A preliminary case series demonstrates how the use of fine-motor-control measurements of the hands may be used for screening for mild traumatic brain injury (mTBI) symptoms. Motor and sensory control factors have been derived from rapid fine-motor-control measurements collected at 4-millisecond intervals during a total of two 1-minute periods for each hand in a repetitious squeeze-and-relax cycle. These derived control factors detect the presence of mTBI symptoms and can measure and document the rate of recovery for persons with mTBI. This information is critically important to determine the efficacy of a therapeutic or rehabilitative regimen as well as to assign the optimal time to return to work or play.Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) are common medical events that exact a significant burden on our healthcare systems and have been increasingly covered in the news media. Mild traumatic brain injury and PTSD are different clinical entities and require specialized treatments. Both can have lifelong effects on the individual if they are not detected and treated promptly and correctly. In its simplest form, mTBI is a physiological injury, whereas PTSD is a psychological injury.While commonly discussed as a war/combat problem, PTSD and mTBI are associated with most life-threatening traumatic events, such as a car crash, mugging, rape, or physical abuse. The definition of PTSD requires that a highly stressful or life-threatening circumstance has occurred. The difficulty with mTBI, sometimes referred to as a mild concussion or closed-head injury, lies in its apparent lack of visible symptoms and apparent lack of physical injury, that is, no visible blood, and quite often a strong denial of any injury. If left untreated, both mTBI and PTSD injuries can cause lifelong cognitive and behavioral issues, reduce the quality of life, or result in premature death through injury or suicide.Mild traumatic brain injury and PTSD are commonly presented at the same time. Standard assessments for both of these injuries rely on cognitive and/or behavioral evaluations. Unfortunately, the cognitive and behavioral symptoms are nearly identical for these 2 injuries. To learn to how to detect the physiological symptoms of mTBI, mTBI must be studied in the absence of the psychological symptoms of PTSD.To illustrate, athletes exposed to the risk of, and incurring, mTBI are notably free from PTSD. Athletes are subjected to concussive injuries without the life-threatening stress associated with PTSD development.Studying mTBI events by separating the variables should provide the ability to learn the physiological symptoms of mTBI in the absence of PTSD. learn the psychological symptoms of PTSD in the absence of mTBI. differentiate mTBI and PTSD symptoms when both are present. This will allow a statistical separation of mTBI symptoms and PTSD symptoms and a more detailed analytical examination of mTBI symptoms without confounding by PTSD. Mild Traumatic Brain InjuriesTraumatic brain injury (TBI) is a si...
Carpal tunnel syndrome (CTS) screening is problematic and often inaccurate. Surgical treatment for CTS, involving open-hand or endoscopic ligament releases, accounts for 11% of all surgeries performed. Of these surgeries, about 50% fail. We compared the sensitivity and specificity of CTS screening tests. Using multiple screening tests is believed to increase accuracy, but the results showed specificity decreases to 48% or less. Most misdiagnoses were false negatives, suggesting that many surgical treatments were unnecessary. This systematic misclassification based on imprecise screening tests is also an error of omission when physicians have only these tests to use. A new screening method and test are considered.Carpal tunnel syndrome (CTS) became the epitome of work-related injury when work processors and keyboards replaced the typewriters. As a subset of ''repetitive stress injury'' or ''repetitive strain injury,'' CTS is found in about 3% to 7% of the general population 1 and much higher in the workforce. The direct medical cost and loss of productivity due to CTS are more than $40 billion. 2 As the etiology and sequelae of CTS are better understood, the more clinically accurate terms cumulative trauma disorders and musculoskeletal disorders or workrelated musculoskeletal disorders are now used in place of repetitive stress injury. The National Institute for Occupational Safety and Health 3 conducted one of the most exhaustive reviews of epidemiologic studies on CTS. Positive association was found between CTS and highly repetitive work alone or in combination with other risk factors, such as forceful work, vibration, and postures. In addition, the surveillance data identified the highest rates of CTS with jobs that demand intensive manual exertion, including meatpacking, poultry processing, and automobile assembly.In 2004, of 3.4 million physician office visits, 849,000 cases were for CTS 4 to treat symptoms of tingling or pain in the injured hand, usually the thumb, index, middle, and ring fingers; numbness in the fingers; cramping of the hand and wrist; feeling swelling of fingers where there is no swelling; weakness of the fingers; and difficulty performing tasks like tying shoes and picking up small objects. In 2000 alone, an estimated 260,000 carpal tunnel release operations were performed. 4 Consider other statistics on CTS:Forty-seven percent of CTS cases are related to work. 5 Women are 3 times more likely to develop CTS than men are. 6
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