scholarly journals Effectiveness of the Influence of Physical Therapy on the Indicators of the Neurological and Functional Status of the Hand in People with Compression Neuropathy of the Median Nerve as a Postimmobilization Complication of Fractures of the Distal Forearm Bo

2021 ◽  
Vol 6 (1) ◽  
pp. 255-262
Author(s):  
V. M. Byrchak ◽  
Keyword(s):  
Physical Therapy ◽  
Functional Status ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Control Group ◽  
Distal Forearm ◽  
Compression Neuropathy ◽  
Boston Carpal Tunnel Questionnaire ◽  
Forearm Bones ◽  
Carpal Tunnel Questionnaire

The social inconsistency of patients with hand injuries is due to the limitation of the possibilities of professional and labor activity (reduced qualifications, limited opportunities for training and retraining, inability to work in their specialty), which justifies the search for new methods of their rehabilitation. The purpose of the study was to determine the effectiveness of physical therapy on the indicators of the neurological and functional status of the hand in patients with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones. Material and methods. The study involved 56 people with postimmobilization contractures of the wrist joint, complicated by compression neuropathy of the median nerve, as a result of fracture of the bones of the distal forearm. They were divided into two groups: the control group (they practiced according to the principles of polyclinic rehabilitation with a predominance of passive means like manual techniques, preformed physical factors) and the main group (they were engaged in a developed physical therapy program based on the principles of International Classification of Functioning, Disability and Health with a predominance of active means like functional training; massage; warm wet compress combined with post-isometric muscle relaxation, posture treatment; kinesiological taping). The effectiveness of the program was assessed by the presence and degree of pain (VAS and DN4), goniometry results, signs of median nerve irritation (Phalen, Hoffmann-Tinel, Durkan), French Arm Test, ABILIHAND, DASH, Boston carpal tunnel questionnaire. Results and discussion. After the rehabilitation intervention, all examined patients showed a decrease in the intensity of pain at rest and during movement (according to VAS). Signs of compression neuropathy of the median nerve decreased (pain intensity according to the DN4 questionnaire, the prevalence of specific symptoms, the results of a quantitative assessment of the Boston carpal tunnel questionnaire). There was an improvement in the functioning of the upper limb according to the ABILIHAND, DASH, French Arm Test scales. For all the studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p <0.05). However, the patients of the main group showed a better result than the patients of the control group (p <0.05). Conclusion. The developed program of physical therapy with the predominant using of active rehabilitation means revealed a statistically significant better effect on the indicators of the neurological and functional status of the hand in persons with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones

scholarly journals The experience of using anti-adhesion gel in the surgery for carpal tunnel syndrome

2021 ◽  
Vol 23 (3) ◽  
pp. 39-47
Author(s):  
A. S. Nikitin ◽  
I. B. Aleynikova
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Control Group ◽  
Study Group ◽  
Clinical Relapse ◽  
Study Objective ◽  
Boston Carpal Tunnel Questionnaire ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

The study objective is to evaluate the effectiveness of anti‑adhesion gel by using in carpal tunnel syndrome surgery.Materials and methods. A prospective study was carried out among 55 patients with carpal tunnel syndrome. All patients were underwent open decompression of the carpal tunnel. Patients of study group (n = 25) got an carboxymethylcellu‑ lose anti‑adhesion gel, which was applied to the nerve before suturing the wound. Patients from control group (n = 30) were underwent surgery without using an anti‑adhesive gel. Before surgery, all patients underwent a clinical neurological examination with an assessment of symptoms according to the Boston Carpal Tunnel Questionnaire, which includes 2 scales: the scale and the functional status scale. The Boston Carpal Tunnel Questionnaire was reevaluated 2.5 years after surgery.Results. In study group the mean symptom severity decreased by 59.5 %, functional status improved by 55.1 %, in control group these indicators were 48.3 and 47.6 %. Clinical relapse of the disease was noted in 8 % of patients of study group and in 20 % of patients of control group.Conclusion. Intraoperative using of an anti‑adhesion gel allows to reduce the frequency of recurrence of carpal tunnel syndrome after surgical decompression.

