Raymond Chou, MD

All Publications

• Prevalence of and risk factors associated with ulnar neuropathy at the elbow in wheelchair-dependent individuals with paraplegia. Spinal cord Chou, R., Lui, B., Wong, H. J., Koltsov, J. C., Shem, K. 2026

  Abstract

  Cross-sectional analysis of baseline data of a prospective cohort study.To determine the prevalence of ulnar neuropathy at the elbow (UNE) and identify risk factors associated with UNE in wheelchair-dependent individuals with paraplegia.Regional outpatient spinal cord injury clinic in San Jose, CA, USA.Wheelchair-dependent individuals with paraplegia completed a questionnaire documenting symptomatology and possible activities contributing to UNE, such as hooking over the wheelchair handle, prolonged elbow leaning, and repetitive elbow flexion. Nerve conduction studies (NCS) of the median and ulnar nerves of the bilateral upper limbs were obtained. UNE was defined based on the motor NCS with an above-elbow to below-elbow segment conduction velocity slowing greater than 10 m/s than the below-elbow to wrist segment conduction velocity.The prevalence of UNE in wheelchair-dependent individuals with paraplegia was 16% (8/49). Frequent hooking over the wheelchair handle (p = 0.05) and frequent elbow bending during transfers or weight shifts (p = 0.04) were associated with UNE. UNE was not significantly associated with age, time since spinal cord injury, or presence of pain and/or paresthesia in the ulnar nerve distribution.Transfers or weight shifts that involve hooking or repetitive elbow flexion may be modifiable risk factors for UNE specific to wheelchair-dependent individuals with paraplegia.

  View details for DOI 10.1038/s41393-026-01176-3

  View details for PubMedID 41741692

  View details for PubMedCentralID 7735619

• Finger growth plate injuries in adolescent sport climbers: A scoping review. PM & R : the journal of injury, function, and rehabilitation Jaini, A., Lu, J., Smuek, A., Chou, R. 2025

  Abstract

  This scoping review aims to better characterize finger growth plate injuries in adolescent sport climbers and to create a diagnostic and management algorithm for adolescent climbers after a finger growth plate injury. PubMed, EMBASE, and ScienceDirect databases were queried to identify articles from database inception to July 2024 for inclusion. The following search terms were used: (epiphys* OR physis OR physeal OR metaphys* OR "growth plate*") AND (climb*). Studies that examined adolescent sport climbers with a diagnosis of finger growth plate injury were included. Demographic and clinical information, injury characteristics, imaging and treatment modalities, and outcome data were extracted and pooled from all included studies. Eleven studies were included. In total, 149 physeal stress injuries occurred in 98 adolescent climbers with a mean age of 14years and range of 10 to 18years. A total of 146 injuries (98%) occurred at the proximal interphalangeal joint. Of these injuries, 74% were fractures, of which 97% occurred at the epiphysis. Baseline radiograph was the most used imaging modality for initial diagnosis of fracture. Treatment ranged from complete rest (21%) to surgical intervention (8%). Overall, return to sport time ranged from 2weeks to 6months, and 91% were able to return to climbing. Epiphyseal fractures are the most common growth plate injury reported in adolescent climbers. Identification of these injuries with clinical history and timely diagnostic imaging is critical to return to sport.

  View details for DOI 10.1002/pmrj.70068

  View details for PubMedID 41424400

• Two rotational traction techniques for treating dynamic median, ulnar, and radial compressive neuropathies at the elbow: Theoretical implications and ultrasonographic correlations. Journal of hand therapy : official journal of the American Society of Hand Therapists Chou, R., Gordon, C., Kenney, D., Curtin, C. 2025

  View details for DOI 10.1016/j.jht.2025.09.004

  View details for PubMedID 41253576

• Clinical Efficacy of Pulsed Electromagnetic Field Therapy on Thumb Carpometacarpal Joint Pain: A Double-Blind, Randomized, Controlled Trial. Hand (New York, N.Y.) Durtschi, M. S., Rajakumar, V., Kenney, D. E., Pham, N. S., Ladd, A. L., Chou, R. C. 2025: 15589447251371088

  Abstract

  Thumb carpometacarpal (CMC) osteoarthritis (OA) is a common source of hand pain with limited nonoperative treatment options. Pulsed electromagnetic field (PEMF) therapy has been recently shown in studies to be effective in providing sustained pain relief in knee osteoarthritis. This study aimed to assess the efficacy of PEMF therapy for treating thumb CMC OA pain.This single-center, double-blind, randomized controlled trial included adults with radiographically and/or clinically diagnosed CMC OA who reported an average Numeric Pain Rating Scale (NPRS) score between 3 and 8. Participants were randomized to either a PEMF device or an identical sham device that was used for 8 hours each night for 4 weeks. The primary outcome measure was the change in average daily NPRS from baseline to 4 weeks. Secondary outcome measures included Patient-Rated Wrist/Hand Evaluation (PRWHE) and Single Assessment Numeric Evaluation at 4 and 6 weeks.Sixty-one participants were recruited, and 51 participants completed the study at 4 weeks. Both the PEMF therapy and sham device groups showed improvements in average NPRS and PRWHE at 4 weeks, but there was not a significant improvement between groups. At 6 weeks, there was a significantly greater change in average NPRS from baseline in the PEMF therapy group compared with the sham device group (P = .02).Pulsed electromagnetic field therapy may improve thumb CMC OA pain with sustained relief beyond the treatment period. Future studies will need to assess if adjusting treatment duration or other factors can enhance its efficacy.

