COMPARATIVE RESPONSIVENESS OF JAPANESE VERSIONS OF THE DASH AND SF-36 QUESTIONNAIRES AND PHYSICAL MEASUREMENT TO CLINICAL CHANGES AFTER CARPAL TUNNEL RELEASE

Hand Surgery ◽  
2006 ◽  
Vol 11 (01n02) ◽  
pp. 27-33 ◽  
Author(s):  
Toshihiko Imaeda ◽  
Hitoshi Hirata ◽  
Satoshi Toh ◽  
Yasushi Nakao ◽  
Jun Nishida ◽  
...  
Keyword(s):  
Carpal Tunnel ◽  
Short Form ◽  
Carpal Tunnel Release ◽  
Objective Assessment ◽  
Pinch Strength ◽  
Medical Outcomes ◽  
Physical Measurements ◽  
Sf 36 ◽  
Tunnel Syndrome ◽  
Clinical Changes

The purpose of the present study was to test the responsiveness of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder and Hand questionnaire (DASH-JSSH) by evaluating effect size (ES) and standardised response mean (SRM) in patients undergoing carpal tunnel release. Subjects comprised 25 patients with carpal tunnel syndrome. All subjects completed the DASH-JSSH, medical outcomes 36-item short-form health survey (SF-36) and visual analogue scale (VAS) for pain and underwent objective assessment of grip strength, pinch strength and static two-point discrimination before and three months after surgery. DASH-JSSH displayed the highest sensitivity to changes at three months, followed by VAS. All subscales of SF-36 were much less sensitive and both grip and pinch strength were unchanged over the three-month period. DASH-JSSH demonstrated more responsiveness to changes after carpal tunnel release than SF-36, VAS and physical measurements, and displayed correlations with subscales of SF-36.

The Relative Responsiveness and Construct Validity of the Spanish Version of the Dash Instrument for Outcomes Assessment in Open Carpal Tunnel Release

2008 ◽  
Vol 34 (1) ◽  
pp. 72-75 ◽  
Author(s):  
R. S. ROSALES ◽  
I. DIEZ DE LA LASTRA ◽  
S. MCCABE ◽  
J. I. ORTEGA MARTINEZ ◽  
Y. M. HIDALGO
Keyword(s):  
Construct Validity ◽  
Carpal Tunnel ◽  
Short Form ◽  
Carpal Tunnel Release ◽  
Physical Exam ◽  
Spanish Version ◽  
Pinch Strength ◽  
Sf 36 ◽  
Study Population ◽  
Open Carpal Tunnel Release

The objective of this study was to evaluate the responsiveness and construct validity of the Spanish version of the DASH as outcome measure for carpal tunnel surgery. The study population was 42 patients with the diagnosis of carpal tunnel syndrome (CTS) based on clinical and electrophysiological criteria. The clinical design was a classic Cohort study with measures the day before and 12 weeks after open carpal tunnel release. The Spanish version of the DASH was compared to the physical exam measures as dexterity time, grip and pinch strength, range of motion of the wrist (ROM) and two-point discrimination (2PPD). The responsiveness was evaluated based on the effect size (ES) and the standardised response means (SRM). The Spanish version of the CTS questionnaire (CTQ) and the Spanish version of the 36-item short-form health survey (SF-36) were self-administered to the same study population and followed the same clinical design. The hypothesis that the DASH instrument should present a responsiveness level higher than the SF-36 and lower than the CTQ was established to demonstrate the construct validity. The DASH instrument showed an ES of 0.68 and an SRM of 1.00. Responsiveness of traditional physical exam measures were lower, running from 0.35 (SRM) for dexterity time to 0.00 (ES) for key pinch strength. The SF-36 presented a responsiveness level (range from 0.07 to 0.14) lower that the DASH. The CTQ showed the highest level of responsiveness (ES = 1.41 and 0.7) (SRM = 1.75 and 0.51). In conclusion, The DASH instrument is more sensitive in detecting clinical change than the physical exam measures for use in clinical outcome studies of CTS done at 12 weeks after surgery. The Spanish DASH showed a responsiveness lower than the CTQ and higher than the SF-36 as a proof of a good construct validity.

