The reader is referred to the updated review 2 for a detailed discussion of the literature and the EDX techniques for the assessment of CTS which are summarized here. Both reviews addressed the following key clinical questions:
Measurable and quantifiable sensory and psychomotor deficits were observed in a working industrial population, and were greatest when positive symptoms or physical exam was accompanied by positive nerve conduction test findings. These data show that clinical criteria used in the diagnosis of CTS corresponds with functional psychomotor and sensory impairments measured in these tests.
This paper presents the initial findings J?om a study using two computer-controlled functional tests for sensory and motor deficits in carpal tunnel syndrome (CTS). The gap detection sensory test quantities dynamic tactile inspection thresholds for areas of the hand innervated by the median nerve. The rapid pinch and release psychomotor test measures the initiation and control of specific muscles innervated by the median nerve motor branch. The purpose ofthis ongoing study is to evaluate industrial subjects recruited from varying high risk industrial settings, such as poultry processing, automotive manufacturing, plastics manufacturing, assembly, and newspaper publishing for longitudinal changes in test outcomes. A total of 169 subjects wwe tested during the first year of this study. All subjects completed a symptom survey, underwent a physical examination of the upper limbs, shoulder and neck, had a nerve conduction study (NCS), and were administered the Wisconsin Test Battery. Both hands of the subjects are examined and categorized by presence of absence of physical exam findings, self-reported symptoms, and nerve conduction study (NCS) results. The data was analyzed for differences between subjects reporting positive or negative symptoms, and positive or negative physical exam and NCS findings. In summary, the psychomotor and sensory test outcomes were related to objective NCS fmdmgs but it is interesting to note that symptoms alone were not significantly associated with functional sensory or psychomotor performance. Unlike our previous studies, where CTS patients in the electromyography (EMG) clinic seeking medical assistance were tested, all subjects were f?om a working population. It is likely that most of the positive exam and NCS subjects in the current study involve CTS symptoms that are less severe than our previous studies using EMG clinic subjects, many whom were preparing for surgery.
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