  View details for DOI 10.1177/15589447251371088

  View details for PubMedID 41015912

• Diagnostic ultrasonography of upper extremity dynamic compressive neuropathies in athletes: A narrative review. International orthopaedics Nguyen, C., Chou, R. 2025

  Abstract

  This narrative review identifies and summarizes current evidence for diagnostic ultrasonographic evaluation of upper extremity dynamic compressive neuropathies affecting athletes.Relevant literature was identified using the PubMed database and then summarized.The compressive neuropathies affecting athletes we identified included: neurogenic thoracic outlet syndrome, pectoralis minor syndrome, quadrilateral space syndrome, suprascapular nerve entrapment, proximal median nerve entrapment or bicipital aponeurosis/lacertus fibrosus (lacertus syndrome), radial tunnel syndrome, and cubital tunnel syndrome. Symptoms may develop only during specific sport activity, after specific sport-related trauma, or in setting of overuse during sport. Diagnostic ultrasound strategies assessing compressive neuropathies focus on static evaluation of nerves and surrounding structures, as well as dynamic evaluation of these structures in certain degrees of shoulder abduction, elbow flexion, or forearm pronation.Ultrasonography can be used as a diagnostic tool in assessing upper extremity dynamic compressive neuropathies. Ultrasound allows for dynamic evaluation of these rare conditions, especially for athletes who primarily develop symptoms during movement or participation in sport.

  View details for DOI 10.1007/s00264-025-06417-3

  View details for PubMedID 39883178

  View details for PubMedCentralID 2890065

• Ultrasound-guided percutaneous carpal tunnel release: A systematic review. PM & R : the journal of injury, function, and rehabilitation Chou, R. C., Robinson, D. M., Homer, S. 2022

  Abstract

  OBJECTIVE: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment mononeuropathy. The purpose of this systematic review is to evaluate the reported clinical effectiveness and safety of ultrasound-guided percutaneous carpal tunnel release (USCTR) for the treatment of CTS.LITERATURE SURVEY: PubMed, EMBASE, and ScienceDirect databases were queried from database inception to February 20th , 2021 to identify clinical studies on USCTR.METHODOLOGY: Two reviewers independently completed title, abstract, and full-text screening and extracted data in duplicate for analysis. Procedure techniques, outcome measures, and complications were descriptively analyzed.SYNTHESIS: A total of 87 studies were eligible for screening. 20 studies (three randomized controlled trials, three prospective cohort studies, and 14 case series) met inclusion criteria, with a total of 1,772 USCTR cases. The overall level of evidence was very low, with seven studies with at least moderate risk of bias. Thirteen studies exceeded the minimal clinically important difference (MCID) for the Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SS) and Boston Carpal Tunnel Questionnaire Functional Status Scale (BCTQ-FS), and six studies exceeded MCID for the Quick Disabilities of Arm, Shoulder & Hand (QDASH). Five studies reported statistically significant improvement in these functional outcome measures as early as the first week post-procedure. Major complication occurred in one patient who developed suspected compartment syndrome, and minor complications were reported in 24 patients.CONCLUSIONS: Based on very low level of evidence, early studies suggest that USCTR may be an effective treatment for CTS, with potential for short post-procedure recovery times. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1002/pmrj.12801

  View details for PubMedID 35254722

• Effects of hybrid-functional electrical stimulation (FES) rowing whole-body exercise on neurologic improvement in subacute spinal cord injury: secondary outcomes analysis of a randomized controlled trial SPINAL CORD Chou, R. C., Taylor, J., Solinsky, R. 2020; 58 (8): 914-920

  Abstract

  Secondary outcome measures analysis of a randomized, controlled study.To assess the effects of hybrid-functional electrical stimulation (FES) rowing on motor and sensory recovery in individuals with spinal cord injury (SCI) 6-18 months post injury.Outpatient rehabilitation network.25 participants 6-12 months after SCI were randomly assigned to hybrid-FES rowing (n = 10) or standard of care (n = 15) groups. The hybrid-FES rowing group completed 6 months of rowing scheduled 3 times per week for 26 weeks at an exercise intensity of 70-85% of maximal heart rate. The standard of care group either participated in an arm ergometer exercise program (n = 6) or a waitlist without an explicit exercise program (n = 9). Changes in motor score and combined sensory score of the International Standards for Neurological Classification of SCI (ISNCSCI) were analyzed.Both groups demonstrated increases in motor and combined sensory scores, but no significant differences were noted between intervention groups (motor difference mean ↑1.3 (95% CI, -1.9 to 4.4), combined sensory difference mean ↓10 (-30 to 18)). There was an average of 63% adherence to the hybrid-FES rowing protocol, with no significant correlation in changes in motor or combined sensory score in the hybrid-FES rowing group with total distance or time rowed.No significant effects to neurologic improvement were found with hybrid-FES rowing when compared with standard of care interventions in individuals with SCI 6-18 months post injury.

  View details for DOI 10.1038/s41393-020-0445-3

  View details for Web of Science ID 000517314100001

  View details for PubMedID 32094516

  View details for PubMedCentralID PMC7415604