S248 PRESENTATIONS

MUSCULOSKELETAL AND SPORTS MEDICINE

Poster 179Do Electrodiagnostic Variables Correlate withFunctional Outcomes in Carpal Tunnel Syndrome?Thiru M. Annaswamy, MD, MA (North Texas VA HealthCare System, Dallas, TX, United States);Samuel M. Bierner, MD, MRM; Alexandru Anastase, MD;Tong Zhu, MD; Donald Kasitinon; Med Student.

Disclosures: T. M. Annaswamy, No Disclosures: I Have NoRelevant Financial Relationships to Disclose.Objective: To correlate electrodiagnostic (EDX) variables andclinical severity assessment with Disabilities of Arm, Shoulder &Hand (DASH) scores and to measure change over time with cor-responding change in DASH scores.Design: Prospective Single Group Cohort, Pre-Post Design.Setting: Hospital-based electrodiagnostic clinic.Participants: 41 consecutive patients consented to participateand were invited to return for repeat study.Interventions: All subjects underwent EDX study and completedDASH. Data included: median sensory, mixed and motor latencies,amplitudes, conduction velocities and needle EMG.Main Outcome Measures: Paired samples t test was per-formed for change in DASH score over time.Results or Clinical Course: 41 subjects (6 female) enrolled. 6rated as severe, 23 moderate and 12 mild CTS (NS). Mean DASHscore [95 % C.I.] at start: 36.4 [30.5, 42.2]; final DASH score: 35.3[27.1, 43.5], thus no significant change (t ¼ .293, df ¼ 27, p¼.772). 26 subjects returned for their repeat study. Initial DASHscore showed significant negative correlation with age: r ¼ -0.379,p < .05), but no significant correlation with time interval betweenmeasurements: r ¼ -0.047, p ¼ .82). Principal components analysiswas used to reduce the large number of EDX variables whichexplained 73.5% of the cumulative variance. None of the EDXvariables alone or in combination gave statistically significantcorrelation with the change in DASH score over time.Conclusions: This prospective cohort study attempted toexamine influence of electrodiagnostic parameters on the self-re-ported disability and outcome using the DASH instrument.Significant drop-out (2nd visit) reduced the power to detecta meaningful difference. Our results showed no significant avg.change in DASH score over the time interval between visits. DASHshowed a significant negative correlation with age of subject.Individual EDX did not predict change in DASH score over time.

Poster 180Dry-Needling Reduces Pain and Alters Status ofActive Trigger Points in Subjects with ChronicMyofascial Pain: A Prospective Study.Naomi Lynn H. Gerber, MD (George Mason Univ,Fairfax, VA, United States); Katee Armstrong, DPT;Paul R. Otto, MS; Diego Turo, PhD;Tadesse M. Gebreab, BS; Nikki Thaker, BS;William Rosenberger, PhD; Siddhartha Sikdar, PhD;Jay P. Shah, MD.

Disclosures: N. H. Gerber, husband consults with Abbvie,Consulting fees or other remuneration (payment); Elsevier, Receiptof royalties

Objective: Determine the effect of dry needling on pain andtrigger point status in subjects with active myofascial trigger points(aMTrPs).Design: Prospective, controlled study comparing pain and triggerpoint status pre and post dry-needling.Setting: University clinical laboratory.Participants: 51 adults subjects with >3 months of neck/shoulder girdle pain and an aMTrP.Interventions: 3 weekly dry needling of 1 a-MTrP.Main Outcome Measures: Comparison of baseline andpost-treatment verbal analogue score 1-10 (VAS), score of theBrief Pain Inventory (BPI) and status change of MTrP from activeto latent or normal. Secondary outcomes include ultrasoundmeasure of MTrP size, cervical range of motion, algometry, self-reports of disability (Oswestry), mood (POMS), health status(SF36).Results or Clinical Course: Differences between baselinemeasures for a-MTrPs compared with post-dry needling demon-strated statistically significant findings for: VAS with change from>3 to 0.9 whether bilateral or unilateral a-MTrPs p<.0001; BPI 3.4to 2.3 p<.0001). Change in MTrP status showed 41 respondersand 11 non-responders (p<.0001). Baseline and post-treatmentscores for secondary outcomes demonstrated: Significantly lowerrelative size of a-MTrPs at follow-up (p<.008) compared to base-line. Significant change in cervical ROM asymmetry rotation p<.02and side bending for unilateral MTrPs only (p.001); significantincrease in pain threshold (p¼.005 and p¼.001 for unilateral andbilateral MTrP respectively). There was significant improvement in:POMS scores for tension and mood (p¼.01); SF36 mental andemotional health and physical function (p<.05); and disability(p<.004).Conclusions: Dry needling effectively reduces soft-tissue pain,changes MTrP status and reduces its size in subjects undergoing 3weekly treatments, reduces asymmetry in neck side-bending androtation. Clinically meaningful improvements are reported in someself-reports of mood, physical and mental function and disabilityfollowing treatment.

Poster 181Ultrasound-Guided Injection of Steroids asa Treatment for Symptomatic Traumatic Adhesionsbetween the Lumbrical and Interosseous Muscles ofthe Hand: A Case Report.Praveen N. Pakeerappa, MD (VAMC Lexington, Lex-ington, KY, United States); Oscar O. Ortiz Vargas, MD.

Disclosures: P. N. Pakeerappa, No Disclosures: I Have No Rele-vant Financial Relationships to Disclose.Case Description: A 31-year-old Caucasian man presentedwith 6-month history of persistent right hand pain after fallingonto his right hand with his wrist and metacarpophalangeal jointin flexion. Pain was located on the lateral side of the dorsum ofthe hand and described as dull and aching, 5 out of 10 (VAS). Noneuropathic symptoms were noted. The pain was reproducedduring activities such as push-up exercises or opening jars.NSAIDs and a hand brace only partially improved pain. Physicalexamination revealed tenderness to palpation in the second webspace with positive Bunnel test. X-ray of the hand was normal.Ultrasound examination revealed hypoechoic areas over distal