-Online and Print. Elsevier Health Sciences; 2012.
25. Turbpaiboon C, Puprasert C, Lohasammakul S, Dacharux W, Numwong T, Pandeya A, Pisanuwongse A, Kasemassawachanont A. Deep Peroneal Nerve: From an Anatomical Basis to Clinical Implementation. Siriraj Med J. 2022;74(7):448-462.
26. Squintani G, Zoppini G, Donato F, Pineschi E, Donini D, Stoico V, Moretto G, Bonora E, Morini A. Antidromic sensory nerve conduction study of the digital branches of the medial plantar nerve: a novel method to detect early diabetic sensory axonal polyneuropathy. Muscle Nerve. 2014;50(2):193-199.
27. Seror P, Maisonobe T, Bouche P. A new electrode placement for recording the compound motor action potential of the first dorsal interosseous muscle. Clin Neurophysiol. 2011;41(4):173-180.
28. Nielsen J, Sinkjaer T. Afferent feedback in the control of human gait. J Electromyogr Kinesiol. 2002;12(3):213-217.
29. Barske HL, DiGiovanni BF, Douglass M, Nawoczenski DA. Current concepts review: isolated gastrocnemius contracture and gastrocnemius recession. Foot Ankle Int. 2012;33(10):915-921.
30. Lorei MP, Hershman EB. Peripheral nerve injuries in athletes: treatment and prevention. Sports Med. 1993;16:130-147.
31. Santana HS, Fernandes de Oliveira I, Medrado A, Nunes S. Neurodynamic mobilization and peripheral nerve regeneration: A narrative review. Int J Neurorehabilitation. 2015;2(2):2376-0281.1000163.
32. Costa AR, Pinto-Costa R, Sousa SC, Sousa MM. The regulation of axon diameter: from axonal circumferential contractility to activity-dependent axon swelling. Front Mol Neurosci. 2018;11:319.
33. Yeoh S, Warner WS, Merchant SS, Hsu EW, Agoston Dv, Mahan MA. Incorporating blood flow in nerve injury and regeneration assessment. Front Surg. 2022;9:862478.
34. Diniz P, Sousa DA, Batista JP, Abdelatif N, Pereira H. Diagnosis and treatment of anterior ankle impingement: state of the art. J ISAKOS. 2020;5(5):295-303.
35. Ghose A, Pullarkat P. The role of mechanics in axonal stability and development. Elsevier; 2023. p. 22-34.
36. Seidl AH. Regulation of conduction time along axons. Neuroscience. 2014;276:126-134.
37. Abd El-Azeim AS, Mahmoud AG, Mohamed MT, El-Khateeb YS. Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: a randomized controlled trial. Eur J Phys Rehabil Med. 2022;58(5):757.
38. Temple C, Ross D, Dunning C, Johnson J, King G. Tensile strength of healing peripheral nerves. J Reconstr Microsurg. 2003;19(07):483-488.
39. Chiou S-W, Lin C-K. Relationship Between Nerve-Impulse Conduction And Tensile Deformation In Rat Sciatic Nerve. J Biomech. 2007;40(2):S117.
40. Topp KS, Boyd BS. Peripheral nerve: from the microscopic functional unit of the axon to the biomechanically loaded macroscopic structure. J Hand Ther. 2012;25(2):142-152.
41. Ashish K. Effects of Different Elbow Positions on Latency and Amplitude of Motor Nerve Conduction Study of Ulnar Nerve. Physiother Occup Ther. 2011;5(3):135.
2. Yao Y, Grandy E, Evans PJ, Seitz Jr WH, Li ZM. Location‐dependent change of median nerve mobility in the carpal tunnel of patients with carpal tunnel syndrome. Muscle Nerve. 2020;62(4):522-527.
3. Schiefer MA, Freeberg M, Pinault G, et al. Selective activation of the human tibial and common peroneal nerves with a flat interface nerve electrode. J Neural Eng. 2013;10(5):056006.
