scholarly journals Relationship between nerve conduction studies and the Functional Dexterity Test in workers with carpal tunnel syndrome

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesco Sartorio ◽  
Francesca Dal Negro ◽  
Elisabetta Bravini ◽  
Giorgio Ferriero ◽  
Stefano Corna ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Diagnostic Accuracy ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
High Specificity ◽  
Nerve Conduction Studies ◽  
Likelihood Ratios ◽  
Discriminative Ability ◽  
Convenience Sample ◽  
Tunnel Syndrome

Abstract Background Dexterity impairments caused by carpal tunnel syndrome (CTS) make working and daily activities challenging. We aimed to investigate: i) the relationship between dexterity and nerve conduction studies (NCS) in workers with classic symptoms presentation; ii) the ability of the Functional Dexterity Test (FDT) to discriminate different levels of CTS severity as classified by NCS; iii) the diagnostic accuracy of a clinical battery composed of the FDT, Phalen’s test and Tinel’s sign. Methods In a convenience sample of individuals diagnosed with CTS, we correlated FDT net scores with the NCS-based classification by means of Spearman’s (rho) test. Discriminative ability of the FDT was assessed by ANOVA, and a ROC curve determined cutoff thresholds. Sensitivity, specificity, and likelihood ratios (LRs) were used to investigate the diagnostic accuracy of the clinical battery. Results Data from 180 hands were collected. The FDT was significantly correlated (rho = 0.25, p <  0.001) with NCS. The FDT was able to discriminate subjects with severe/extreme NCS findings, and two thresholds (0.29–0.36) were identified. Adding the FDT to the provocative tests improved the overall diagnostic accuracy (specificity: 0.97, CI95% 0.83–0.99; LR+: 14.49, CI95% 2.09–100.53). Conclusions Sensorimotor impairments related to CTS can affect hand dexterity. The FDT discriminated patients with severe NCS involvement. Positive results on the clinical battery (Phalen, Tinel, and FDT) could help to confirm the CTS diagnosis, showing a very high specificity and LR+. On the contrary, the low sensitivity is not able to rule out CTS in individuals with negative results.

scholarly journals Assessment of the diagnostic accuracy of nerve conduction study and the correlation between severity of symptoms and nerve conduction studies in carpal tunnel syndrome

2019 ◽  
Vol 5 (4) ◽  
pp. 559
Author(s):  
Benjamin Alex ◽  
Mithun Joy Kattoor ◽  
Samson Samuel Edayalamuriyil
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Diagnostic Accuracy ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Symptom Severity ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Severity Scores ◽  
Tunnel Syndrome ◽  
Surgical Release

<p class="abstract"><strong>Background:</strong> This study was done to assess the diagnostic accuracy of nerve conduction study in carpal tunnel syndrome and comparability of nerve conduction measures before and after carpal tunnel release.</p><p class="abstract"><strong>Methods:</strong> 31 patients (30 females and 1 male) with carpal tunnel syndrome were subjected to nerve conduction study and Boston symptom severity scores before surgery and at 3 months post-operative period and nerve conduction values compared. The effect of duration of symptoms on nerve conduction values was studied.<strong></strong></p><p class="abstract"><strong>Results:</strong> Nerve conduction studies were found to be reliable in diagnosing carpal tunnel syndrome. 61.30% patients showed a right-handed involvement, or right side getting affected first in a bilateral case. 60-80% patients had Boston symptom severity scores which were comparable to the nerve conduction grades ascertaining the relationship between them. Only 58.8% patients with extreme and severe NCS grades preoperatively showed improvement post-surgical release. In patients with symptoms for more than 12 months, only 33.33% had improved nerve conduction grades post-surgical release at 3 months, validating the need for early surgical release.</p><p class="abstract"><strong>Conclusions:</strong> Nerve conduction study was found to be a reliable diagnostic modality for diagnosis of carpal tunnel syndrome and nerve conduction study values correlated with the Boston symptom severity score. The post-operative nerve conduction values revealed definite neurological improvement in patients who underwent early surgical management. Hence, we recommend early release for carpal tunnel syndrome patients for speedy recovery from the condition.</p>

scholarly journals Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands

2009 ◽  
Vol 67 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Dante Guilherme Velasco Hardoim ◽  
Guilherme Bueno de Oliveira ◽  
João Aris Kouyoumdjian
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Compound Action