The results of carpal tunnel release for carpal tunnel syndrome diagnosed on clinical grounds, with or without electrophysiological investigations: a randomized study

2012 ◽  
Vol 38 (1) ◽  
pp. 44-49 ◽  
Author(s):  
A. Żyluk ◽  
Z. Szlosser
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Randomized Study ◽  
Clinical Importance ◽  
Nerve Conduction Studies ◽  
Pinch Strength ◽  
Tunnel Syndrome ◽  
To Receive

We compared the results of carpal tunnel release in patients with the diagnosis of carpal tunnel syndrome based on only clinical grounds and those diagnosed on clinical and electrophysiological grounds. Ninety-three patients, 83 women (89%) and ten men (11%), meeting the criteria of ‘typical’ carpal tunnel syndrome, were randomly assigned to receive carpal tunnel release with ( n = 45, 48%) or without ( n = 48, 52%) nerve conduction studies. Patients were followed-up at 1 and 6 months, by assessments that included the Levine scores, filament tests, grip and pinch strength. No significant differences in Levine scores were found at the 1 and 6 months assessments. Statistically significant differences were noted in three-point pinch strength and sensation; however, they were not of clinical importance. The results of the study show that the results of carpal tunnel release in patients with typical symptoms are no better after nerve conduction studies and, therefore, nerve conduction studies can be omitted.

scholarly journals Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome

2021 ◽  
Author(s):  
Masato Ise ◽  
Taichi Saito ◽  
Yoshimi Katayama ◽  
Ryuichi Nakahara ◽  
Yasunori Shimamura ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Clinical Outcomes ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Characteristic Curve ◽  
Objective Assessment ◽  
Cutoff Score ◽  
Tunnel Syndrome

Abstract Background:Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS.Methods:Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement.Results:The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6–12 months, r = 0.67; 0–12 months, r = 0.60) and DASH (0–12 months, r = 0.77). Moreover, postoperative DML correlated with the change in DASH (6–12 months, r = -0.33; 0–12 months, r = -0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below.Conclusions:NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS.

A comparison of outcomes of carpal tunnel release for carpal tunnel syndrome in patients diagnosed with and without electrophysiological studies

2017 ◽  
Vol 49 (05) ◽  
pp. 304-308
Author(s):  
Piotr Puchalski ◽  
Andrzej Zyluk ◽  
Zbigniew Szlosser
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Clinical Findings ◽  
Pinch Strength ◽  
Electrophysiological Studies ◽  
Tunnel Syndrome

AbstractRecords were analysed from the institutional database, including 943 patients (1089 hands) with CTS who were operated on in the authors’ department over a period of four years (2012 to 2015). The diagnosis of CTS was made solely on the basis of clinical findings in 551 patients (58 %); 392 patients (42 %) also had electrodiagnostic tests performed, for various reasons. Patients were followed-up at 1 and 6 months with assessments that included the Levine scores, filament tests, grip and pinch strength. No significant differences in Levine scores were found at the 1 and 6 month assessments. Statistically significant differences were noted in 3-point pinch strength and sensation: however, these were not clinically meaningful. The results of the study show that the results of carpal tunnel release in patients with typical symptoms are no better after electrodiagnostic tests.

Ultrasound of the Median Nerve in the Surgical Treatment of Severe Carpal Tunnel Syndrome

Hand ◽  
2021 ◽  
pp. 155894472098807
Author(s):  
William Melton ◽  
Maximillian Soong ◽  
Gabrielle Paci ◽  
Brian Clair ◽  
Dayana Blanchet ◽  
...  
Keyword(s):  
High Resolution ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Statistical Significance ◽  
Objective Assessment ◽  
Boston Carpal Tunnel Questionnaire ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Background High-resolution ultrasound (HRU) has demonstrated utility in the diagnosis and treatment of carpal tunnel syndrome (CTS) by measuring the cross-sectional area (CSA) of the median nerve. We investigated whether HRU could be helpful in evaluating outcomes of carpal tunnel release in patients with severe CTS. Methods Patients greater than 18 years of age with severe CTS on electrodiagnostic (EDX) studies and scheduled to have carpal tunnel release were enrolled. At baseline visit within 6 weeks preoperatively, HRU was used to measure median nerve CSA at the carpal tunnel inlet and forearm, and the wrist/forearm ratio (WFR) was calculated. Patients also completed the Boston Carpal Tunnel Questionnaire (BCTQ). Ultrasound and BCTQ were repeated at 6 weeks and 6 months postoperatively. Results Twelve patients completed the study (average age, 69 years; range, 52-80 years). The WFR improved significantly at 6 weeks and reached normal levels at 6 months. The CSA at the wrist also improved at 6 months, although this did not reach statistical significance ( P = .059). Boston Carpal Tunnel Questionnaire symptoms and function scores improved significantly at 6 weeks and 6 months. Conclusions High-resolution ultrasound provides an objective assessment of surgical outcomes in cases of severe CTS, demonstrating normalization of WFR in our series of successful cases. Future study of poor outcomes may help determine whether improvement in WFR and CSA can provide reassurance and support for observation rather than reoperation. Ultrasound also provides anatomical evaluation and may be helpful in cases with medicolegal or psychosocial issues while potentially being less costly and better tolerated than EDX or magnetic resonance imaging.

Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

2017 ◽  
Vol 22 (03) ◽  
pp. 275-280 ◽  
Author(s):  
Claire Marie Durban ◽  
Bernard Antolin ◽  
Chung Ying Sau ◽  
Sheung Wai Li ◽  
Wing Yuk Ip
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pinch Strength ◽  
Muscle Recovery ◽  
Abductor Pollicis Brevis ◽  
Palmaris Longus ◽  
Contralateral Hand ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Background: Various techniques of opponensplasty have been developed with the aim of restoring the thumb function. The modified Camitz opponensplasty is a simple technique done together with an open carpal tunnel release. It restores thumb palmar abduction soon after the procedure, during such time that the abductor pollicis brevis (APB) is still recovering. The aim of this study was to assess the recovery and level of activity of the abductor pollicis brevis and palmaris longus (PL) muscles during thumb opposition and abduction after performing the modified Camitz opponensplasty. Methods: The records of 21 patients who underwent modified Camitz opponensplasty for severe carpal tunnel syndrome were reviewed. Thumb function was evaluated using the Van Wetter Apogee test, Kapandji index, tripod pinch strength, and power grip. Electromyography was utilized to evaluate APB recovery; ultrasonography was employed to evaluate PL activity. Results: Twenty patients reached 80% of the abduction height of the contralateral hand; the Kapandji index was good in thirteen. Palmaris longus activity was evaluated together with the APB muscle recovery. There was significant improvement in the average grip strength and average tripod pinch strength. However, this did not correlate with the degree of neurologic and muscular recovery of the APB. We surmise that the palmaris longus augmented the abductor pollicis brevis muscle even in those with full muscle recovery. Conclusions: The modified Camitz opponensplasty is a practical option for patients suffering from severe carpal tunnel syndrome with diminished thumb function.

scholarly journals A Prospective, Randomized Trial Comparing Open and Endoscopic Carpal Tunnel Release Within the Same Patient

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 322-326 ◽  
Author(s):  
Brett M. Michelotti ◽  
Kavita T. Vakharia ◽  
Diane Romanowsky ◽  
Randy M. Hauck
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Carpal Tunnel Release ◽  
Demographic Data ◽  
Pinch Strength ◽  
Postoperative Time ◽  
Tunnel Syndrome ◽  
A Prospective Study

Background: Surgical management of carpal tunnel syndrome includes performing an endoscopic (ECTR) or open (OCTR) carpal tunnel release. Several studies have shown less postoperative pain and improvement in grip and pinch strength with the endoscopic technique. The goal of this study was to prospectively examine outcomes, patient satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient. Methods: This was a prospective study in which patients with bilateral carpal tunnel syndrome underwent surgical release with both techniques, with initial operative approach randomized in the more symptomatic hand. Demographic data and functional outcomes were recorded, including the pain score, 2-point discrimination, Semmes-Weinstein monofilament testing, thenar strength testing, grip strength, carpal tunnel syndrome functional status score, carpal tunnel syndrome symptom severity score, and overall satisfaction. Results: Thirty patients completed the study; there were no significant differences in any measure at any of the postoperative time points. Symptom severity and functional status scores were not significantly different between groups at any evaluation. Subjectively, 24 of 30 patients did state they preferred the ECTR, mostly citing less pain as their primary reason, although pain scores were not significantly different. Differences in overall satisfaction were also not significant. Conclusions: Both techniques are well tolerated with no differences in outcomes. With the added cost and equipment associated with ECTR, and no added benefit, the usefulness of ECTR is questionable.