scholarly journals Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients

2019 ◽  
Vol 109 (4) ◽  
pp. 343-350
Author(s):  
J. Multanen ◽  
J. Ylinen ◽  
T. Karjalainen ◽  
H. Kautiainen ◽  
J. P. Repo ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Severity Scale ◽  
Floor Effect ◽  
Symptom Severity Scale ◽  
Boston Carpal Tunnel Questionnaire ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Background and Aims: The Boston Carpal Tunnel Questionnaire is the most commonly used outcome measure in the assessment of carpal tunnel syndrome. The purpose of this study was to translate the original Boston Carpal Tunnel Questionnaire into Finnish and validate its psychometric properties. Materials and Methods: We translated and culturally adapted the Boston Carpal Tunnel Questionnaire into Finnish. Subsequently, 193 patients completed the Finnish version of the Boston Carpal Tunnel Questionnaire, 6-Item CTS Symptoms Scale, and EuroQol 5 Dimensions 12 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire was re-administered after a 2-week interval. We calculated construct validity, internal consistency, test–retest reliability, and coefficient of repeatability. We also examined floor and ceiling effects. Results: The cross-cultural adaptation required only minor modifications to the questions. Both subscales of the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Functional Status Scale) correlated significantly with the CTS-6 and EuroQol 5 Dimensions, indicating good construct validity. The Cronbach’s alpha was 0.93 for both the Symptom Severity Scale and Functional Status Scale, indicating high internal consistency. Test–retest reliability was excellent, with an intraclass correlation coefficient greater than 0.8 for both scales. The coefficient of repeatability was 0.80 for the Symptom Severity Scale and 0.68 for the Functional Status Scale. We observed a floor effect in the Functional Status Scale in 28% of participants. Conclusion: Our study shows that the present Finnish version of the Boston Carpal Tunnel Questionnaire is reliable and valid for the evaluation of symptom severity and functional status among surgically treated carpal tunnel syndrome patients. However, owing to the floor effect, the Functional Status Score may have limited ability to detect differences in patients with good post-operative outcomes.

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.

scholarly journals Retinaculotomía endoscópica de doble portal en el síndrome del túnel carpiano

2020 ◽  
Vol 85 (4) ◽  
pp. 349-356
Author(s):  
Álvaro C. Ojeda ◽  
Víctor A. Contreras ◽  
Edgardo S. Sanzana
Keyword(s):  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Severity Scale ◽  
Symptom Severity Scale ◽  
Palabras Clave ◽  
Boston Carpal Tunnel Questionnaire ◽  
Carpal Tunnel Questionnaire

Objetivo: Evaluar los resultados de la retinaculotomía endoscópica para tratar el síndrome del túnel carpiano mediante la técnica de doble portal de Chow, entre enero de 2006 y diciembre de 2015. Materiales y Métodos: Estudio de 179 pacientes (edad promedio 48.2 años [rango 32-68]), con 217 casos de síndrome del túnel carpiano idiopático y un seguimiento promedio de 97.9 meses. Los pacientes eran 145 mujeres (81%) (31 bilaterales) y 34 hombres (19%) (7 bilaterales) y fueron evaluados con la Symptom Severity Scale (SSS) y la Functional Status Scale (FSS) del Boston Carpal Tunnel Questionnaire (BCTQ). Resultados: El puntaje medio de la SSS-BCTQ fue de 3,20 + 0,26 antes de la cirugía, mejoró a 1,30 + 0,12 a los 6 meses y se mantuvo en 1,25+ 0,11 a largo plazo. El puntaje medio de la FSS-BCTQ fue de 2,57 + 0,29 antes de la cirugía, mejoró a 1,28 + 0,18 a los 6 meses y se mantuvo en 1,20 + 0,09 a largo plazo. Hubo 7 casos (3,2%) de neuropraxia posquirúrgica transitoria. No hubo conversiones a técnica abierta. Conclusión: La liberación endoscópica del túnel carpiano con la técnica de Chow es un método quirúrgico eficaz y seguro para tratar el síndrome del túnel carpiano idiopático. Palabras clave: Síndrome del túnel carpiano; técnica de doble portal de Chow; liberación endoscópica; compresión neural; nervio mediano. Nivel de Evidencia: III

