A prognostic model for the patient-reported outcome of surgical treatment of carpal tunnel syndrome

Background: The carpal tunnel syndrome is a neuralgia of the median nerve of the hand caused by permanent pressure which results in sensation and motion disturbances in the area. Principal symptoms include pain in the hand and wrist, numbness and tingling of the fingers, sensation dysfunctions, and finally, the limitation of mobility and manual flexibility of the hand. The discomfort leads to a significant decrease in the patient’s quality of life. In case of carpal tunnel syndrome surgical and non-surgical treatments with selected elements of physiotherapy are applied. Aim of the study: The aim of this study was to present and evaluate possible methods of treatment such as massage therapy and lymphatic drainage as the form of post-surgery treat-ment in carpal tunnel syndrome.Material and methods: The young woman with the carpal tunnel syndrome after the surgical treatment received 50-minute lymphatic drainage (three sessions) and 30-minute therapeutic massage (four sessions). The procedures were performed every two days.Results: After the application of both kinds of massage in appropriate sequence, the following changes have been notified. The swelling in the area of the hand was reduced and the patient reported definite decrease of pain.Conclusions: The massage might be one of the forms of therapy used after surgical treatment in carpal tunnel syndrome, especially when the symptoms occur. It is also often effective with other components of physiotherapy as non-surgical treatment.

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Assessment of Validity, Reliability, Responsiveness and Bias of Three Commonly Used Patient-Reported Outcome Measures in Carpal Tunnel Syndrome

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/15093492.1005085 ◽

2012 ◽

Vol 14 (4) ◽

pp. 4-4 ◽

Cited By ~ 15

Author(s):

H Bakhsh ◽

I Ibrahim ◽

WS Khan ◽

P Smitham ◽

N Goddard

Keyword(s):

Carpal Tunnel Syndrome ◽

Outcome Measures ◽

Carpal Tunnel ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Patient Reported ◽

Tunnel Syndrome

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Incorporation of the experience of patients in the development of a patient-reported outcome measures (PROM) for carpal tunnel syndrome

Acta Neurochirurgica ◽

10.1007/s00701-013-1708-y ◽

2013 ◽

Vol 155 (6) ◽

pp. 1057-1067

Author(s):

Ronald H. M. A. Bartels ◽

Hieronymus Boogaarts ◽

Gert Westert

Keyword(s):

Carpal Tunnel Syndrome ◽

Outcome Measures ◽

Carpal Tunnel ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Patient Reported ◽

Tunnel Syndrome

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The Effect of Hand Dominance on Patient-Reported Outcomes of Carpal Tunnel Release in Patients with Bilateral Carpal Tunnel Syndrome

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s0218810417500344 ◽

2017 ◽

Vol 22 (03) ◽

pp. 303-308

Author(s):

Qian Ying TANG ◽

Wei Hong LAI ◽

Shian Chao TAY

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Complete Resolution ◽

Carpal Tunnel Release ◽

Patient Reported Outcome ◽

Dominant Hand ◽

Hand Dominance ◽

Significant Difference ◽

Patient Reported ◽

Tunnel Syndrome

Background: There is a paucity of studies in published literature that examines the effect of hand dominance on the resolution of symptoms following a carpal tunnel release. The objective of this study is to examine the effect of hand dominance on the resolution of symptoms following surgical decompression in patients with severe and moderate carpal tunnel syndrome. Methods: Bilateral carpal tunnel release (total 90 open and 84 endoscopic) was performed on 87 patients (11 males, 76 females) presenting with bilateral severe or moderate carpal tunnel syndrome of equal severity. Patient-reported outcome of resolution of symptoms were recorded, with patients followed up until complete resolution of symptoms or last recorded consultation (mean follow-up duration 11.4 months, range 3.1 to 32.4 months). Results: In patients with bilateral severe carpal tunnel syndrome, a larger proportion of non-dominant hand (75.4%) achieved complete resolution compared to dominant hand (72.1%), and did so at a statistically shorter time (mean: 52.3 days) than the dominant hand (mean: 81.0 days). However, there was no statistically significant difference between proportion of patients and time taken before complete resolution of symptoms between dominant and non-dominant hand in patients with bilateral moderate carpal tunnel syndrome. Conclusions: Symptoms in the non-dominant hand resolved faster after carpal tunnel release in patients with severe carpal tunnel syndrome. We postulate that greater daily activity by the dominant hand compared to the non-dominant hand may be a contributing factor to its slower rate of symptoms resolution post-surgically in patients with bilateral severe carpal tunnel syndrome. This effect of hand dominance is not evident in post-surgical patients with moderate carpal tunnel syndrome.

