Association between body composition and median neuropathy in patients with physical disabilities

Background. Patients with physical disabilities more often have median neuropathies of the wrist and more than 70% of wheelchair users are overweight or obese. Aim. To explore the effects of body composition on the occurrence of distal median neuropathy and to search for the best probabilistic cutoff value of indicators to predict the likelihood of developing distal median neuropathy in patients with physical disabilities. Design. A prospective study. Setting. A 1-day annual physical checkup program for employees of a social welfare organization. Population. In total, 72 patients with a physical disability (mean age ± SD, 40.0 ± 8.8 years; 40 women). Methods. Using electrophysiologic testing to assess distal median nerve function and using a dual-energy X-ray absorptiometry examination to assess body composition. The formula for leg exercise burden index (EBI) was: leg EBI = body fat mass of both legs/lean tissue mass of both legs. Results. The risk of developing a low median sensory nerve conduction velocity in the wrist-to-palm segment (<43 m/s) was greater for patients with a higher leg EBI, yielding an adjusted odds ratio of 6.88 (P<0.005). The body mass index (BMI) and being a wheelchair user were predictors of developing long median distal motor latency (>4 ms). Using receiver operating characteristic analyses, we determined that patients with a physical disability were likely to develop distal median sensory neuropathy if they had a leg EBI of ≥0.943 and were likely to develop distal median motor neuropathy if they had a BMI of ≥24.5 kg/m². Conclusion. The leg EBI is a predictor of having distal median sensory neuropathy among patients with a physical disability. Clinical Rehabilitation Impact. The value of the leg EBI can be useful information for identifying risk of distal median sensory neuropathy in patients with a physical disability.