title: Development of Kinematic Graphs of Median Nerve during Active Finger Motion: Implications of Smartphone Use.
abstract: BACKGROUND
  Certain hand activities cause deformation and displacement of the median nerve at the carpal tunnel due to the gliding motion of tendons surrounding it. As smartphone usage escalates, this raises the public's concern whether hand activities while using smartphones can lead to median nerve problems.
  
  
  OBJECTIVE
  The aims of this study were to 1) develop kinematic graphs and 2) investigate the associated deformation and rotational information of median nerve in the carpal tunnel during hand activities.
  
  
  METHODS
  Dominant wrists of 30 young adults were examined with ultrasonography by placing a transducer transversely on their wrist crease. Ultrasound video clips were recorded when the subject performing 1) thumb opposition with the wrist in neutral position, 2) thumb opposition with the wrist in ulnar deviation and 3) pinch grip with the wrist in neutral position. Six still images that were separated by 0.2-second intervals were then captured from the ultrasound video for the determination of 1) cross-sectional area (CSA), 2) flattening ratio (FR), 3) rotational displacement (RD) and 4) translational displacement (TD) of median nerve in the carpal tunnel, and these collected information of deformation, rotational and displacement of median nerve were compared between 1) two successive time points during a single hand activity and 2) different hand motions at the same time point. Finally, kinematic graphs were constructed to demonstrate the mobility of median nerve during different hand activities.
  
  
  RESULTS
  Performing different hand activities during this study led to a gradual reduction in CSA of the median nerve, with thumb opposition together with the wrist in ulnar deviation causing the greatest extent of deformation of the median nerve. Thumb opposition with the wrist in ulnar deviation also led to the largest extent of TD when compared to the other two hand activities of this study. Kinematic graphs showed that the motion pathways of median nerve during different hand activities were complex.
  
  
  CONCLUSIONS
  We observed that the median nerve in the carpal tunnel was rotated, deformed and displaced during the hand activities that people may be performed when using a smartphone, suggesting an increased risk of carpal tunnel syndrome (CTS). In addition, the kinematic graphs of median nerve developed in the present study provide new clues for further studies on the pathophysiology of CTS, and alerting smartphone users to establish proper postural habits when using handheld electronic devices.
authors.affiliation: Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
authors.forename: Hoi-Chi
authors.initials: HC
authors.lastname: Woo
authors.affiliation: Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
authors.forename: Peter
authors.initials: P
authors.lastname: White
authors.affiliation: Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
authors.forename: Ho-Kwan
authors.initials: HK
authors.lastname: Ng
authors.affiliation: Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
authors.forename: Christopher W K
authors.initials: CW
authors.lastname: Lai
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005385:Fingers / Q000294:innervation* / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D055595:Mechanical Phenomena; D008475:Median Nerve / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology*; D009068:Movement; D012399:Rotation; D000068997:Smartphone; D013997:Time Factors; D014463:Ultrasonography; D014953:Wrist / Q000294:innervation / Q000502:physiology; D055815:Young Adult