Direct and indirect utilities of patients with mild to moderate versus severe carpal tunnel syndrome

2020 ◽  
Vol 45 (8) ◽  
pp. 832-837
Author(s):  
Annie M. Q. Wang ◽  
Helene Retrouvey ◽  
Murray Krahn ◽  
Steven J. McCabe ◽  
Heather L. Baltzer
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Visual Analogue Scale ◽  
Carpal Tunnel ◽  
Analogue Scale ◽  
Standard Gamble ◽  
Short Form ◽  
Health Utility ◽  
Health Utilities ◽  
Euroqol 5D ◽  
Tunnel Syndrome

Health utility is a quantitative global measure of patients’ health status. This retrospective cohort study aimed to compare health utilities of patients with mild to moderate versus severe carpal tunnel syndrome and determine inter-instrumental agreement. Health utilities of 29 patients with varying severity of carpal tunnel syndrome were measured indirectly by Short-Form Sixth Dimension and EuroQol 5D questionnaire and directly by Chained Standard Gamble and a visual analogue scale. Health utility was 0.69 for Short-Form Sixth Dimension, 0.78 for EuroQol 5D Questionnaire, 0.98 for Chained Standard Gamble, and 0.76 for the visual analogue scale. There was a significant inter-instrumental agreement between three of the instruments, but not the Chained Standard Gamble. The difference in health utilities between patients with mild or moderate versus severe carpal tunnel syndrome was significant only for the EuroQol 5D questionnaire. We conclude based on our results that there are no clear indications on how health utilities can be integrated into decision analysis models and economic evaluation regarding carpal tunnel syndrome of various severities . Level of evidence: IV

scholarly journals APLIKASI NEUROMUSCULAR TAPING PADA KONDISI CARPAL TUNNEL SYNDROM UNTUK MENGURANGI NYERI

2020 ◽  
Vol 3 (1) ◽  
pp. 12-17
Author(s):  
Ayu Permata ◽  
Ismaningsih Ismaningsih
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Visual Analogue Scale ◽  
Carpal Tunnel ◽  
Analogue Scale ◽  
Repetitive Motion ◽  
Nervus Medianus ◽  
Post Test ◽  
Tunnel Syndrome

Latar Belakang: Carpal tunnel syndrome (CTS) merupakan kumpulan gejala dan tanda penyakit yang disebabkan oleh terjepitnya saraf medianus di terowongan karpal pada pergelangan tangan. Kondisi CTS ini merupakan salah satu jenis neuropati yang paling sering terjadi. Sindrom ini timbul dengan gejala nyeri, baal, dan kelemahan pada tangan akibat penekanan nervus medianus. Carpal tunnel syndrome merupakan suatu syndrome yang berhubungan dengan gerakan yang berulang (repetitive motion) dan posisi yang menetap pada durasi yang lama sehingga memperngaruhi suplai darah ke tangan dan menimbulkan rasa nyeri. Tujuan: Penelitian ini ditujukan kepada penderita kondisi Carpal Tunnel Syndrom untuk mengurangi nyeri. Intervensi fisioterapi yang diberikan pada kondisi CTS  yaitu penurunan nyeri yang dapat dilakukan dengan berbagai tindakan diantaranya dengan pemberian teknik Neuromuskuler Taping Metode Penelitian: Case study dengan desain penelitian pre and post test yaitu membandingkan antara tingkat nilai nyeri sebelum dan sesudah  yang diukur dengan alat ukur Visual Analogue Scale (VAS) terhadap pemberian intervensi  Neuromuskuler Taping pada kondisi carpal tunnel syndrome selama 3 mingggu. Hasil: Analisa uji beda nilai nyeri dengan VAS pada kelompok sampel dengan nilai signifikasi yaitu 0,006 yang menunjukkan < 0.05yang bermakna ada pengaruh pemberian Neruromusculer taping terhadap perubahan tingkat nyeri VAS penderita Carpal Tunnel Syndrom.

scholarly journals Evaluation of Ultrasound Therapeutic Effect on Patients with Carpal Tunnel Syndrome Attending in a Tertiary Care Hospital of Bangladesh

2019 ◽  
Vol 9 (1) ◽  
pp. 70-73
Author(s):  
Nadia Siddiquee ◽  
Farzana Akonjee Mishu ◽  
Sohely Rahman ◽  
Abul Khan Ahmed Zaman
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Visual Analogue Scale ◽  
Carpal Tunnel ◽  
Analogue Scale ◽  
Ultrasound Therapy ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Wrist Splint

