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.

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.

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.

scholarly journals Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome

2021 ◽  
Author(s):  
Masato Ise ◽  
Taichi Saito ◽  
Yoshimi Katayama ◽  
Ryuichi Nakahara ◽  
Yasunori Shimamura ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Clinical Outcomes ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Characteristic Curve ◽  
Objective Assessment ◽  
Cutoff Score ◽  
Tunnel Syndrome

Abstract Background:Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS.Methods:Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement.Results:The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6–12 months, r = 0.67; 0–12 months, r = 0.60) and DASH (0–12 months, r = 0.77). Moreover, postoperative DML correlated with the change in DASH (6–12 months, r = -0.33; 0–12 months, r = -0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below.Conclusions:NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS.

Upper extremity disability is associated with pain intensity and grip strength in women with bilateral idiopathic carpal tunnel syndrome

2019 ◽  
Vol 44 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Akihito Yoshida ◽  
Shigeru Kurimoto ◽  
Katsuyuki Iwatsuki ◽  
Masaomi Saeki ◽  
Takanobu Nishizuka ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Pain Intensity ◽  
Grip Strength ◽  
Upper Extremity ◽  
Carpal Tunnel ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome

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

Effect of Wrist Position on Power Grip and Key Pinch Strength Following Carpal Tunnel Decompression

2004 ◽  
Vol 29 (4) ◽  
pp. 390-392 ◽  
Author(s):  
K. MATHUR ◽  
P. B. PYNSENT ◽  
S. B. VOHRA ◽  
B. THOMAS ◽  
S. C. DESHMUKH
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
Pinch Strength ◽  
Wrist Flexion ◽  
Wrist Extension ◽  
Local Infiltration ◽  
Power Grip ◽  
Tunnel Syndrome ◽  
Flexion And Extension

Power grip and thumb key pinch strength were measured pre- and immediately postoperatively in 30 patients with carpal tunnel syndrome while the wrist was in flexion and extension. The carpal tunnel decompression was performed under local infiltration with 1% lignocaine. Grip strength decreased more in wrist flexion than in wrist extension. No difference was found in thumb pinch strength. The authors conclude that some of the immediate postoperative loss of grip strength in wrist flexion can be attributed to prolapse of flexor tendons out of the carpal tunnel in this position.

scholarly journals Diagnostic accuracy of sensory and motor tests for the diagnosis of carpal tunnel syndrome: a systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Armaghan Dabbagh ◽  
Joy C. MacDermid ◽  
Joshua Yong ◽  
Tara L. Packham ◽  
Luciana G. Macedo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Diagnostic Accuracy ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
Test Accuracy ◽  
Pinch Grip ◽  
Motor Test ◽  
Tunnel Syndrome ◽  
Motor Tests

Abstract Background Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy of the upper extremity. The previous systematic review of the diagnostic tests for CTS was outdated. The objective of this study was to compile and appraise the evidence on the accuracy of sensory and motor tests used for the diagnosis of CTS. Methods MEDLINE, CINAHL, and Embase databases were searched on January 20, 2020. Studies assessing at least one diagnostic accuracy property of the sensory or motor tests for CTS diagnosis were selected by two independent reviewers. Diagnostic test accuracy extension of the PRISMA guidelines was followed. Risk of bias and applicability concerns were rated using QUADAS-2 tool. Any reported diagnostic accuracy property was summarized. Study characteristics and any information on the accuracy of the sensory and motor tests for CTS diagnosis were extracted. Results We included sixteen clinical studies, assessing thirteen different sensory or motor tests. The most sensitive test for CTS diagnosis was the Semmes-Weinstein monofilament test (with 3.22 in any radial digit as the normal threshold) with sensitivity from 0.49 to 0.96. The tests with the highest specificity (Sp) were palmar grip strength (Sp = 0.94), pinch grip strength (Sp from 0.78 to 0.95), thenar atrophy (Sp from 0.96 to 1.00), and two-point discrimination (Sp from 0.81 to 0.98). Conclusions The evidence was inconclusive on which sensory or motor test for CTS diagnosis had the highest diagnostic accuracy. The results suggest that clinicians should not use a single sensory or motor test when deciding on CTS diagnosis. Trial registration PROSPERO CRD42018109031, on 20 December 2018.

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