Carpal tunnel syndrome (CTS) is the most common of the entrapment neuropathies. Surgical decompression is commonly performed and has traditionally been considered the defnitive treatment for CTS. Conservative treatment options include physical therapy, bracing, steroid injections and alternative medicine. While CTS is often progressive, patients may get better without formal treatment. The resolution of symptoms is not necessarily related to the severity of the clinical findings and self-limited activity is common. The current literature suggests that bracing and corticosteroid injections may be useful in the nonsurgical treatment of CTS, although the benefits may be short term. There is limited evidence regarding the efficacy of other treatments, such as therapy, exercise, yoga, acupuncture, lasers and magnets, and further studies are needed. Surgery is recommended for progressive functional deficits and significant pain. Carpal tunnel syndrome represents the compression of the median nerve within the carpal tunnel. The borders of the carpal tunnel are wrist carpal bones on the medial, lateral and dorsal aspect and the transverse carpal ligament on the volar aspect. The median nerve and nine of the finger and thumb flexor tendons pass through this space. CTS is characterized by symptoms of numbness, tingling and paraethesias, which are not always limited to the median nerve distribution. Individuals with CTS tend to initially present with intermittent symptoms that may be worse at night or with repetitive upper-extremity activity. The symptoms may improve with splinting, repositioning or vigorous shaking of the hand [3][4][5][6].
This work has undergone a double-blind review by a minimum of two faculty members from institutions of higher learning from around the world. The faculty reviewers have expertise in disciplines closely related to those represented by this work. If possible, the work was also reviewed by undergraduates in collaboration with the faculty reviewers. Abstract Locomotion and movement economy are cornerstone topics in movement science. Modeling the leg as a hybrid mass-spring pendulum shows walking economy should be optimized when stride frequency matches the resonant frequency of the limb. Human walking is described as self-optimizing because mean preferred (PSF) and modeled resonant (RSF) stride frequencies usually are statistically equivalent, but this depiction may not be fully justified. Purpose: To more thoroughly examine the self-optimization characterization and the consequences of obligating use of the RSF. Methods: Forty-seven individuals of diverse statures completed 3 consecutive days of preferred walking trials on a treadmill where stride rate, stride length, walking speed, heart rate and walking economy measures were made under steady state heart rate conditions. Anthropometric measures were taken to build a hybrid model of the leg and model the RSF. Reliability across days was evaluated via repeated measures analysis of variance (ANOVA) and intra-class correlation (α=.05) and correlations were calculated for PSF and RSF. A separate sample of 20 participants walked under 3 conditions, (1) completely preferred; (2) at the original preferred speed using the RSF; and (3) with the option to establish a new preferred speed while using the RSF. Results: Gait characteristics were fundamentally reliable across days and the correlation between PSF and RSF was weak (8% explained variance). Walking economy improved 14% when using the RSF and allowed to self-select the speed / stride length used at that cadence. Conclusions: The results raised slight questions about current self-optimization presumptions and further emphasized the role of resonance in walking economy
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