Reply to: Revisiting the Functional Status Scale of the Boston Carpal Tunnel Questionnaire, a comment concerning the use of digital communication technology

Background and Aims: The Boston Carpal Tunnel Questionnaire is the most commonly used outcome measure in the assessment of carpal tunnel syndrome. The purpose of this study was to translate the original Boston Carpal Tunnel Questionnaire into Finnish and validate its psychometric properties. Materials and Methods: We translated and culturally adapted the Boston Carpal Tunnel Questionnaire into Finnish. Subsequently, 193 patients completed the Finnish version of the Boston Carpal Tunnel Questionnaire, 6-Item CTS Symptoms Scale, and EuroQol 5 Dimensions 12 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire was re-administered after a 2-week interval. We calculated construct validity, internal consistency, test–retest reliability, and coefficient of repeatability. We also examined floor and ceiling effects. Results: The cross-cultural adaptation required only minor modifications to the questions. Both subscales of the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Functional Status Scale) correlated significantly with the CTS-6 and EuroQol 5 Dimensions, indicating good construct validity. The Cronbach’s alpha was 0.93 for both the Symptom Severity Scale and Functional Status Scale, indicating high internal consistency. Test–retest reliability was excellent, with an intraclass correlation coefficient greater than 0.8 for both scales. The coefficient of repeatability was 0.80 for the Symptom Severity Scale and 0.68 for the Functional Status Scale. We observed a floor effect in the Functional Status Scale in 28% of participants. Conclusion: Our study shows that the present Finnish version of the Boston Carpal Tunnel Questionnaire is reliable and valid for the evaluation of symptom severity and functional status among surgically treated carpal tunnel syndrome patients. However, owing to the floor effect, the Functional Status Score may have limited ability to detect differences in patients with good post-operative outcomes.

Download Full-text

Effectiveness of the Influence of Physical Therapy on the Indicators of the Neurological and Functional Status of the Hand in People with Compression Neuropathy of the Median Nerve as a Postimmobilization Complication of Fractures of the Distal Forearm Bo

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.01.255 ◽

2021 ◽

Vol 6 (1) ◽

pp. 255-262

Author(s):

V. M. Byrchak ◽

Keyword(s):

Physical Therapy ◽

Functional Status ◽

Median Nerve ◽

Carpal Tunnel ◽

Control Group ◽

Distal Forearm ◽

Compression Neuropathy ◽

Boston Carpal Tunnel Questionnaire ◽

Forearm Bones ◽

Carpal Tunnel Questionnaire

The social inconsistency of patients with hand injuries is due to the limitation of the possibilities of professional and labor activity (reduced qualifications, limited opportunities for training and retraining, inability to work in their specialty), which justifies the search for new methods of their rehabilitation. The purpose of the study was to determine the effectiveness of physical therapy on the indicators of the neurological and functional status of the hand in patients with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones. Material and methods. The study involved 56 people with postimmobilization contractures of the wrist joint, complicated by compression neuropathy of the median nerve, as a result of fracture of the bones of the distal forearm. They were divided into two groups: the control group (they practiced according to the principles of polyclinic rehabilitation with a predominance of passive means like manual techniques, preformed physical factors) and the main group (they were engaged in a developed physical therapy program based on the principles of International Classification of Functioning, Disability and Health with a predominance of active means like functional training; massage; warm wet compress combined with post-isometric muscle relaxation, posture treatment; kinesiological taping). The effectiveness of the program was assessed by the presence and degree of pain (VAS and DN4), goniometry results, signs of median nerve irritation (Phalen, Hoffmann-Tinel, Durkan), French Arm Test, ABILIHAND, DASH, Boston carpal tunnel questionnaire. Results and discussion. After the rehabilitation intervention, all examined patients showed a decrease in the intensity of pain at rest and during movement (according to VAS). Signs of compression neuropathy of the median nerve decreased (pain intensity according to the DN4 questionnaire, the prevalence of specific symptoms, the results of a quantitative assessment of the Boston carpal tunnel questionnaire). There was an improvement in the functioning of the upper limb according to the ABILIHAND, DASH, French Arm Test scales. For all the studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p <0.05). However, the patients of the main group showed a better result than the patients of the control group (p <0.05). Conclusion. The developed program of physical therapy with the predominant using of active rehabilitation means revealed a statistically significant better effect on the indicators of the neurological and functional status of the hand in persons with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones

