Upper limb amputation leads to significant physical and psychosocial burden; however, it remains underrepresented in global epidemiological and rehabilitation studies. This study aimed to systematically review the global epidemiological data on upper limb amputation, focusing on its prevalence, incidence, anatomical levels, and etiology. According to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, and Regional Information Sharing Systems (up to May 2023). Two authors independently selected the studies, assessed their methodological quality, and summarized the evidence. Nineteen studies were finally included in this study. The prevalence of major upper limb amputation was higher in individuals with disabilities than in the general population. The prevalence in general population was 11.6 per 100,000 adults between 2006 and 2008 in Norway, whereas the prevalence in individuals with disabilities was 6.9 per 1,000 individuals in 2011 and increased to 11.3 per 1,000 individuals in 2020 in South Korea. The incidence rates were generally higher in the occupational population than in the general population. Below-elbow amputation was consistently the most common major amputation level reported. Although traumatic causes were predominant, medical conditions substantially contributed to upper limb impairment among individuals with disabilities. Upper limb amputation presents significant global variations in prevalence, incidence, anatomical level, and cause. The scarcity of standardized, disaggregated data limits effective planning for prosthetic services and rehabilitation. Future studies should prioritize comprehensive data collection to support equitable healthcare delivery and inform prosthetic innovation.
Objective To establish the reference standard of the median nerve conduction study (NCS) in Korea.
Methods A total of 648 median motor and 602 median sensory NCSs from 349 Korean healthy volunteers were tested and analyzed prospectively. Equipment calibration, assessment of intraand inter-rater reliability, and the NCSs per se were conducted according to a predetermined protocol. A reference standard was established from uncertainty components for the following parameters: the onset and peak latencies; the baseline-to-peak and peak-to-peak amplitudes; the area and duration of the negative wave; and the nerve conduction velocity. The effects of sex, age and stimulation intensity were analyzed.
Results Each measured value of 648 median motor and 602 median sensory nerves were obtained and presented with both mean and expanded uncertainties, as well as mean and standard deviations. The cut-off values with expanded uncertainty were determined for different age and sex groups. After adjusting for anthropometric covariates, all parameters except duration were affected by age, and sex appeared to influence both duration and area. While stimulation intensity significantly affected some parameters including latencies, the effect sizes were negligible.
Conclusion We propose the median NCS reference standard using the largest Korean dataset ever available. The use of the traceable and reliable reference standard is anticipated to promote more accurate and dependable diagnosis and appropriate management of median neuropathies in Korea.
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Электронейромиография в педиатрической практике (обзор литературы)
Павел Олегович Ляжьев, Мария Юрьевна Фомина Pediatrician (St Petersburg).2026; 16(5): 70. CrossRef
Objective To develop a set of reference standards for tibial motor, common peroneal motor, sural sensory, and superficial peroneal sensory nerve conduction studies (NCSs) with expanded uncertainty in a healthy Korean population.
Methods Standardized procedures were conducted for individual lower extremity NCSs of 199 healthy participants in their 20s (n=100) and 50s (n=99). Mean values and expanded uncertainties for parameters were analyzed with thorough consideration of multiple uncertainty factors under the International Guide to the Expression of Uncertainty in Measurement. In addition, side-to-side differences in onset latency, amplitude, and nerve conduction velocity (NCV) were analyzed.
Results Mean (reference range) for distal onset latency, baseline to negative peak amplitude, NCV of tibial motor nerve in males in their 20s were 4.3 ms (3.1–5.4 ms), 7.1 mV (3.4–10.9 mV), and 50.7 m/s (42.2–59.3 m/s), respectively; sural sensory nerve baseline to negative peak amplitude in males in their 20s was 21.7 μV (8.3–35.2 μV). Including the aforementioned data, we present a vast dataset of normative mean values and expanded uncertainties for NCSs of the leg in a healthy Korean population. Furthermore, upper limits for normal side-to-side differences for onset latency, amplitude, and NCV of each nerve are suggested.
Conclusion To our knowledge, this is the first study to present the reference standards of leg NCSs with consideration for multifactorial uncertainties in an Asian population. We expect these results to help practitioners make reliable and reproducible clinical decisions.
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