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Long-term result and patient reported outcome of wrist splint treatment for Carpal Tunnel Syndrome

Journal of Plastic Surgery and Hand Surgery ◽

10.3109/2000656x.2013.837392 ◽

2013 ◽

Vol 48 (3) ◽

pp. 175-178 ◽

Cited By ~ 9

Author(s):

Bo Povlsen ◽

Muhammad Bashir ◽

Fabian Wong

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Patient Reported Outcome ◽

Term Result ◽

Patient Reported ◽

Long Term Result ◽

Tunnel Syndrome ◽

Wrist Splint

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Outcome Metrics in the Treatment of Carpal Tunnel Syndrome: A Systematic Review

Hand ◽

10.1177/1558944720949951 ◽

2020 ◽

pp. 155894472094995

Author(s):

Kevin Mertz ◽

Sarah E. Lindsay ◽

Arden Morris ◽

Robin N. Kamal

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Final Analysis ◽

Patient Reported Outcome ◽

Patient Centered ◽

Patient Reported ◽

Tunnel Syndrome ◽

Level I ◽

Meta Analyses

Background: The purpose of this systematic review was to determine the metrics used to assess outcomes after treatment for carpal tunnel syndrome. Methods: We performed a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of level I and II randomized controlled trials of treatment for carpal tunnel syndrome. We searched the PubMed/MEDLINE electronic database for studies on treatment of carpal tunnel syndrome from January 2008 to January 2018. A total of 105 studies were included in the final analysis. The metrics used to assess outcomes in each studies were collected, compared, and described. Results: Nearly all the studies used a patient-reported outcome measure (PROM) to assess outcomes (94%). The most common PROMs used were the Boston Carpal Tunnel Questionnaire (60%) and the Visual Analog Scale for pain (51%). Electrophysiological testing and physical examination were also commonly used to assess outcomes (50% and 46%, respectively). Cost, sleep, and return to activities of daily living were assessed in a minority of studies (1%, 1%, and 5%, respectively). Conclusions: Successful treatment of carpal tunnel syndrome is commonly defined based on a PROM, highlighting recent efforts to measure outcomes from the patient’s perspective. Other patient-centered metrics such as return to work and sleep quality, however, were rarely reported, whereas objective measures such as nerve conduction studies were prevalent. Further work is needed to determine patients’ preferred method of measuring outcomes after treatment for carpal tunnel syndrome to inform goal-directed decision-making and treatment.

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Evaluation of PROMIS Outcomes for Surgical Treatment of Cubital Tunnel Syndrome With and Without Carpal Tunnel Syndrome

Hand ◽

10.1177/15589447211028921 ◽

2021 ◽

pp. 155894472110289

Author(s):

Amy Phan ◽

Warren Hammert

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Postoperative Period ◽

Cubital Tunnel Syndrome ◽

Cubital Tunnel ◽

Measurement Information ◽

Level Of Evidence ◽

Patient Reported ◽

Tunnel Syndrome ◽

Measurement Information System

Background: Assessment of outcomes for cubital tunnel syndrome (CuTS) surgeries has been difficult due to heterogeneity in outcome reporting. Our objective was to evaluate the outcomes for 2 cohorts treated surgically for isolated CuTS and for combined CuTS and carpal tunnel syndrome (CTS) using Patient Reported Outcomes Measurement Information System (PROMIS). Methods: There were 29 patients in the isolated CuTS cohort and 30 patients in the combined CuTS and CTS cohort. PROMIS Physical Function (PF), Pain Interference (PI), Depression, and Upper Extremity (UE) were completed preoperatively and 1-week, 6-weeks, and 3-months postoperatively. Responsiveness was evaluated by standardized response means (SRM). Results: Significant improvements from the 1-week to 6-week postoperative period are shown in the isolated CuTS cohort for PROMIS PF ( P = .002), PI ( P = .0002), and UE ( P = .02), but scores plateau after 6-weeks postoperatively. A similar pattern for the same time points was seen for the combined CuTS and CTS group for PROMIS PF ( P = .001), PI ( P = .02), and UE ( P = .04), with a plateau of scores beyond 6 weeks postoperatively. PROMIS UE was more responsive (SRM range: 0.11-1.03) than the PF (SRM range: 0.02-0.52) and PI (SRM range: 0.11-0.40), which were both mildly responsive for both cohorts. Conclusions: PROMIS lacks the sensitivity to show improvement beyond 6-weeks postoperatively for both isolated CuTS and combined CuTS and CTS. Patients with combined nerve compressions follow similar trajectories in the postoperative period as those with isolated CuTS. Level of Evidence: Level IV.

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