Longitudinal excursion and strain in the median nerve during novel nerve gliding exercises for carpal tunnel syndrome

Nerve and tendon gliding exercises are advocated in the conservative and postoperative management of carpal tunnel syndrome (CTS). However, traditionally advocated exercises elongate the nerve bedding substantially, which may induce a potentially deleterious strain in the median nerve with the risk of symptom exacerbation in some patients and reduced benefits from nerve gliding. This study aimed to evaluate various nerve gliding exercises, including novel techniques that aim to slide the nerve through the carpal tunnel while minimizing strain (sliding techniques). With these sliding techniques, it is assumed that an increase in nerve strain due to nerve bed elongation at one joint (e.g., wrist extension) is simultaneously counterbalanced by a decrease in nerve bed length at an adjacent joint (e.g., elbow flexion). Excursion and strain in the median nerve at the wrist were measured with a digital calliper and miniature strain gauge in six human cadavers during six mobilization techniques. The sliding technique resulted in an excursion of 12.4 mm, which was 30% larger than any other technique (p 0.0002). Strain also differed between techniques (p 0.00001), with minimal peak values for the sliding technique. Nerve gliding associated with wrist movements can be considerably increased and nerve strain substantially reduced by simultaneously moving neighboring joints. These novel nerve sliding techniques are biologically plausible exercises for CTS that deserve further clinical evaluation. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:972-980, 2007

Effect of Co addition on the lattice parameter, electrical conductivity and sintering of gadolinia-doped ceria

Co-sintering aid has been added to Ce1.9Gd0.1O1.95 (CGO) by treating a commercial powder with Co(NO3)(2) (COCGO), X-ray diffraction (XRD) measurements of lattice parameter indicated that the Co was located on the CGO particle surface after calcination at 650 degreesC. After heat treatment at temperatures above 650 degreesC, the room temperature lattice parameter of CGO was found to increase, indicating redistribution of the Gd. Compared to CGO, the lattice parameter of CGO + 2 cation% Co (2CoCGO) was lower for a given temperature (650-1100 degreesC), A.C. impedance revealed that the lattice conductivity of 2CoCGO was enhanced when densified at lower temperatures, Transmission electron microscopy (TEM) showed that, even after sintering for 4 h at 980 degreesC, most of the Co was located at grain boundaries. (C) 2002 Published by Elsevier Science B.V.