scholarly journals The Construct Validity and Responsiveness of Sensory Tests in Patients with Carpal Tunnel Syndrome

2014 ◽  
Vol 8 (1) ◽  
pp. 100-107 ◽  
Author(s):  
Derek K.M Cheung ◽  
JoyC MacDermid ◽  
Dave Walton ◽  
Ruby Grewal
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Construct Validity ◽  
Carpal Tunnel ◽  
Hand Function ◽  
Change Score ◽  
Important Change ◽  
Measurement Properties ◽  
Sensory Threshold ◽  
Tunnel Syndrome ◽  
Sensory Tests

Background and Purpose : Sensory evaluation is fundamental to evaluation of patients with Carpal Tunnel Syndrome (CTS). The purpose of this study was to determine the construct validity and responsiveness for sensory threshold tests in patients with CTS. Methods : Sixty-three patients diagnosed with CTS were evaluated prior to orthotic intervention and again at follow up at 6 and 12 weeks. Sensory tests included touch threshold PSSD (Pressure Specified Sensory Device) and vibration threshold (Vibrometer). Construct validity was assessed by comparing sensory tests to hand function, and dexterity testing using Spearman rho (rs). Patients were classified as either responders or non-responders to orthotic intervention based on the change score of the Symptom Severity Scale (SSS) of 0.5. Responsiveness of the sensory tools was measured using ROC (receiver operating characteristic) curves, SRM (Standardized Response Mean), and ES (Effect Sizes). Results : The PSSD had low to moderate correlations (rs ≤ 0.32) while Vibrometer scores had moderate correlations (rs = 0.36 - 0.41) with dexterity scores. The Clinically Important Difference (CID) for the PSSD was estimated at 0.15 g/mm2 but was not discriminative. The Vibrometer demonstrated moderate responsiveness, with a SRM = 0.61 and an ES = 0.46 among responders. The PSSD had a SRM = 0.09 and an ES = 0.08 and showed low responsiveness for patients with a clinically important improvement in symptoms. Conclusion : Measurement properties suggest that the Vibrometer was preferable to the PSSD because it was more correlated to hand function, and was more responsive. Clinicians may choose use the Vibrometer opposed to the PSSD for determining important change in sensation after orthotic intervention.

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.

scholarly journals Author Correction: Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Young Hoon Kim ◽  
Eun Young Han ◽  
Jinseok Kim ◽  
Kyu‑Bum Seo ◽  
Young Tae Jeon ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Hand Function ◽  
Hand Osteoarthritis ◽  
Different Ages ◽  
Electrophysiological Measurements ◽  
Tunnel Syndrome

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The Validity of Sensory Threshold Measures and Functional Measures in Patients with Carpal Tunnel Syndrome

2011 ◽  
Vol 24 (4) ◽  
pp. 380-381
Author(s):  
Derek K. Cheung ◽  
Joy C. MacDermid ◽  
Dave Walton ◽  
Ruby Grewal
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Sensory Threshold ◽  
Functional Measures ◽  
Tunnel Syndrome

scholarly journals The Impact of Sensory, Motor and Pain Impairments on Patient- Reported and Performance Based Function in Carpal Tunnel Syndrome

2017 ◽  
Vol 11 (1) ◽  
pp. 1258-1267 ◽  
Author(s):  
Goris Nazari ◽  
Niyati Shah ◽  
Joy C MacDermid ◽  
Linda Woodhouse
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Hand Function ◽  
Pinch Strength ◽  
Sensory Motor ◽  
Tunnel Syndrome ◽  
And Performance ◽  
Quick Dash ◽  
The Impact ◽  
Vibration Threshold

Background: Research has suggested that persistent sensory and motor impairments predominate the symptoms experienced by patients with carpal tunnel syndrome (CTS); with intermittent pain symptoms, being less predominant. Objective: The study aims to determine the relative contribution of sensory, motor and pain impairments as contributors to patient-report or performance-based hand function. Methods: Fifty participants with a diagnosis of CTS confirmed by a hand surgeon and electrodiagnosis were evaluated on a single occasion. Impairments were measured for sensibility, pain and motor performance. A staged regression analysis was performed. In the first step, variables with each of the 3 impairment categories were regressed on the Symptom Severity Scale (SSS) to identify the key variables from this domain. Models were created for both self report (Quick Disabilities of arm, shoulder and hand- Quick DASH) and performance based (Dexterity) functional outcomes. Backward regression modelling was performed for SSS and then, to allow comparability of the importance of different impairments across models, the 7 significant variables from the SSS model were forced into the models. Results: Variables: age, touch threshold and vibration threshold of the little finger of unaffected hand, median-ulnar vibration threshold ratio of affected hand, mean pain tolerance of unaffected hand, grip strength and pinch strength of affected hand, explained 31%, 36% and 63% of the variance in SSS, Quick DASH and dexterity scores, respectively. Conclusion: Hand function in patients with CTS is described by variables that reflect sensory status of the median and ulnar nerves, the persons pain threshold, grip and pinch strength impairments and age.

