Prevalence and risk factors for upper extremity entrapment neuropathies in polio survivors

Objective: To investigate the electrophysiological prevalence and associated risk factors of upper extremity entrapment neuropathies in a cohort of Taiwanese patients with prior paralytic poliomyelitis. Design: Cross-sectional study involving a consecutive series of patients. Subjects: Ninety-seven polio survivors. Methods: Demographic factors, medical and work history were recorded. Symptoms and functional deficits of the hand, mobility impairment level, physical activity level and manual muscle testing were assessed, and nerve conduction studies were performed. Results: The electrophysiological prevalence of nerve entrapment among the polio survivors was 80%. The most common electrodiagnostic dysfunction was median neuropathy at the wrist (62%), followed by ulnar neuropathy at the elbow (41%) and ulnar neuropathy at the wrist (38%). In multiple logistic regression, subjects who reported that their jobs involved repetitive hand movements, had a body mass index greater than 24 kg/m², or used a cane/crutch were at increased risk of both median neuropathy at the wrist and ulnar neuropathy at the wrist. Subjects who used a wheelchair were also at increased risk of ulnar neuropathy at the wrist. Conclusion: These results indicate a high occurrence of upper extremity entrapment neuropathies in polio survivors. The documentation of risk factors in this study provides support for screening of at-risk subjects.