Background: Carpal tunnel syndrome is a common condition in medical practice. Ultrasound therapy is a common non-surgical treatment of carpal tunnel syndrome including other modalities like the use of antiinflammatory agents and exercise. This study was designed to evaluate the effect of ultrasound therapy for the relief of symptoms of patients with carpal tunnel syndrome. Methods: This was a randomized controlled trial. This study as conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhakaduring the period from March 2014 to August 2014to evaluate the effect of ultrasound therapy on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly. The patients were divided in two groups by lottery. For group A patients treatment schedule (Ultrasound therapy+ Exercise+ Wrist splint +NSAIDs) and group B (Exercise+ Wrist splint+ NSAIDs) were applied for a period of 6 weeks. Group A were compared to group B byVisual Analog Scale after 3weeks and 6weeks of treatment.Statistical analysis of the finding was done with the help of statistical package for social science version (SPSS) 19. The student t test used to analyze the level of significance, p< 0.05. Results: This study showed mean visual analogue scale (VAS) at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3). Mean Visual Analogue scale in groupA- was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W 6) after 6 weeks . So these result reveled that group-A is significantly better than group-B. Conclusion: This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. Birdem Med J 2019; 9(1): 70-73

The SF-6D Health Utility Index in Carpal Tunnel Syndrome

2007 ◽  
Vol 32 (2) ◽  
pp. 198-202 ◽  
Author(s):  
I. ATROSHI ◽  
C. GUMMESSON ◽  
S. J. MCCABE ◽  
E. ORNSTEIN
Keyword(s):  
Cost Effectiveness ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Health Utility Index ◽  
Health Utility ◽  
Life Questionnaire ◽  
Utility Index ◽  
Sf 36 ◽  
Tunnel Syndrome

Cost effectiveness is an important factor to consider when choosing between various hand surgical interventions. Health utility measures can be used to determine cost effectiveness. The SF-6D is a health utility index derived from 11 items of the SF-36 quality of life questionnaire; values range from 0.296 to 1.0 (“perfect” health). We evaluated the validity of the SF-6D in patients with carpal tunnel syndrome (CTS) who completed the SF-36 and the CTS symptom severity and functional status questionnaire before and 3 months after carpal tunnel release. Complete responses to the SF-6D items were available for 100 patients at baseline and 95 patients at baseline and follow-up. The mean SF-6D health utility index was 0.69 (SD 0.13) before surgery and 0.77 (SD 0.13) after surgery (moderate effect size). The SF-6D could discriminate between patient groups differing in self-rated global health and in whether, or not, they had a minimal clinically important improvement in CTS symptom severity after surgery. The SF-6D appears to be a valid measure of health utilities in patients with CTS and can be used in cost effectiveness studies.

A Comparative Analysis of the Results of Vertebroplasty and Kyphoplasty in Osteoporotic Vertebral Compression Fractures

2010 ◽  
Vol 67 (3) ◽  
pp. ons171-ons188 ◽  
Author(s):  
Krishna Kumar ◽  
Rita Nguyen ◽  
Sharon Bishop
Keyword(s):  
Visual Analogue Scale ◽  
Health Survey ◽  
Oswestry Disability Index ◽  
Analogue Scale ◽  
Short Form ◽  
Vertebral Compression Fractures ◽  
Short Form 36 ◽  
Scale Scores ◽  
Euroqol 5D

Abstract BACKGROUND: The most common complication of osteoporosis is vertebral fractures, which occur more frequently than all other fractures (hip, wrist, and ankle). OBJECTIVE: To prospectively analyze vertebroplasty compared with kyphoplasty for the treatment of osteoporotic vertebral compression fractures using improvement in pain, functional capacity, and quality of life as outcome measures. METHODS: The study population included 28 patients in the vertebroplasty group and 24 patients in the kyphoplasty group. The mean follow-up period was 42.2 weeks and 42.3 weeks in the vertebroplasty and kyphoplasty groups, respectively. Outcomes were measured pre- and postoperatively using the visual analogue scale, the Oswestry Disability Index, the EuroQol-5D questionnaire, and the Short-Form 36 Health Survey. RESULTS: In the vertebroplasty group, visual analogue scale scores improved from a mean of 8.0 cm to 5.5 cm at last follow-up (P = .001). Preoperatively, the Oswestry Disability Index was 57.6, which improved to 38.4 (P = .006). The EuroQol-5D score preoperatively was 0.157 and improved to 0.504 (P = .001). The Short-Form 36 Health Survey showed greatest improvement in the areas of physical health, role physical, body pain, and vitality. In the kyphoplasty group, visual analogue scale scores improved from a mean of 7.5 cm preoperatively to 2.5 cm postoperatively (P = .000001). The mean Oswestry Disability Index preoperatively was 50.7 and improved to 28.8 (P = .002). The EuroQol-5D score improved from a mean of 0.234 preoperatively to 0.749 (P = .00004). The Short-Form 36 Health Survey showed greatest improvement in the areas of physical health, physical functioning, role physical, body pain, and social functioning. CONCLUSION: Both vertebroplasty and kyphoplasty are effective at improving pain, functional disability, and quality of life; however, kyphoplasty provides better results, which are maintained over long-term follow-up.

