A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire

Leite, José Carlos de Carvalho; Jerosch‐Herold, Christina; Song, Fujian

doi:10.1186/1471-2474-7-78

Cited by 271 publications

(226 citation statements)

References 22 publications

(50 reference statements)

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“…Although statistically significant, the improvement in the Boston questionnaire did indeed not reach the previously established scores for a clinically meaningful change. 38 The significant improvement in the patient specific functional scale was however clinically meaningful. 33 We like to emphasize though that this study was designed to reveal possible therapeutic mechanisms of nerve and tendon gliding exercises and splinting, and not to evaluate the clinical efficacy of these interventions.…”

Section: Discussionmentioning

confidence: 99%

Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome—an MRI study to reveal therapeutic mechanisms

Schmid

Elliott

Strudwick

et al. 2012

Journal Orthopaedic Research

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Splinting and nerve and tendon gliding exercises are commonly used to treat carpal tunnel syndrome (CTS). It has been postulated that both modalities reduce intraneural edema. To test this hypothesis, 20 patients with mild to moderate CTS were randomly allocated to either night splinting or a home program of nerve and tendon gliding exercises. Magnetic resonance images of the wrist were taken at baseline, immediately after 10 min of splinting or exercise, and following 1 week of intervention. Primary outcome measures were signal intensity of the median nerve at the wrist as a measure of intraneural edema and palmar bowing of the carpal ligament. Secondary outcome measures were changes in symptom severity and function. Following 1 week of intervention, but not immediately after 10 min, signal intensity of the median nerve was reduced by $11% at the radioulnar level for both interventions (p ¼ 0.03). This was accompanied by a mild improvement in symptoms and function (p < 0.004). A similar reduction in signal intensity is not observed in patients who only receive advice to remain active. No changes in signal intensity were identified further distally (p > 0.28). Ligament bowing remained unchanged (p > 0.08). Intraneural edema reduction is a likely therapeutic mechanism of splinting and exercise. Keywords: MRI; nerve and tendon gliding exercises; splinting; carpal tunnel syndrome; neurodynamics Carpal tunnel syndrome (CTS) is a peripheral neuropathy at the level of the wrist. Despite considerable efforts, the pathophysiology of CTS is not yet fully understood. 1 There is however a well-established link between an elevated pressure in the carpal tunnel and the development of CTS. 2,3 When the pressure on a peripheral nerve is experimentally increased, a reduction of intraneural microcirculation occurs with subsequent breakdown of the blood nerve barrier and the formation of intraneural and extraneural edema. 4 In CTS, swelling of the median nerve has been identified intra-operatively, 5,6 with ultrasound imaging 7 and with conventional magnetic resonance imaging (MRI). 8,9 If present for prolonged periods, intraneural edema may lead to potentially irreversible fibrotic changes. 4 These fibrotic changes are present in patients with severe CTS. 9 Edema reduction to prevent progression to a fibrotic stage is therefore a plausible target in the management of patients with mild to moderate CTS.Besides advice, splinting and nerve and tendon gliding exercises are the most frequently performed noninvasive treatment modalities for CTS. 10 The beneficial effect of night splinting in a neutral wrist position is commonly attributed to the avoidance of end-range positions associated with high carpal tunnel pressures. 11,12 Maintenance of a neutral wrist position is believed to promote adequate blood circulation with a subsequent reduction of edema. 13 Although further research is required, recent systematic reviews indicate that conservative management with nerve and tendon gliding exercises may be beneficial for patie...

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Section: Discussionmentioning

confidence: 99%

Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome—an MRI study to reveal therapeutic mechanisms

Schmid

Elliott

Strudwick

et al. 2012

Journal Orthopaedic Research

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“…The second refers to patient's functional status and contains eight items, graduated in 1 to 5 points, which measures the ability to perform a given task using the hands. Higher BCTQ scores are associated to higher symptom's severity and higher functional disability 5 . The wrist US was performed by a blind physician using a Toshiba © system Xario © device, with the 12 MHz multifrequency linear transducer.…”

Section: Methods Methods Methods Methodsmentioning

confidence: 99%

“…Symptoms severity and functional impairment are the main concerns of patients. Aiming to quantify these problems, Levine et al 3 developed a specific questionnaire known as Boston Carpal Tunnel Questionnaire (BCTQ) that is a valid, reliable and well accepted tool for the quantification of symptoms and functional damage associated with CTS 4,5 . The most widely accepted theories for CTS ethiopathology are the mechanical and the microvascular nerve damage 2 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Ultrasound evaluation on carpal tunnel syndrome before and after bariatric surgery

Castro

Skare

Nassif

et al. 2014

Rev. Col. Bras. Cir.