Minimal clinically important difference for the Boston Carpal Tunnel Questionnaire: new insights and review of literature

2018 ◽  
Vol 44 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Floriaan G.C.M. De Kleermaeker ◽  
Hieronymus D. Boogaarts ◽  
Jan Meulstee ◽  
Wim I.M. Verhagen
Keyword(s):  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Minimal Clinically Important Difference ◽  
Severity Scale ◽  
Symptom Severity Scale ◽  
Clinically Important Difference ◽  
Boston Carpal Tunnel Questionnaire ◽  
Scale Scores ◽  
Carpal Tunnel Questionnaire

No consensus exists about the minimal clinically important difference for the Boston Carpal Tunnel Questionnaire, which hampers its clinical application. This study assessed the minimal clinically important difference of this questionnaire. The Boston Carpal Tunnel Questionnaire was completed by 180 patients, with clinically defined carpal tunnel syndrome, preoperatively and at about 8 months follow-up after carpal tunnel release, together with a six-point scale for perceived improvement. Receiver operator characteristics curves showed that relative changes in Symptom Severity Scale and Functional Status Scale scores correspond better to a clinically relevant improvement than absolute changes. The minimal clinically important difference should be individually calculated from baseline Symptom Severity Scale and Functional Status Scale scores, as patients experiencing more symptoms require more improvement to notice a clinically important difference. By taking this into account, the Boston Carpal Tunnel Questionnaire is more meaningful as an outcome measure in research and clinical practice.

scholarly journals Measurement properties of the Danish version of the Boston Carpal Tunnel Questionnaire

JPRAS Open ◽  
2021 ◽  
Vol 29 ◽  
pp. 17-25
Author(s):  
S.B.M. Sebastian Breddam Mosegaard ◽  
M.S. Maiken Stilling ◽  
M.B. Marianne Breddam ◽  
T.B.H. Torben Bæk Hansen
Keyword(s):  
Carpal Tunnel ◽  
Measurement Properties ◽  
Danish Version ◽  
Boston Carpal Tunnel Questionnaire ◽  
Carpal Tunnel Questionnaire

scholarly journals Intra-Carpal Injection of Ozone versus Methylprednisolone in Carpal Tunnel Syndrome of Systemic Sclerosis Patients: A Randomized Single-Blind Clinical Trial

2021 ◽  
pp. E453-E458
Keyword(s):  
Systemic Sclerosis ◽  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Favourable Outcome ◽  
University Hospital ◽  
Electrophysiologic Study ◽  
Tunnel Syndrome