scholarly journals Thermography in the diagnosis of carpal tunnel syndrome

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 175-182
Author(s):  
Piotr Bargiel ◽  
Norbert Czapla ◽  
Piotr Prowans ◽  
Daniel Kotrych ◽  
Paweł Ziętek ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Objective Assessment ◽  
Clinical Image ◽  
Control Group ◽  
List Type ◽  
Electrodiagnostic Testing ◽  
Tunnel Syndrome ◽  
Dynamic Thermography

Abstract Introduction Carpal tunnel syndrome (CTS) is a condition caused by chronic compression of the median nerve. The diagnosis is made mainly on the basis of clinical image and confirmed with electrodiagnostic testing (electromyography and nerve conduction study); however, these methods do not always aid in reaching the diagnosis of CTS. Moreover, they are invasive examinations, unpleasant for the patient and have to be performed by a qualified physician. Aim An evaluation of the usefulness of dynamic thermography in the diagnosis of CTS. Material and methods Forty patients were included in the study group. CTS was diagnosed based on clinical examination and electromyography. Forty healthy volunteers were included in the control group. Each of the participants was examined thrice with dynamic thermography. The patient’s hands were first cooled down and then a thermal camera measured their return to normal temperature. The measurement was repeated on the dorsal and volar aspects of each hand. Results The results obtained in the study show that a relief of symptoms after carpal tunnel release does not correlate with thermal image. Moreover, the return to normal hand temperature was faster in the control group. In patients with unilateral CTS, no difference was observed in thermographic images of the affected and healthy hands. Conclusions Dynamic thermography can be useful in confirming CTS diagnosis. Dynamic thermography does not allow for objective assessment of patient’s complaints in the postoperative period. This method has currently limited clinical application. Due to complexity, it presently serves mainly scientific purposes.

The effect of the involvement of the dominant or non-dominant hand on grip/pinch strengths and the Levine score in patients with carpal tunnel syndrome

2011 ◽  
Vol 37 (5) ◽  
pp. 427-431 ◽  
Author(s):  
A. Żyluk ◽  
I. Walaszek
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
Outcome Measurement ◽  
Carpal Tunnel Release ◽  
Pinch Strength ◽  
Dominant Hand ◽  
Before And After ◽  
Tunnel Syndrome

The Levine questionnaire is a disease-oriented instrument developed for outcome measurement of carpal tunnel syndrome (CTS) management. The objective of this study was to compare Levine scores in patients with unilateral CTS, involving the dominant or non-dominant hand, before and after carpal tunnel release. Records of 144 patients, 126 women (87%) and 18 men (13%) aged a mean of 58 years with unilateral CTS, treated operatively, were analysed. The dominant hand was involved in 100 patients (69%), the non-dominant in 44 (31%). The parameters were analysed pre-operatively, and at 1 and 6 months post-operatively. A comparison of Levine scores in patients with the involvement of the dominant or non-dominant hand showed no statistically significant differences at baseline and any of the follow-up measurements. Statistically significant differences were noted in total grip strength at baseline and at 6 month assessments and in key-pinch strength at 1 and 6 months.

Comparative responsiveness of the Hand 20 and the DASH-JSSH questionnaires to clinical changes after carpal tunnel release

2013 ◽  
Vol 39 (2) ◽  
pp. 145-151 ◽  
Author(s):  
K. Iwatsuki ◽  
K. Nishikawa ◽  
M. Chaki ◽  
A. Sato ◽  
A. Morita ◽  
...  
Keyword(s):  
Carpal Tunnel ◽  
Effect Size ◽  
Carpal Tunnel Release ◽  
Japanese Version ◽  
Standardized Response Mean ◽  
Tunnel Syndrome ◽  
Effect Of Treatment ◽  
Clinical Changes ◽  
Open Carpal Tunnel Release ◽  
Hand Scale

This study compared the responsiveness of the Hand 20 and the Japanese version of the disabilities of the arm, shoulder and hand (DASH-JSSH) questionnaires in carpal tunnel syndrome. The scores before and 3 months after surgery were used to calculate the standardized response mean and effect size. Of 57 patients enrolled in the study, 13 underwent open carpal tunnel release and 44 had endoscopic carpal tunnel release. The standardized response mean and the effect size of the Hand 20 scale were 0.60 and 0.54, respectively, and those of the disabilities of the arm, shoulder and hand scale were 0.39 and 0.36, respectively. Compared with the Disabilities of the Arm, Shoulder and Hand questionnaire, the Hand 20 questionnaire appears to have better responsiveness for assessing the effect of treatment by carpal tunnel release.

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