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.

scholarly journals Comparison of the efficacy of a neutral wrist splint and a wrist splint incorporating a lumbrical unit for the treatment of patients with carpal tunnel syndrome

2016 ◽  
Vol 40 (5) ◽  
pp. 617-623 ◽  
Author(s):  
Batol Golriz ◽  
Monireh Ahmadi Bani ◽  
Mokhtar Arazpour ◽  
Mahmood Bahramizadeh ◽  
Sarah Curran ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
T Test ◽  
Pinch Strength ◽  
Before And After ◽  
Quasi Experimental ◽  
Tunnel Syndrome ◽  
Wrist Splint

Background: Different types of splints have been used as a conservative intervention to improve symptoms in patients with Carpal tunnel syndrome (CTS). Although a number of studies have been undertaken to compare different splints, information and understanding of the influence of these interventions are lacking. Objectives: The purpose of this study was to compare the effect of a classic thermoplastic wrist splint or a wrist splint with an additional metacarpophalangeal unit on pain, function, grip strength, and pinch strength in patients with mild-to-moderate carpal tunnel syndrome. Study design: Quasi experimental design. Methods: A total of 24 patients received conservative treatment using either the classic wrist splint or the wrist splint with the metacarpophalangeal unit for a period of 6 weeks. Primary outcome measures were pain, function, grip strength, and pinch strength. Data were collected immediately before and after using the two types of splints at baseline (0 weeks) and 6 weeks. Statistical analysis was performed using the paired t-test and an independent t-test. Results: Compared to baseline, both the classic thermoplastic wrist splint and the wrist splint with a metacarpophalangeal unit significantly decreased pain and increased function, pinch strength, and grip strength. Comparisons of the two types of splints for grip strength ( P = 0.675) and pinch strength ( P = 0.650) revealed that there were no significant differences between the two after 6 weeks of wear. However, there were significant differences in pain levels ( P = 0.022) and the Disability of the Arm, Shoulder, and Hand score ( P = 0.027) between the two types of splints from baseline to 6 weeks. Conclusion: The wrist splint with a metacarpophalangeal unit was more effective than the classic thermoplastic wrist splint in pain reduction and improvement of function. Clinical relevance A wrist splint with a metacarpophalangeal unit may be an appropriate conservative treatment in the rehabilitation of patients with mild-to-moderate carpal tunnel syndrome.

Which Factors Affect the Rate of Surgery Performed in Patients with Carpal Tunnel Syndrome?

2018 ◽  
Vol 23 (04) ◽  
pp. 562-565 ◽  
Author(s):  
Yo-Han Lee ◽  
Jihyeung Kim ◽  
Jaewoo Cho ◽  
Min Ho Lee ◽  
Sohee Oh ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Dominant Hand ◽  
Significant Difference ◽  
Electrophysiologic Test ◽  
Tunnel Syndrome ◽  
Age Over 60

Background: Carpal tunnel release is recommended when patients have positive electrophysiologic test and their symptoms are not resolved in spite of conservative treatment. However, only some of them eventually undergo the surgery. The purposes of this study, therefore, were to evaluate the rate of carpal tunnel release performed among the patients with positive electrophysiologic test, and to identify which factors were associated with the rate of the surgery. Methods: Subjects of this study were 865 wrists of 508 patients (90 males and 418 females) who were diagnosed as carpal tunnel syndrome between January 2013 and December 2016. The diagnosis of carpal tunnel syndrome was confirmed by electrophysiologic test, and only the patients who were followed up for more than 1 year were enrolled in this study. The average age at the time of the electrophysiologic test performed was 61.4 years, and the severity of carpal tunnel syndrome was evaluated according to the Bland scale (Gr 1–6) based on the electrophysiologic test. Whether or not the patients received carpal tunnel release was evaluated at the last follow-up visit. Results: Among the 865 wrists, carpal tunnel release was performed on 528 wrists (61%). Rate of the surgery performed significantly increased in patients with more severe grades on electrophyisiologic test. More patients in female (63.3%) than in male (50.3%) and more patients with age under 60 (67.5%) than age over 60 (57.1%) received the surgery. However, there was no significant difference in the rate of carpal tunnel release according to the bilaterality or dominant hand. Conclusions: The rate of carpal tunnel release among the patients diagnosed and confirmed as carpal tunnel syndrome was not higher than we expected. We should also pay more attention to the patients who did not undergo carpal tunnel release and investigate the reasons why those patients did not undergo surgery.