4. Kendal F, McCreary EK, Provance PG, Rodgers M, Romani W. Muscles: testing and function with posture and pain. Baltimore: Lippincott Williams & Wilkins; 2005.
5. O’Neill PJ, Parks BG, Walsh R, Simmons LM, Miller SD. Excursion and strain of the superficial peroneal nerve during inversion ankle sprain. J Bone Joint Surg Am. 2007;89(5):979-986.
6. Padua L, Coraci D, Erra C, et al. Prolonged phone-call posture causes changes of ulnar motor nerve conduction across elbow. Clin Neurophysiol. 2016;127(8):2728-2732.
7. Chowet AL, Lopez JR, Brock-Utne JG, Jaffe RA. Wrist hyperextension leads to median nerve conduction block: implications for intra-arterial catheter placement. Anesthesiology. 2004;100(2):287-291.
8. Broadhurst PK, Robinson LR. Effect of hip and knee position on nerve conduction in the common fibular nerve. Muscle Nerve. 2017;56(3):519-521.
9. Bruni JE, Montemurro DG. Human neuroanatomy: a text, brain atlas, and laboratory dissection guide. New York: Oxford University Press, USA; 2009.
10. Rydevik BL, Kwan MK, Myers RR, et al. An in vitro mechanical and histological study of acute stretching on rabbit tibial nerve. J Orthop Res. 1990;8(5):694-701.
11. Driscoll PJ, Glasby MA, Lawson GM. An in vivo study of peripheral nerves in continuity: biomechanical and physiological responses to elongation. J Orthop Res. 2002;20(2):370-375.
12. Voller T. Surgical anatomy and biomechanics of the foot. Orthop Trauma. 2022;36(4):239-243.
13. Greening J, Dilley A. Posture‐induced changes in peripheral nerve stiffness measured by ultrasound shear‐wave elastography. Muscle Nerve. 2017;55(2):213-222.
14. Joshua AM, Misri Z. Peripheral Nerve Disorders. In: Physiotherapy for Adult Neurological Conditions. Springer; 2022. p. 621-729.
15. Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH. The carpal tunnel syndrome: A study of carpal canal pressures. J Bone Joint Surg Am. 1981;63(3):380-383.
16. Cherni Y, Desmyttere G, Hajizadeh M, Bleau J, Mercier C, Begon M. Effect of 3D printed foot orthoses stiffness on muscle activity and plantar pressures in individuals with flexible flatfeet: A statistical non-parametric mapping study. Clin Biomech. 2022;92:105553.
17. Khamis NK, Md Deros B, Nuawi MZ, Schramm D. Pattern of Muscle Contraction in Car Pedal Control. Jurnal Kejuruteraan. 2018;30(1):23-29.
18. DiDomenico LA, Masternick EB. Anterior tarsal tunnel syndrome. Clin Podiatr Med Surg. 2006;23(3):611-620.
19. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361-374.
20. Mathis S, Ciron J, Du Boisgueheneuc F, Godenèche G, Hobeika L, Larrieu D, Neau J-P. Study of accessory deep peroneal nerve motor conduction in a population of healthy subjects. Clin Neurophysiol. 2011;41(1):29-33.
21. Huber J, Leszczyńska K, Wincek A, Szymankiewicz-Szukała A, Fortuna W, Okurowski S, Tabakow P. The role of peripheral nerve electrotherapy in functional recovery of muscle motor units in patients after incomplete spinal cord injury. Appl Sci. 2021;11(20):9764.
22. Sorenson EJ. Sensory Nerve Conduction Studies and Sensory Nerve Action Potentials. In: Clinical Neurophysiology. 2021. p. 292-311.
23. Tankisi H, Burke D, Cui L, de Carvalho M, Kuwabara S, Nandedkar SD, Rutkove S, Stålberg E, van Putten MJ, Fuglsang-Frederiksen A. Standards of instrumentation of EMG. Clin Neurophysiol. 2020;131(1):243-258.