scholarly journals Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Daniel Gregor Schulze ◽  
Kristian Bernhard Nilsen ◽  
Rikke Munk Killingmo ◽  
John Anker Zwart ◽  
Margreth Grotle
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Construct Validity ◽  
Internal Consistency ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Clinical Utility ◽  
Severity Assessment ◽  
Discriminative Ability ◽  
Tunnel Syndrome ◽  
Severity Levels

Background: Self-reported measures are often used in research and clinical practice to diagnose carpal tunnel syndrome (CTS) and guide therapeutic choices. We aimed to assess the clinical utility of the Norwegian versions of two self-reported outcome measures for symptom severity assessment, the 6-item CTS (CTS-6), and Boston-CTS (BCTQ), and of one diagnostic measure, the hand-diagram, by evaluating measurement properties including discriminative ability for severity assessment (CTS-6, BCTQ), and diagnosis of CTS (hand-diagram).Methods: We performed forward and backward translation and cultural adaptation of the Norwegian CTS-6 and BCTQ. Following COSMIN guidelines, we investigated internal consistency, reliability, construct validity, and discriminative ability for distinguishing between severity levels of CTS in patients with confirmed CTS for the CTS-6 and BCTQ and reliability and discriminative ability for diagnosing CTS for the hand-diagram.Results: Two hundred and fifty-one patients referred for diagnostic work-up for CTS with nerve conduction studies (NCS) participated. The CTS-6 and BCTQ had acceptable internal consistency (Crohnbach's α = 0.82 and 0.86, respectively), reliability (ICC = 0.86 and 0.90; SEM = 0.24 and 0.20; SDC95% = 0.68 and 0.55, respectively), construct validity (all eight pre-defined hypotheses confirmed) and discriminative ability to distinguish between severity levels of CTS [Area under the curve (AUC) = 0.75, 95% CI 0.64–0.85]. The hand-diagram had acceptable reliability (Cohen's kappa = 0.69) and discriminative ability to diagnose CTS (sensitivity = 0.72, specificity = 0.90).Conclusion: Our findings support the clinical utility of the CTS-6 and BCTQ for symptom severity assessment and of the hand-diagram for diagnostic screening.

scholarly journals Hand Function among Patients with Carpal Tunnel Syndrome

2019 ◽  
Vol 07 (04) ◽  
pp. 170-177
Author(s):  
Israa Anwar ◽  
Afshan Ameer ◽  
Shehryar Azam ◽  
Mehwish Khalid ◽  
Hafiz Muhammad Asim
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Hand Function ◽  
Tunnel Syndrome

Prevalence of carpal tunnel syndrome and wrist osteoarthritis in long-term paraplegic patients compared with controls

2013 ◽  
Vol 39 (2) ◽  
pp. 132-138 ◽  
Author(s):  
M. Akbar ◽  
S. Penzkofer ◽  
M. A. Weber ◽  
T. Bruckner ◽  
M. Winterstein ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Structural Changes ◽  
Hand Function ◽  
Trapeziometacarpal Osteoarthritis ◽  
Gender And Age ◽  
Tunnel Syndrome ◽  
The Right ◽  
Matching Criteria

We compared functional and structural changes in the hands, in particular the prevalence of carpal tunnel syndrome, in 56 paraplegic patients who had been wheelchair dependent for over 25 years with a group of able-bodied volunteers (with matching criteria for gender and age). The hands were assessed by clinical examination, electrophysiology, disabilities of the arm shoulder and hand score and magnetic resonance imaging. Hand function was worse and wrist pain was experienced more often in the paraplegic patients, and they also had a significantly higher prevalence of carpal tunnel syndrome both clinically and electrophysiologically. The prevalence of wrist and trapeziometacarpal osteoarthritis was significantly higher in the right hand.

An OT Perspective: The Association of Sleep and Hand Function in Persons With Carpal Tunnel Syndrome (CTS)

2019 ◽  
Vol 73 (4_Supplement_1) ◽  
pp. 7311505088p1
Author(s):  
Angela Goorman ◽  
Colleen Schneck ◽  
Doris Pierce ◽  
Spencer Dawson
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Hand Function ◽  
Tunnel Syndrome
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