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INTRODUCTION

The electrical conduction ability of sensory and motor nerves of the human body is generally evaluated using nerve conduction studies (NCS).1 NCS isan objective, quantitative and reproducible measure of peripheral nerve function and is widely used in diagnosis of neuropathies.2 The electrophysiologic procedure has become so sensitive that it not only confirms the clinical diagnosis in most patients but also detects an incidental finding in some asymptomatic subjects.3

Repetitive force applied during daily activities commonly leads to compression neuropathies. Several factors related to the external force application can lead to compression neuropathies. The external compression can be applied in several ways: (a) a low force present for a long timeperiod; (b) an acute focal application of a large external force or (c) repetitive application of brief large forces. Combination of stretching, shearing and/or compressive force application may result into compression.4 Athelete suffers from various acute and chronic mechanical injuries of peripheral nerves based on physiological demands. Around elbow injuries are very common in racquet sports due to high repetition of motions, high muscular forces and extreme elbow positions leading to overuse.5

Badminton is a non-contact sport requiring jumps, lunges, quick changes in direction and rapid arm movements from a wide variety of postural positions and also rapid and repetitive wrist movement.6 Studies reporting epidemiological data of musculoskeletal injuries in upper extremity of badminton injuries are sparse, but previous studies have shown that these injuries often are severe in character but of relatively low frequency.7,8

Hence, the present study intends to evaluate the nerve conduction velocity of ulnar nerves in elite badminton players and compared with normal healthy individuals.

MATERIALS AND METHODS

In this study total 20 male subjects were included, out of which 10 were elite badminton players and 10 were age matched control subjects, between age group of 20-40 years through purposive sampling technique. The elite badminton players were recruited from Dakshin Kannada Badminton Association and were included only if they were training for minimum of 1 hour per day, four days a week. The age matched asymptomatic control individuals were included if they had not participated in any of the sports activities on regular basis. The subjects were excluded if, they had significant history, signs or symptoms of peripheral neuropathy orcompression syndrome of upper extremities. All the participants were right hand dominant in this study. The details and purpose of the study were explained to all the individuals for maximum co-operation and informed written consent was signed by all of them.

Neuro CareTM - 2000, having facilities of computerized electromyography (EMG) with nerve conduction velocity (NCV) and evoked potential (EP), manufactured by Bio-TechTM, India was used to evaluate nerve conduction parameters (i.e., conduction velocities and distal latencies).

Nerve conduction studies were performed using standard techniques of supramaximal percutaneous stimulation with a constant current stimulator and surface electrode recording on both extremities of each subject. Parameters studied: 1)Latency, 2) Amplitude, 3) Conduction velocity: sensory part and motor part.

For Ulnar Nerve:

Motor component: The stimulating electrode is placed at wrist and below elbow (about 4 cm below the medial epicondyle), recording electrode: from abductor digiti minimi, reference electrode on little finger, ground electrode between stimulating and recording electrode.

Sensory component (Orthodromic study): The stimulation is done using ring electrode at interphalangeal joint of 5th digit, recording electrode along course of ulnar nerve, reference electrode: 2 cm proximal to the recording electrode, ground electrode between stimulating and recording electrode.

RESULTS

SPSS 20.0 by IBM was used for data evaluation. Mean and standard deviationwas calculated for the descriptive statistics and comparison of latencies and conduction velocities of motor as well as sensory components of ulnar nerve among elite badminton players and age matched control subjects was done using two-way ANOVA. Level of significance was set at p<0.05.

Table 1: Comparison of baseline characteristics of subjects (n=20)

Table-1 shows comparison of baseline characteristic which proves that there is a significant difference at p<0.05 for age in badminton playersand control normal subjects.  Other characteristics such as weight, height and BMI showed no significant difference.

Table 2: Comparison of baseline nerve conduction parameters of subjects (n=20)

Table-2 shows the comparison of baseline nerve conduction characteristics by comparing means and standard deviations, and at p<0.05 level of significance there is no significant difference between these baseline values.

Table 3: Comparison of differences between two groups using 2-way ANOVA (n=20)

Table-3 is showing the comparison of differences between both groups using two-way ANOVA. Significant differences can be seen in motor and sensory latencies; SNCVs also showed statistically significant differences but MNCVs showed no significance at p<0.05. There was no significant difference seen in dominant and non-dominant extremity of players and control subjects in ulnar nerve.