OBJECTIVE: To compare a long-term carpal tunnel syndrome (CTS) on nerve conduction studies (NCS) in hands treated non-surgically. METHOD: We retrospectively selected 261 symptomatic CTS hands (166 patients), all of them confirmed by NCS. In all cases, at least 2 NCS were performed in an interval greater than 12 months. Cases with associated polyneuropathy were excluded. NCS parameters for CTS electrodiagnosis included a sensory conduction velocity (SCV) <46.6 m/s (wrist to index finger, 14 cm) and distal motor latency (DML) >4.25 ms (wrist to APB, 8 cm). RESULTS: 92.8% were women; mean age was 49 years (20-76); the mean interval between NCS was 47 months (12-150). In the first exam, the median sensory nerve action potential (SNAP) and the compound action muscular potential were absent in 9.8% and 1.9%, respectively. In the second/last exam, SCV worsened in 54.2%, remained unchanged in 11.6% and improved in 34.2%. SNAP amplitude worsened in 57.7%, remained unchanged in 13.1% and improved in 29.2%. DML worsened in 52.9%, remained unchanged in 7.6% and improved in 39.5%. Overall, NCS parameters worsened in 54.9%, improved in 34.3% and remained unchanged in 10.8%. CONCLUSION: Long-term changing in NCS of CTS hands apparently were not related to clinical symptomatology and could lead to some difficulty in clinical correlation and prognosis. Aging, male gender and absent SNAP were more related to NCS worsening, regardless the mean interval time between the NCS.

scholarly journals Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

2021 ◽  
Vol 8 (11) ◽  
pp. 181
Author(s):  
Konstantinos I. Tsamis ◽  
Prokopis Kontogiannis ◽  
Ioannis Gourgiotis ◽  
Stefanos Ntabos ◽  
Ioannis Sarmas ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Automatic Detection ◽  
Nerve Conduction Studies ◽  
Machine Learning Techniques ◽  
Tunnel Syndrome

Recent literature has revealed a long discussion about the importance and necessity of nerve conduction studies in carpal tunnel syndrome management. The purpose of this study was to investigate the possibility of automatic detection, based on electrodiagnostic features, for the median nerve mononeuropathy and decision making about carpal tunnel syndrome. The study included 38 volunteers, examined prospectively. The purpose was to investigate the possibility of automatically detecting the median nerve mononeuropathy based on common electrodiagnostic criteria, used in everyday clinical practice, as well as new features selected based on physiology and mathematics. Machine learning techniques were used to combine the examined characteristics for a stable and accurate diagnosis. Automatic electrodiagnosis reached an accuracy of 95% compared to the standard neurophysiological diagnosis of the physicians with nerve conduction studies and 89% compared to the clinical diagnosis. The results show that the automatic detection of carpal tunnel syndrome is possible and can be employed in decision making, excluding human error. It is also shown that the novel features investigated can be used for the detection of the syndrome, complementary to the commonly used ones, increasing the accuracy of the method.

scholarly journals KINESIOLOGY TAPING AND NEURAL GLIDING EXERCISE IN CARPAL TUNNEL SYNDROME