Download Full-text

Retinaculotomía endoscópica de doble portal en el síndrome del túnel carpiano

Revista de la Asociación Argentina de Ortopedia y Traumatología ◽

10.15417/issn.1852-7434.2020.85.4.1062 ◽

2020 ◽

Vol 85 (4) ◽

pp. 349-356

Author(s):

Álvaro C. Ojeda ◽

Víctor A. Contreras ◽

Edgardo S. Sanzana

Keyword(s):

Functional Status ◽

Carpal Tunnel ◽

Symptom Severity ◽

Severity Scale ◽

Symptom Severity Scale ◽

Palabras Clave ◽

Boston Carpal Tunnel Questionnaire ◽

Carpal Tunnel Questionnaire

Objetivo: Evaluar los resultados de la retinaculotomía endoscópica para tratar el síndrome del túnel carpiano mediante la técnica de doble portal de Chow, entre enero de 2006 y diciembre de 2015. Materiales y Métodos: Estudio de 179 pacientes (edad promedio 48.2 años [rango 32-68]), con 217 casos de síndrome del túnel carpiano idiopático y un seguimiento promedio de 97.9 meses. Los pacientes eran 145 mujeres (81%) (31 bilaterales) y 34 hombres (19%) (7 bilaterales) y fueron evaluados con la Symptom Severity Scale (SSS) y la Functional Status Scale (FSS) del Boston Carpal Tunnel Questionnaire (BCTQ). Resultados: El puntaje medio de la SSS-BCTQ fue de 3,20 + 0,26 antes de la cirugía, mejoró a 1,30 + 0,12 a los 6 meses y se mantuvo en 1,25+ 0,11 a largo plazo. El puntaje medio de la FSS-BCTQ fue de 2,57 + 0,29 antes de la cirugía, mejoró a 1,28 + 0,18 a los 6 meses y se mantuvo en 1,20 + 0,09 a largo plazo. Hubo 7 casos (3,2%) de neuropraxia posquirúrgica transitoria. No hubo conversiones a técnica abierta. Conclusión: La liberación endoscópica del túnel carpiano con la técnica de Chow es un método quirúrgico eficaz y seguro para tratar el síndrome del túnel carpiano idiopático. Palabras clave: Síndrome del túnel carpiano; técnica de doble portal de Chow; liberación endoscópica; compresión neural; nervio mediano. Nivel de Evidencia: III

Download Full-text

The experience of using anti-adhesion gel in the surgery for carpal tunnel syndrome

Russian journal of neurosurgery ◽

10.17650/1683-3295-2021-23-3-39-47 ◽

2021 ◽

Vol 23 (3) ◽

pp. 39-47

Author(s):

A. S. Nikitin ◽

I. B. Aleynikova

Keyword(s):

Carpal Tunnel Syndrome ◽

Functional Status ◽

Carpal Tunnel ◽

Control Group ◽

Study Group ◽

Clinical Relapse ◽

Study Objective ◽

Boston Carpal Tunnel Questionnaire ◽

Tunnel Syndrome ◽

Carpal Tunnel Questionnaire

The study objective is to evaluate the effectiveness of anti‑adhesion gel by using in carpal tunnel syndrome surgery.Materials and methods. A prospective study was carried out among 55 patients with carpal tunnel syndrome. All patients were underwent open decompression of the carpal tunnel. Patients of study group (n = 25) got an carboxymethylcellu‑ lose anti‑adhesion gel, which was applied to the nerve before suturing the wound. Patients from control group (n = 30) were underwent surgery without using an anti‑adhesive gel. Before surgery, all patients underwent a clinical neurological examination with an assessment of symptoms according to the Boston Carpal Tunnel Questionnaire, which includes 2 scales: the scale and the functional status scale. The Boston Carpal Tunnel Questionnaire was reevaluated 2.5 years after surgery.Results. In study group the mean symptom severity decreased by 59.5 %, functional status improved by 55.1 %, in control group these indicators were 48.3 and 47.6 %. Clinical relapse of the disease was noted in 8 % of patients of study group and in 20 % of patients of control group.Conclusion. Intraoperative using of an anti‑adhesion gel allows to reduce the frequency of recurrence of carpal tunnel syndrome after surgical decompression.