BACKGROUND: Carpal tunnel syndrome (CTS) is the most entrapment syndrome in general and is the most frequent peripheral nervous system involvement in systemic sclerosis (SSc). Local injection of steroid hydrodissection or ozone-oxygen showed favourable outcome in CTS in general. OBJECTIVES: To compare the clinical efficacy of ozone versus methylprednisolone intracarpal injection upon pain, functional status, and nerve conduction in patients with CTS due to SSc. STUDY DESIGN: A randomized single-blinded trial. SETTING: Anesthesia, pain, and rheumatology clinics in a university hospital. METHODS: Fifty CTS patients with > 3 months duration of SSc were equally randomized into either group O (injection of ozone/oxygen 25 mu-g/mL in 20 mL) or group M (methylprednisolone acetate 40mg, and 40 mg lidocaine in 20 mL). Visual analog scale (VAS) was measured pre-injection, then re-evaluated post-injection at 4 time points (1 week, 1 month, 3 months , and 6 months); Cochin Hand Function Scale (CHFS); and a median nerve electrophysiologic study was done before injection, then by the end of 3 months and 6 months. RESULTS: VAS was significantly lower in group M after 1 week (P = 0.01). Group O showed significantly lower VAS after 3 and 6 month (P < 0.001). Additionally, there was a significant decrease in the VAS during the whole study period within each group, in comparison to its baseline value. CHFS was significantly lower in the ozone group after 6 months (P < 0.001). The sixth month’s sensory conduction was significantly higher in group O (P = 0.002). The motor distal latency was significantly lower in the ozone group after 3 and 6 months (P < 0.001). LIMITATIONS: Follow-up period could be furtherly extended. CONCLUSION: Both intracarpal ozone or methylprednisolone afford favorable effects upon CTS in patients with SSc. However, ozone alleviates pain much more, enhances the hand functional status, and improves median nerve conduction in study with over six months duration. KEY WORDS: Carpal Tunnel Syndrome, systemic sclerosis, methylprednisolone, ozone

A COMPARISON OF FUNCTIONAL ASSESSMENT OF PRE- AND POSTSURGICAL CARPAL TUNNEL SYNDROME USING BOSTON CARPAL TUNNEL QUESTIONNAIRE AND NERVE CONDUCTION STUDY: A PROSPECTIVE STUDY FROM A TERTIARY CENTER OF SOUTH INDIA

2021 ◽  
pp. 117-120
Author(s):  
Padmapriyadarsini V ◽  
Navin K ◽  
Abdul Gafoor S ◽  
Chitra G
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Outcome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Electrophysiological Study ◽  
Carpal Tunnel Release ◽  
Boston Carpal Tunnel Questionnaire ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment syndrome of median nerve causing frequent disability especially among working populations. Boston Carpal Tunnel Questionnaire and Electrophysiological study helps in detecting and aiding in the diagnosis of CTS and helps in determining level of improvement after surgical release of carpal tunnel. OBJECTIVES: To assess functional outcome of patients with Carpal Tunnel Syndrome after surgery as assessed by Boston Carpel Tunnel Questionnaire and Electrophysiological study. METHODS: A prospective observational study conducted over a period of one year (January 2017 to January 2018). The study was conducted among consecutive 31 electrophysiological conrmed carpal tunnel syndrome attending the outpatient department of Physical Medicine and Rehabilitation, Government Medical College, Thiruvananthapuram. All patients underwent open carpal tunnel release. Functional outcome was assessed using Boston Carpal Tunnel Questionnaire (BCTQ) both preoperatively and at interval of 3 weeks, 6weeks and 3 months postoperatively. Electrophysiological study assessed using nerve conduction study both preoperatively and 3 weeks post operatively. Data was entered in Microsoft excel and analyzed using SPSS statistical software. RESULTS: The study involves 31 conrmed cases of Carpal tunnel syndrome patients. Mean Boston Carpal Tunnel Questionnaire (BCTQ) score preoperatively was 58.52 ± 12.73 which was markedly improved postoperatively at 3weeks with mean score of 29.77±6.68. At 6 weeks and 3 month follow up period it was reduced respectively to mean score of 23.94±4.23 and 22.94±4.62. Preoperative NCS shows decreased conduction velocity with mean nerve sensory velocity (NSV) score 21.51±8.19 and mean nerve motor velocity (NMV) score of 20.72±8.81 which statistically improved following surgery with mean NSV score of 32.04±9.01 and mean NML score of 33.78±8.1. Correlation between pre- and post-operative BCTQ and NCS parameters shows positive correlation with latency and negative correlation with amplitude and conduction velocity. Increased latency and decreased conduction velocity associated with higher BCTQ score with signicant 'p' value (p<0.05). CONCLUSION: There is statistically signicant improvement of functional outcome following carpal tunnel release surgery assessed through Boston Carpal Tunnel Questionnaire and Electrophysiological ndings

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