Italian multicentre study of carpal tunnel syndrome: study design

1998 ◽  
Vol 19 (5) ◽  
pp. 285-289 ◽  
Author(s):  
L. Padua ◽  
R. Padua ◽  
M. LoMonaco ◽  
E. Romanini ◽  
P. Tonali ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Multicentre Study ◽  
Study Design ◽  
Carpal Tunnel ◽  
Tunnel Syndrome

Italian Multicentre Study of Carpal Tunnel Syndrome

1999 ◽  
Vol 24 (5) ◽  
pp. 579-582 ◽  
Author(s):  
L. PADUA ◽  
R. PADUA ◽  
I. APRILE ◽  
P. TONALI
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Multicentre Study ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Study Group ◽  
Men And Women ◽  
Neurophysiological Data ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Two Populations

The Italian Carpal Tunnel Syndrome Study Group has carried out a multicentre study on 1123 hands with idiopathic carpal tunnel syndrome. We have compared the findings on clinical examination, the neurophysiological data and a patient-oriented assessment in men and women. The patient-oriented assessment showed that men complain of less discomfort than women; clinical examination was similar in the two populations and neurophysiological investigations showed greater changes in men.

scholarly journals Effect of custom-made and prefabricated orthoses on grip strength in persons with carpal tunnel syndrome

2013 ◽  
Vol 38 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Maja Mlakar ◽  
Nerrolyn Ramstrand ◽  
Helena Burger ◽  
Gaj Vidmar
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Study Design ◽  
Carpal Tunnel ◽  
Clinical Relevance ◽  
Neutral Position ◽  
Wrist Position ◽  
Affected Side ◽  
Custom Made ◽  
Tunnel Syndrome

Background: Based on the literature, patients with carpal tunnel syndrome are suggested to wear a custom-made wrist orthosis immobilizing the wrist in a neutral position. Many prefabricated orthoses are available on the market, but the majority of those do not assure neutral wrist position. Objectives: We hypothesized that the use of orthosis affects grip strength in persons with carpal tunnel syndrome in a way that supports preference for custom-made orthoses with neutral wrist position over prefabricated orthoses. Study design: Experimental. Methods: Comparisons of grip strength for three types of grips (cylindrical, lateral, and pinch) were made across orthosis types (custom-made, prefabricated with wrist in 20° of flexion, and none) on the affected side immediately after fitting, as well as between affected side without orthosis and nonaffected side. Results: Orthosis type did not significantly affect grip strength ( p = 0.661). Cylindrical grip was by far the strongest, followed by lateral and pinch grips ( p < 0.050). The grips of the affected side were weaker than those of the nonaffected side ( p = 0.002). Conclusions: In persons with carpal tunnel syndrome, neither prefabricated orthoses with 20° wrist extension nor custom-made wrist orthoses with neutral wrist position influenced grip strength of the affected hand. Compared to the nonaffected side, the grips of the affected side were weaker. Clinical relevance The findings from this study can be used to guide application of orthoses to patients with carpal tunnel syndrome.

scholarly journals Progesterone - new therapy in mild carpal tunnel syndrome? Study design of a randomized clinical trial for local therapy

2014 ◽  
Vol 05 (01) ◽  
pp. e124-e130 ◽  
Author(s):  
Paolo Milani ◽  
Mauro Mondelli ◽  
Federica Ginanneschi ◽  
Riccardo Mazzocchio ◽  
Alessandro Rossi
Keyword(s):  
Clinical Trial ◽  
Carpal Tunnel Syndrome ◽  
Randomized Clinical Trial ◽  
Study Design ◽  
Carpal Tunnel ◽  
Local Therapy ◽  
New Therapy ◽  
Tunnel Syndrome

Local Effects of Acupuncture on the Median and Ulnar Nerves in Patients with Carpal Tunnel Syndrome (CTS): Study Design and Preliminary Results

2014 ◽  
Vol 20 (5) ◽  
pp. A42-A42
Author(s):  
Alexandra Dimitrova ◽  
Jau-Shin Lou ◽  
Sarah Andrea ◽  
Yunpeng Luo ◽  
Charles Murchison ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Study Design ◽  
Carpal Tunnel ◽  
Local Effects ◽  
Preliminary Results ◽  
Tunnel Syndrome

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

Clinical Update: Understanding Causation: An Example Using Carpal Tunnel Syndrome

2007 ◽  
Vol 12 (6) ◽  
pp. 5-8 ◽  
Author(s):  
J. Mark Melhorn
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Legal Responsibility ◽  
Medical Evidence ◽  
Anatomic Structure ◽  
Legal Professionals ◽  
Compensation Systems ◽  
Tunnel Syndrome ◽  
Four Levels

Abstract Medical evidence is drawn from observation, is multifactorial, and relies on the laws of probability rather than a single cause, but, in law, finding causation between a wrongful act and harm is essential to the attribution of legal responsibility. These different perspectives often result in dissatisfaction for litigants, uncertainty for judges, and friction between health care and legal professionals. Carpal tunnel syndrome (CTS) provides an example: Popular notions suggest that CTS results from occupational arm or hand use, but medical factors range from congenital or acquired anatomic structure, age, sex, and body mass index, and perhaps also involving hormonal disorders, diabetes, pregnancy, and others. The law separately considers two separate components of causation: cause in fact (a cause-and-effect relationship exists) and proximate or legal cause (two events are so closely related that liability can be attached to the first event). Workers’ compensation systems are a genuine, no-fault form of insurance, and evaluators should be aware of the relevant thresholds and legal definitions for the jurisdiction in which they provide an opinion. The AMA Guides to the Evaluation of Permanent Impairment contains a large number of specific references and outlines the methodology to evaluate CTS, including both occupational and nonoccupational risk factors and assigning one of four levels of evidence that supports the conclusion.

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