Measurement properties of the EuroQoL EQ-5D-5L to assess quality of life in patients undergoing carpal tunnel release

2016 ◽  
Vol 41 (9) ◽  
pp. 957-962 ◽  
Author(s):  
C. Marti ◽  
S. Hensler ◽  
D. B. Herren ◽  
K. Niedermann ◽  
M. Marks
Keyword(s):  
Quality Of Life ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Short Form ◽  
Intraclass Correlation ◽  
Measurement Properties ◽  
Minimal Important Change ◽  
Tunnel Syndrome ◽  
Assess Quality

The objective of this study was to investigate the measurement properties of the EuroQol EQ-5D-5L questionnaire (EQ-5D-5L). A total of 60 patients with carpal tunnel syndrome completed the EQ-5D-5L twice before surgical decompression and once more 6 weeks after surgery. In addition, they filled out the Short Form 12 and Michigan Hand Outcomes Questionnaire at the baseline and postoperative follow-up examinations. Test–retest reliability was excellent with an intraclass correlation coefficient of 0.81. Internal consistency was high with Cronbach’s alpha of 0.83. Good validity of the EQ-5D-5L was indicated by correlations of r = 0.7 and r = 0.5 with the Short Form 12 and Michigan Hand Outcomes Questionnaire, respectively. Moderate responsiveness was shown by an effect size of 0.5. The minimal important change was 0.09 points. Overall, the EQ-5D-5L demonstrates sound measurement properties and can be recommended as a suitable tool to assess quality of life in patients with carpal tunnel syndrome. Level of evidence: I

scholarly journals Electrophysiological evaluation of carpal tunnel syndrome female patients after vitamin D replacement

2020 ◽  
Vol 78 (4) ◽  
pp. 224-229
Author(s):  
Hikmet SAÇMACI ◽  
Nermin TANIK ◽  
Özlem BALBALOĞLU ◽  
Tülin AKTÜRK ◽  
Levent Ertuğrul İNAN
Keyword(s):  
Vitamin D ◽  
Nervous System ◽  
Carpal Tunnel Syndrome ◽  
Vitamin D Deficiency ◽  
Carpal Tunnel ◽  
Analogue Scale ◽  
Onset Latency ◽  
Female Patients ◽  
Before And After ◽  
Tunnel Syndrome

Abstract Objective: The effects of vitamin D on the central and peripheral nervous system continue to be investigated today. In the present study, we aimed to evaluate pain and electrophysiologic response in patients with carpal tunnel syndrome (CTS) who have undergone replacement therapy due to vitamin D deficiency. Methods: Fifty female patients diagnosed with mild and moderate CTS and accompanied by vitamin D deficiency were included in this study. Nerve conduction study (NCS) was performed before and after vitamin D replacement, and the patient’s pain was evaluated with Visual Analogue Scale (VAS). Results: When NCS were compared before and after treatment, there was a statistically significant improvement in the median distal sensory onset latency (DSOL) and sensory conduction velocity (CV) and motor distal latencies (DML) values (p=0.001; p<0.001; p=0.001, respectively). At the same time, there was a decrease in the VAS values in patients (p<0.001). When the two groups were compared there was an improvement in DSOL and sensory CV in both groups, but in DML only in moderate CTS group. Conclusion: In this study, it was shown that mild and moderate CTS patients had an improvement in pain and electrophysiological parameters after vitamin D replacement. Replacing vitamin D in early stages of CTS may be beneficial.

Hand Syndromes Associated with Diabetes: Impairments and Obesity Predict Disability

2009 ◽  
Vol 36 (12) ◽  
pp. 2766-2771 ◽  
Author(s):  
CHRISTINE L. REDMOND ◽  
GREGORY I. BAIN ◽  
LAURA L. LASLETT ◽  
JULIAN D. McNEIL
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
Short Form ◽  
Functional Limitations ◽  
Medical Outcomes ◽  
Limited Joint Mobility ◽  
Touch Perception ◽  
Hand Disability ◽  
Tunnel Syndrome

Objective.We determined patterns of disability in diabetic hand conditions and identified factors that contributed to functional limitations.Methods.Hand assessments were performed on 60 adults with DM1 or DM2 and carpal tunnel syndrome, trigger finger, Dupuytren’s disease, or the syndrome of limited joint mobility. The examination included measurement of grip strength, light touch perception, and dexterity, as well as self-reported function using the Disabilities of the Arm, Shoulder and Hand (DASH) instrument and the Medical Outcomes Study Short Form-36 questionnaire. Associations with hand disability were analyzed using correlation and regression.Results.The most frequent presentation was carpal tunnel syndrome (45%) but it was common for patients to present with clinical features associated with more than one hand syndrome (47%). Overall, women had greater difficulties, with significantly higher DASH scores than men [mean 30.3 (95% CI 23.2, 37.5) vs 18.0 (95% CI 12.1, 23.9), respectively; p = 0.01]. Grip strength, dexterity, and obesity were associated with hand disability (p < 0.05).Conclusion.In adults with hand syndromes associated with diabetes, disability was related to impaired muscle function and carpal tunnel syndrome. Obesity and overall physical functioning influenced hand disability, particularly in women.

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.

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