Ultrasonographic Evaluation of the Effects of Different Wrist Positions on the Median Nerve in Patients With Generalized Joint Hypermobility

NCT06918613 | Completed

• 1 other identifier: IstPRMTRH1A
• Study Type: observational
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study was to evaluate the effects of different wrist positions (neutral, flexion, extension, and ulnar deviation) on median nerve morphology in patients with generalized joint hypermobility (GJH) using ultrasonography and to compare them with healthy controls. The investigators' hypothesis is that the deformability of the median nerve in response to active maximal wrist flexion, extension, or ulnar deviation may be increased in patients with GJH

Conditions

Hypermobility Syndrome (Disorder); Ultrasonography; Median Nerve

Keywords

Generalized Joint Hypermobility; Median Nerve; Ultrasonography; Wrist Positions; Neural Mobility

Outcome Measures

Primary Outcomes (3)

• Area deformation ratio

  To evaluate the deformability of the median nerve, deformation ratios for area (mm²), perimeter (mm), and circularity ( Circularity = 4π (Area / Perimeter²) ) is calculated. The deformation ratio is defined as the measurement in the final position divided by the corresponding measurement in the initial position.

  On the day one of testing

• Perimeter deformation ratio

  To evaluate the deformability of the median nerve, deformation ratios for area (mm²), perimeter (mm), and circularity ( Circularity = 4π (Area / Perimeter²) ) is calculated. The deformation ratio is defined as the measurement in the final position divided by the corresponding measurement in the initial position.

  On the day one of testing

• Circularity deformation ratio

  To evaluate the deformability of the median nerve, deformation ratios for area (mm²), perimeter (mm), and circularity ( Circularity = 4π (Area / Perimeter²) ) is calculated. The deformation ratio is defined as the measurement in the final position divided by the corresponding measurement in the initial position.

  On the day one of testing

Secondary Outcomes (7)

• Area

  On the day one of testing

• Perimeter

  On the day one of testing

• Circularity

  On the day one of testing

• Beighton Score

  On the day one of testing

• Height

  On the day one of testing

Study Arms (2)

Generalized Joint Hypermobility

Subjects in this group are diagnosed with Generalized joint hypermobility. Asymptomatic ( no arthralgia, subluxation, pain etc.) subjects with Beighton score 5 or more are included in this group. Full wrist range of motion is required. Ultrasonography of median nerve in proximal carpal tunnel will be done in different wrist positions.

Healthy

This group consists of healthy volunteers. Full wrist range of motion is required. Beighton scores must be 4 or lower. Ultrasonography of median nerve in proximal carpal tunnel will be done in different wrist positions.

Eligibility Criteria

• Age: 15 Years - 45 Years
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Subjects who met the criteria were selected from those who presented to Istanbul Physical Medicine Rehabilitation Training and Research Hospital.

You may qualify if:

• years of age
• Female gender
• Diagnosed with GJH according to the hypermobility spectrum disorders definition
• Patients who agree to participate in the study and provide written consent

You may not qualify if:

• Having wrist pain
• Inability to complete full range of motion in the wrist joint
• Patients diagnosed with carpal tunnel syndrome
• Anatomical abnormalities (bifid median nerve, aberrant persistent median artery, Martin-Gruber or other anastomoses)
• History of trauma, operation, fracture, or steroid injection of the hand/wrist
• History of known rheumatological, hereditary, genetic disease, or connective tissue disease other than GJH
• Having neurological disease affecting hand functions (cervical radiculopathy, peripheral nerve lesion, polyneuropathy, cerebrovascular event, etc.)
• Patients with history of regular steroid or non-steroid use, receiving oral glucosamine/hyaluronate supplementation
• Those with systemic diseases (inflammatory joint diseases, diabetes mellitus, acromegaly, hypothyroidism, kidney failure, etc.)
• Having a body mass index (BMI) of 30 or above, or history of morbid obesity
• Being pregnant or in lactation period
• Presence of malignancy

Sponsors & Collaborators

• Istanbul Physical Medicine Rehabilitation Training and Research Hospital: lead

Study Sites (1)

Istanbul Physical Medicine Rehabilitation Training and Research Hospital

Istanbul, Bahçelievler, 34158, Turkey (Türkiye)

Location

Related Publications (3)

• Castori M, Tinkle B, Levy H, Grahame R, Malfait F, Hakim A. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):148-157. doi: 10.1002/ajmg.c.31539. Epub 2017 Feb 1.

  PMID: 28145606 RESULT

• Aktas I, Ofluoglu D, Albay T. The relationship between benign joint hypermobility syndrome and carpal tunnel syndrome. Clin Rheumatol. 2008 Oct;27(10):1283-7. doi: 10.1007/s10067-008-0909-x. Epub 2008 Jun 5.

  PMID: 18528726 RESULT

• Wang Y, Filius A, Zhao C, Passe SM, Thoreson AR, An KN, Amadio PC. Altered median nerve deformation and transverse displacement during wrist movement in patients with carpal tunnel syndrome. Acad Radiol. 2014 Apr;21(4):472-80. doi: 10.1016/j.acra.2013.12.012.

  PMID: 24594417 RESULT

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 1, 2025
• First Posted: April 9, 2025
• Study Start: February 1, 2024
• Primary Completion: May 15, 2025
• Study Completion: June 28, 2025
• Last Updated: November 20, 2025

Record last verified: 2025-11

Locations

TU (1)