Download Full-text

Minimal clinically important difference for the Boston Carpal Tunnel Questionnaire: new insights and review of literature

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193418812616 ◽

2018 ◽

Vol 44 (3) ◽

pp. 283-289 ◽

Cited By ~ 11

Author(s):

Floriaan G.C.M. De Kleermaeker ◽

Hieronymus D. Boogaarts ◽

Jan Meulstee ◽

Wim I.M. Verhagen

Keyword(s):

Functional Status ◽

Carpal Tunnel ◽

Symptom Severity ◽

Minimal Clinically Important Difference ◽

Severity Scale ◽

Symptom Severity Scale ◽

Clinically Important Difference ◽

Boston Carpal Tunnel Questionnaire ◽

Scale Scores ◽

Carpal Tunnel Questionnaire

No consensus exists about the minimal clinically important difference for the Boston Carpal Tunnel Questionnaire, which hampers its clinical application. This study assessed the minimal clinically important difference of this questionnaire. The Boston Carpal Tunnel Questionnaire was completed by 180 patients, with clinically defined carpal tunnel syndrome, preoperatively and at about 8 months follow-up after carpal tunnel release, together with a six-point scale for perceived improvement. Receiver operator characteristics curves showed that relative changes in Symptom Severity Scale and Functional Status Scale scores correspond better to a clinically relevant improvement than absolute changes. The minimal clinically important difference should be individually calculated from baseline Symptom Severity Scale and Functional Status Scale scores, as patients experiencing more symptoms require more improvement to notice a clinically important difference. By taking this into account, the Boston Carpal Tunnel Questionnaire is more meaningful as an outcome measure in research and clinical practice.

Download Full-text

Measurement properties of the Boston Carpal Tunnel Questionnaire in subjects with neurophysiological confirmation of carpal tunnel syndrome: a Rasch analysis perspective

Quality of Life Research ◽

10.1007/s11136-021-02860-y ◽

2021 ◽

Author(s):

Camilo Mendoza-Pulido ◽

Fernando Ortiz-Corredor

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Rasch Analysis ◽

Measurement Properties ◽

Boston Carpal Tunnel Questionnaire ◽

Tunnel Syndrome ◽

Carpal Tunnel Questionnaire

Download Full-text

Measurement properties of the Danish version of the Boston Carpal Tunnel Questionnaire

JPRAS Open ◽

10.1016/j.jpra.2021.03.007 ◽

2021 ◽

Vol 29 ◽

pp. 17-25

Author(s):

S.B.M. Sebastian Breddam Mosegaard ◽

M.S. Maiken Stilling ◽

M.B. Marianne Breddam ◽

T.B.H. Torben Bæk Hansen

Keyword(s):

Carpal Tunnel ◽

Measurement Properties ◽

Danish Version ◽

Boston Carpal Tunnel Questionnaire ◽

Carpal Tunnel Questionnaire

Download Full-text

A COMPARISON OF FUNCTIONAL ASSESSMENT OF PRE- AND POSTSURGICAL CARPAL TUNNEL SYNDROME USING BOSTON CARPAL TUNNEL QUESTIONNAIRE AND NERVE CONDUCTION STUDY: A PROSPECTIVE STUDY FROM A TERTIARY CENTER OF SOUTH INDIA

10.36106/gjra/4311387 ◽

2021 ◽

pp. 117-120

Author(s):

Padmapriyadarsini V ◽

Navin K ◽

Abdul Gafoor S ◽

Chitra G

Keyword(s):