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Objective:To evaluate the prevalence of carpal tunnel syndrome in candidates for bariatric surgery comparing with the non-obese population and verify the effects on it of bariatric treatment. Methods:We studiedthree groups of individuals: 1) patients waiting for bariatric surgery (preoperative); 2) individuals who had already undergone the procedure (postoperative); and 3) control group. We collected demographic and clinical data of carpal tunnel syndrome. The Ultrasound examination was carried out to diagnose the syndrome by measuring the median nerve area. Results:We included 329 individuals (114 in the preoperative group, 90 in the postoperative group and 125 controls). There was a higher prevalence of paresthesias (p=0.0003), clinical tests (p=0.0083) on the preoperative group when compared with controls (p<0.00001). There were lowe levels of paresthesias (p=0.0002) and median nerve area (p=0.04) in postoperative patients but with no significant difference in general. A significant difference was found between the preoperative and postoperative groups (p=0.05) in those who performed non-manual work.Conclusion: There was a higher prevalence of carpal tunnel syndrome in the preoperative group compared with the control one, but no significant difference was observed between the pre and postoperative groups in general. There was difference between pre and postoperative groups for non-manual workers.

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“…Manyauthors consider BCTQ reliable and valid methods in dealing with CTS. (Leite et al, 2006) Improvement appear in case of BCTQ as well as SDL and MDLin case of magnetic group than both placebo and surgical group may explained in basis of PEMF enhanced sub-cellular levels (including ion binding and molecular conformation at cell membrane level), with an ever increasing scale of effect through to whole organism (or 'organism wide') bio effects.…”

Section: Discussionmentioning

confidence: 99%

“…The evidence base of the psychometric properties indicates that the BCTQ is a valid, reliable, responsive and acceptable instrument and should be included as a primary outcome measures in future CTS trials. (Leite, 2006) The functional level of patients were determined using boston carpal tunnel syndrome questionnaire(BCTQ) which has been reported to be reliable and valid method of measuring progression of CTS state. (Leite, 2006) that patient answer questionnaire in beginning of intervention and after 3 months without looking in her initial answer.…”

Section: Methodsmentioning

confidence: 99%

Pulsed Magnetic Field Versus Surgery in Carpal Tunnel Syndrome: A Randomized, Placebo Controlled Double Blind Study

Ewidea¹,

Hamed²

2015

Adv. Sci.

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This study investigated the efficacy of pulsed magnetic field therapy (PMFT) versus surgical intervention in case of mild and moderate carpal tunnel syndrome (CTS) in a randomized, placebo-controlled, double-blinded study. Forty five female patients diagnosed as mild to moderate CTS were included in the study. Their ages were 35:55 years with mean age 41 ± 2.5 years. Patients were divided randomly into three equal groups, placebo group received sham exposure, and group ΙΙ received PEMT at frequency of 50 Hz, and the ΙΙΙ group received surgical interference. The outcome measurements were median nerve sensory distal latency (SDL), motor distal latency (MDL) and Boston carpal tunnel questionnaire (BCTQ). Measurements were carried out at baseline and three months later. Paired analysis for comparison between pre and post treatment measurements in each group showed significant decrease of SDL, MDL and BCTQ scores of both magnetic and surgery groups. In other hand there were non-significant increases of any variable in the placebo group. Despite the equal baseline of all groups before treatment, there were significant decrease of all measurements of both magnetic and surgical groups than placebo group and significant decrease of all measurements of magnetic group than surgical group. The results suggested that PEMT might be beneficial in improving median nerve electrophysiological function and improving hand functional abilities.

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A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire

Cited by 271 publications

References 22 publications

Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome—an MRI study to reveal therapeutic mechanisms

Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome—an MRI study to reveal therapeutic mechanisms

Ultrasound evaluation on carpal tunnel syndrome before and after bariatric surgery

Pulsed Magnetic Field Versus Surgery in Carpal Tunnel Syndrome: A Randomized, Placebo Controlled Double Blind Study

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