An Assessment of Sleep Disturbance in Patients before and after Carpal Tunnel Release

2019 ◽  
Vol 24 (02) ◽  
pp. 144-146 ◽  
Author(s):  
John Erickson ◽  
Daniel Polatsch ◽  
Steven Beldner ◽  
Eitan Melamed
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Continuous Variables ◽  
Night Time ◽  
Before And After ◽  
Tunnel Syndrome ◽  
English Speaking

Background: Night time numbness is a key characteristic of CTS and relief of night time symptoms is one of the outcomes most important to patients. This study tested the null hypothesis that there is no difference between sleep quality and night symptoms before and after carpal tunnel release (CTR). Methods: Forty-four, English-speaking adult patients requesting open CTR for electrodiagnostically confirmed carpal tunnel syndrome completed questionnaires before and after surgery. Average age was 59, 24 patients were men and 20 were women. Patient with a primary or secondary sleep disorder were excluded. Before surgery, patients completed the Pittsburg Sleep Quality index (PSQI). At an average of 3 months after surgery, participants completed PSQI questionnaires. Onset of sleep quality improvement was specifically addressed. Differences between preoperative and postoperative sleep quality were evaluated using the paired t-test. Spearman correlations were used to assess the relationship between continuous variables. Results: Of the 44 patients, 32 (72%) were classified as poor sleepers (PSQI > 5.5) prior to surgery. At 3 months follow up, there was a significant improvement PSQI global scores (7.8 ± 5.1 vs 4 ± 3.5, p < 0.001) as well as subdivisions. Daytime dysfunction (0.2 ± 0.4, p < 0.001) and medication use (1.0 ± 1.2 vs 0.9 ± 1.2, p < 0.045) secondary to sleep disturbance and was improved as well. In all patients, onset of improvement was within 24 hours of surgery. Conclusions: CTR is associated with improvement in sleep quality at 3 months follow-up. CTR improves daytime dysfunction related to the sleep disturbance. The onset of sleep improvement is 24 hours after surgery in most cases.

Use of Nerve Conduction Studies and the Pressure-Specified Sensory Device in the Diagnosis of Carpal Tunnel Syndrome

2009 ◽  
Vol 34 (1) ◽  
pp. 60-65 ◽  
Author(s):  
D. J. SLUTSKY
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Diagnostic Yield ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Control Group ◽  
Asymptomatic Volunteers ◽  
Before And After ◽  
Tunnel Syndrome

Sixty-nine patients with signs of carpal tunnel syndrome (CTS) underwent nerve conduction studies (NCS) and testing with the Pressure-Specified Sensory Device (PSSD). A total of 102 tests were performed (28 bilateral). Twenty patients underwent a carpal tunnel release and were retested after 4 to 6 months. The Symptom Severity Score (SSS) was calculated before and after surgery. A control group of 20 hands in 10 asymptomatic volunteers underwent identical testing. The NCS sensitivity was 87% with a specificity of 90% whereas the PSSD sensitivity was 81% with a specificity of 65%. The combined sensitivity of the two tests was 93%. In the operative group the SSS improved from a mean of 3.34 pre-operatively to 1.95 postoperatively. The NCS improved in 19/21 hands whereas the PSSD improved in 16/19 hands. The non-invasive SSS and PSSD can increase the diagnostic yield in CTS, especially when the NCS are normal.

Co-existing carpal tunnel syndrome in complex regional pain syndrome after hand trauma

2009 ◽  
Vol 35 (3) ◽  
pp. 228-231 ◽  
Author(s):  
S. M. Koh ◽  
F. Moate ◽  
D. Grinsell
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Range Of Motion ◽  
Grip Strength ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pain Syndrome ◽  
Hand Surgery ◽  
Pain Scores ◽  
Tunnel Syndrome

This study highlights the benefits of carpal tunnel release (CTR) in four patients presenting with complex regional pain syndrome (CRPS) after hand surgery who also had carpal tunnel syndrome (CTS) diagnosed clinically and by nerve conduction studies. Three of the patients underwent pre- and postoperative volumetric, circumference, grip strength and range of motion measurements. The Disabilities of the Arm, Shoulder and Hand (DASH) functional outcome measure and pain scores were also used. There was almost complete resolution of CRPS symptoms in all four patients, with notable reductions in oedema and improvements in grip strength and range of motion. There were also improvements in DASH outcome scores and pain scores after CTR.

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 Mini-open Carpal Tunnel Release

2018 ◽  
Vol 19 (4) ◽  
pp. 21-27
Author(s):  
Paulo Henrique Pires De Aguiar ◽  
Carlos Alexandre Martins Zicarelli ◽  
Fabio V. C. Sparapani ◽  
Pedro Augusto De Santana Jr ◽  
Alexandros Theodoros Panagoupolos ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Neurological Deficits ◽  
Motor Branch ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Nerve Entrapment Syndrome ◽  
Mini Open

Introduction: Median nerve compression is the most common nerve entrapment syndrome. After carpal tunnel release, patients often complain about the scar cosmetic appearance. Objective: The aim of our study was to evaluate the clinical outcome, surgical technique and complications of mini-open carpal release. Methods: We reviewed data from 48 surgical procedures for Carpal Tunnel Syndrome in 32 patients at the Pinheiros Neurologicaland Neurosurgical Clinic in the period of 2000 and 2008. The mean age was 49 years-old. We used a 2 cm incision and microscopic technique to obtain meticulous access of the palmar hand anatomy with special attention to both the recurrent motor branch and palmar cutaneous nerve. Results: Twenty-two patients had total resolution of symptoms. Two patients had no change of neurological symptoms. During the follow up no infection or neurological deficits were observed. Conclusion: Mini-open is a safe and effective approach for carpal tunnel syndrome release. However detailed palmar hand anatomy is mandatory to prevent lesion of branching palmar nerve. The use of microscope is desirable to help identify important structures and avoid complications.

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