Carpal Tunnel Syndrome ◽

Functional Outcome ◽

Conduction Velocity ◽

Carpal Tunnel ◽

Nerve Conduction Study ◽

Electrophysiological Study ◽

Carpal Tunnel Release ◽

Boston Carpal Tunnel Questionnaire ◽

Tunnel Syndrome ◽

Carpal Tunnel Questionnaire

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment syndrome of median nerve causing frequent disability especially among working populations. Boston Carpal Tunnel Questionnaire and Electrophysiological study helps in detecting and aiding in the diagnosis of CTS and helps in determining level of improvement after surgical release of carpal tunnel. OBJECTIVES: To assess functional outcome of patients with Carpal Tunnel Syndrome after surgery as assessed by Boston Carpel Tunnel Questionnaire and Electrophysiological study. METHODS: A prospective observational study conducted over a period of one year (January 2017 to January 2018). The study was conducted among consecutive 31 electrophysiological conrmed carpal tunnel syndrome attending the outpatient department of Physical Medicine and Rehabilitation, Government Medical College, Thiruvananthapuram. All patients underwent open carpal tunnel release. Functional outcome was assessed using Boston Carpal Tunnel Questionnaire (BCTQ) both preoperatively and at interval of 3 weeks, 6weeks and 3 months postoperatively. Electrophysiological study assessed using nerve conduction study both preoperatively and 3 weeks post operatively. Data was entered in Microsoft excel and analyzed using SPSS statistical software. RESULTS: The study involves 31 conrmed cases of Carpal tunnel syndrome patients. Mean Boston Carpal Tunnel Questionnaire (BCTQ) score preoperatively was 58.52 ± 12.73 which was markedly improved postoperatively at 3weeks with mean score of 29.77±6.68. At 6 weeks and 3 month follow up period it was reduced respectively to mean score of 23.94±4.23 and 22.94±4.62. Preoperative NCS shows decreased conduction velocity with mean nerve sensory velocity (NSV) score 21.51±8.19 and mean nerve motor velocity (NMV) score of 20.72±8.81 which statistically improved following surgery with mean NSV score of 32.04±9.01 and mean NML score of 33.78±8.1. Correlation between pre- and post-operative BCTQ and NCS parameters shows positive correlation with latency and negative correlation with amplitude and conduction velocity. Increased latency and decreased conduction velocity associated with higher BCTQ score with signicant 'p' value (p<0.05). CONCLUSION: There is statistically signicant improvement of functional outcome following carpal tunnel release surgery assessed through Boston Carpal Tunnel Questionnaire and Electrophysiological ndings

Download Full-text

Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale: a Rasch analysis one year after surgery

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03626-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Juhani Multanen ◽

Jari Ylinen ◽

Teemu Karjalainen ◽

Joona Ikonen ◽

Arja Häkkinen ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Differential Item Functioning ◽

Carpal Tunnel ◽

Response Category ◽

Structural Validity ◽

Item Functioning ◽

Boston Carpal Tunnel Questionnaire ◽

Tunnel Syndrome ◽

Ordered Response ◽

Carpal Tunnel Questionnaire

Abstract Background The Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among patients who had undergone surgery for treatment of carpal tunnel syndrome. Methods The data for this cross-sectional analysis were obtained from 217 adult patients who had undergone carpal tunnel release surgery 1 year earlier. All patients completed the CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ at 12 months after surgery. The Rasch Measurement Theory (RMT) was applied to investigate the unidimensionality, residual correlation, differential item functioning, scale coverage/targeting, and person separation of the CTS-6, SSS and FSS of the BCTQ. Results The FSS showed unidimensionality and good scale and item fit. All items showed ordered response category thresholds. Eight of the FSS items displayed differential item functioning favoring age or gender. The multidimensional structure of the CTS-6 was absorbed by creating a testlet for frequency of symptoms or testlets for pain and numbness. The testlets supported unidimensionality in the BCTQ SSS. One item in the CTS-6 and two items in the BCTQ SSS showed differential item functioning favoring age or gender. Four items in the BCTQ SSS and two items in the CTS-6 exhibited disordered response category thresholds. Merging of the relevant response categories led to ordered response category thresholds. The person separation indices were 0.73, 0.86 and 0.77 for the CTS-6, BCTQ SSS and FSS, respectively. Conclusions Based on the RMT analysis, the CTS-6 has superior psychometric properties compared to the BCTQ SSS in surgically treated patients. The CTS-6 might be more accurate when separated into item sets measuring pain or numbness. The FSS of the BCTQ has acceptable construct validity, although gender differences at some ages were observed in responses.

Download Full-text