2020 ◽  
Vol 7 (7) ◽  
pp. 13-16
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Factory Workers ◽  
Wrist Movement ◽  
Tingling Sensation ◽  
Repetitive Injury ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Introduction: Carpal Tunnel Syndrome (CTS) is a condition of neuropathy caused by median nerve entrapment, which is related to repetitive injury mostly due to workload. Some people have occupation that require a lot of repetitive wrist movement such as cigarette factory workers. Kinesiology taping and neural gliding exercises are conservative interventions, which can be performed on people with CTS. Case: This case report showed that there was improvement symptom of carpal tunnel syndrome treated with kinesiology taping and neural gliding exercise. The patient was female, 43 years old, a cigarette factory worker. She had complains of tingling sensation on her palms, moreover on finger 1, 2 and 3 since 2 weeks before. The physical examination revealed positive test of carpal tunnel syndrome such as Phalen, Pressure Provocation and Tinel test. Boston Carpal Tunnel Questionnaire (BCTQ) was also performed. The diagnose was confirmed with nerve conduction studies result. Kinesiology taping was applied on this patient and reapplied weekly until 4 weeks. Patient was also taught about neural gliding exercise and was asked to do it every day for 4 weeks. BCTQ was evaluated weekly and improved every week. While nerve conduction studies was evaluated in 4 weeks and there was also improvement in the result. Conclusion: The improved outcome occurring in this case shows that kinesiology taping and neural gliding exercise can be considered as management of carpal tunnel syndrome, but of course further research is needed to prove its significance.

Ultrasonography Provides a Diagnosis Similar to That of Nerve Conduction Studies for Carpal Tunnel Syndrome

Orthopedics ◽  
2019 ◽  
Vol 42 (5) ◽  
pp. e460-e464
Author(s):  
Dionysios Drakopoulos ◽  
Evanthia Mitsiokapa ◽  
Erineos Karamanis ◽  
Vasilios Kontogeorgakos ◽  
Andreas F. Mavrogenis
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Tunnel Syndrome

Nerve conduction studies and carpal tunnel syndrome

1995 ◽  
Vol 27 (2) ◽  
pp. 311-312 ◽  
Author(s):  
Peter A. Nathan ◽  
Richard C. Keniston ◽  
Kenneth D. Meadows ◽  
Richard S. Lockwood
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Tunnel Syndrome

scholarly journals Usefulness of additional nerve conduction techniques in mild carpal tunnel syndrome

2002 ◽  
Vol 60 (4) ◽  
pp. 923-927 ◽  
Author(s):  
João Aris Kouyoumdjian ◽  
Maria P. A. Morita ◽  
Amalia F. P. Molina
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Tunnel Syndrome ◽  
Very High

This study was done to assess the percentage of abnormality in additional nerve conduction techniques after normal median distal latency (routine) in mild carpal tunnel syndrome (CTS). Bilateral nerve conduction studies were carried out in 116 consecutive symptomatic CTS patients (153 hands). Mild cases were based on normal routine (< 3.7 ms, peak-measured, 14 cm) and at least one technique abnormal of the following: sensory median-radial difference (MR); sensory median-ulnar difference (MU4); mixed palm median-ulnar difference (MUP); median palm latency (PW); and motor median distal latency (MDL). After normal cut-off values for routine, 3.1 to 3.6 ms (< 3.7 ms), we found an abnormal MR, ranging from 86.6 to 93.4%, followed by MU4 (40 to 81.7%), MUP (20 to 71.2%), PW (0 to 41.1%), and MDL (0 to 19.6%). The most frequent abnormal association were MR plus MU4 in 90.1%, followed by MR plus MUP and MU4 plus MUP. The most frequent abnormal additional nerve conduction technique for mild CTS electrodiagnosis was MR, followed by MU4 and MUP. Percentage of MR abnormality was very high regardless of the median routine latency cut-off (< 3.1 to < 3.6 ms).

Comparison of Borderline Ultrasound and Nerve Conduction Studies for Carpal Tunnel Syndrome

Hand ◽  
2020 ◽  
pp. 155894472096496
Author(s):  
Cory Demino ◽  
John R. Fowler
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Threshold Values ◽  
Cutoff Values ◽  
Number Of Patients ◽  
Tunnel Syndrome ◽  
Median Neuropathy

Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

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