24. Aminoff MJ. Aminoff’s Electrodiagnosis in Clinical Neurology E-Book: Expert Consult-Online and Print. Elsevier Health Sciences; 2012.
25. Turbpaiboon C, Puprasert C, Lohasammakul S, Dacharux W, Numwong T, Pandeya A, Pisanuwongse A, Kasemassawachanont A. Deep Peroneal Nerve: From an Anatomical Basis to Clinical Implementation. Siriraj Med J. 2022;74(7):448-462.
26. Squintani G, Zoppini G, Donato F, Pineschi E, Donini D, Stoico V, Moretto G, Bonora E, Morini A. Antidromic sensory nerve conduction study of the digital branches of the medial plantar nerve: a novel method to detect early diabetic sensory axonal polyneuropathy. Muscle Nerve. 2014;50(2):193-199.
27. Seror P, Maisonobe T, Bouche P. A new electrode placement for recording the compound motor action potential of the first dorsal interosseous muscle. Clin Neurophysiol. 2011;41(4):173-180.
28. Nielsen J, Sinkjaer T. Afferent feedback in the control of human gait. J Electromyogr Kinesiol. 2002;12(3):213-217.
29. Barske HL, DiGiovanni BF, Douglass M, Nawoczenski DA. Current concepts review: isolated gastrocnemius contracture and gastrocnemius recession. Foot Ankle Int. 2012;33(10):915-921.
30. Lorei MP, Hershman EB. Peripheral nerve injuries in athletes: treatment and prevention. Sports Med. 1993;16:130-147.
31. Santana HS, Fernandes de Oliveira I, Medrado A, Nunes S. Neurodynamic mobilization and peripheral nerve regeneration: A narrative review. Int J Neurorehabilitation. 2015;2(2):2376-0281.1000163.
32. Costa AR, Pinto-Costa R, Sousa SC, Sousa MM. The regulation of axon diameter: from axonal circumferential contractility to activity-dependent axon swelling. Front Mol Neurosci. 2018;11:319.
33. Yeoh S, Warner WS, Merchant SS, Hsu EW, Agoston Dv, Mahan MA. Incorporating blood flow in nerve injury and regeneration assessment. Front Surg. 2022;9:862478.
34. Diniz P, Sousa DA, Batista JP, Abdelatif N, Pereira H. Diagnosis and treatment of anterior ankle impingement: state of the art. J ISAKOS. 2020;5(5):295-303.
35. Ghose A, Pullarkat P. The role of mechanics in axonal stability and development. Elsevier; 2023. p. 22-34.
36. Seidl AH. Regulation of conduction time along axons. Neuroscience. 2014;276:126-134.
37. Abd El-Azeim AS, Mahmoud AG, Mohamed MT, El-Khateeb YS. Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: a randomized controlled trial. Eur J Phys Rehabil Med. 2022;58(5):757.
38. Temple C, Ross D, Dunning C, Johnson J, King G. Tensile strength of healing peripheral nerves. J Reconstr Microsurg. 2003;19(07):483-488.
39. Chiou S-W, Lin C-K. Relationship Between Nerve-Impulse Conduction And Tensile Deformation In Rat Sciatic Nerve. J Biomech. 2007;40(2):S117.
40. Topp KS, Boyd BS. Peripheral nerve: from the microscopic functional unit of the axon to the biomechanically loaded macroscopic structure. J Hand Ther. 2012;25(2):142-152.
41. Ashish K. Effects of Different Elbow Positions on Latency and Amplitude of Motor Nerve Conduction Study of Ulnar Nerve. Physiother Occup Ther. 2011;5(3):135.
| Issue | Articles in Press | |
| Section | Research Article(s) | |
| Keywords | ||
| Ankle; Ankle Joint, Electromyography, Peroneal Nerve, Nerve Conduction Studies | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
El-Gendy M, Abd El- Fattah M, ElMeligie M, Kentiba E, Lasheen Y. The Effects of Ankle Joint Position on Deep Peroneal Nerve Latencies. jmr. 2024;(-).
