Assessment of Vibrotactile Sensitivity in Patients with Carpal Tunnel Syndrome

Checkosky, Christine M.; Bolanowski, Stanley J.; Cohen, Jason C.

doi:10.1097/00043764-199606000-00010

Cited by 13 publications

(5 citation statements)

References 38 publications

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“…In addition, these authors did not find any significant differences in vibration sense in those with CTS compared to a control group at 16, 32, 125, 250, or 500 Hz. There were differences at 8 and 63 Hz, but in another level I study, Checkosky et al 59 found a difference in CTS cases and controls at 10 Hz but no differences at 1 or 300 Hz.…”

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confidence: 83%

“…Pacinian corpuscles are also fast adapting, responding to frequencies of 40 to more than 500 Hz, but have ill-defined receptive fields. 59,166 Based on this physiology, vibration testing at different frequencies could provide different informa--LRs range from 0.75 to 1.90. Studies used different criteria for what was considered a positive test (TABLE 4).…”

Section: Vibrotactile Testingmentioning

confidence: 99%

“…Results from studies on reliability and diagnostic accuracy of sensory instruments are reported in TABLES 5 through 7. 59,67,107,126,139,170,171,173,182,183,274,291,300 Testing with the PCV50 computerized vibrometer (Z tech Medical, Salt Lake City, UT) demonstrated excellent intrarater reliability (TABLE 5). However, this instrument may not be available for clinicians.…”

Section: Sensory Measuresmentioning

confidence: 99%

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Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome

Erickson¹,

Lawrence²,

Jansen³

et al. 2019

Journal of Orthopaedic & Sports Physical Therapy

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When examining a patient with suspected carpal tunnel syndrome (CTS), clinicians should use Semmes-Weinstein monofilament testing (SWMT), using the 2.83 or 3.22 monofilament as the threshold for normal light touch sensation and static 2-point discrimination on the middle finger to aid in determining the extent of nerve damage. In those with suspected moderate to severe CTS, clinicians should assess any radial finger using the 3.22 filament as the threshold for normal. Semmes-Weinstein monofilament testing should be repeated by the same provider. BIn those with suspected CTS, clinicians should use the Katz hand diagram, Phalen test, Tinel sign, and carpal compression test to determine the likelihood of CTS and interpret examination results in the context of all clinical exam findings.Clinicians should assess and document patient age (older than 45 years), whether shaking their hands relieves their symptoms, sensory loss in the thumb, the wrist ratio index (greater than 0.67), and scores from the Boston Carpal Tunnel Questionnairesymptom severity scale (CTQ-SSS) (greater than 1.9). The presence of more than 3 of these clinical findings has shown acceptable diagnostic accuracy. D There is conflicting evidence on the diagnostic accuracy and clinical utility of the upper-limb neurodynamic tests, scratch-collapse test, and tests of vibration sense in the diagnosis of CTS, and therefore no recommendation can be made. EXAMINATION -OUTCOME MEASURES: ACTIVITY LIMITATIONS/SELF-REPORTED MEASURES BClinicians should use the CTQ-SSS to assess symptoms and the Boston Carpal Tunnel Questionnaire functional scale (CTQ-FS) or the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to assess function when examining patients with CTS. Clinicians should use the CTQ-SSS to assess change in those undergoing nonsurgical management. EXAMINATION -ACTIVITY LIMITATIONS/ PHYSICAL PERFORMANCE MEASURES C Clinicians may use the Purdue Pegboard (PPB) or the Dellon-modified Moberg pick-up test (DMPUT) to quantify dexterity at the onset of treatment and compare scores with established norms. Clinicians should not use the PPB test, Jebsen-Taylor Hand Function Test, or the Nine-Hole Peg Test to assess clinical change following carpal tunnel release (CTR) surgery. Clinicians may use the DMPUT to assess change following CTR surgery. EXAMINATION -ACTIVITY LIMITATIONS/ PHYSICAL IMPAIRMENT MEASURES Strength MeasuresA Clinicians should not use lateral pinch strength as an outcome measure for patients with nonsurgically or surgically managed CTS. B Clinicians should not use grip strength when assessing short-term (less than 3 months) change in individuals following CTR surgery.C Clinicians may assess grip strength and 3-point or tip pinch strength in individuals presenting with signs and symptoms of CTS and compare scores with established norms. D There is conflicting evidence on the use of tip and 3-point pinch strength and abductor pollicis brevis muscle strength testing in individuals following CTR surgery. Sensory and Provocative MeasuresC C...

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confidence: 83%

Section: Vibrotactile Testingmentioning

confidence: 99%

Section: Sensory Measuresmentioning

confidence: 99%

See 1 more Smart Citation

Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome

Erickson¹,

Lawrence²,

Jansen³

et al. 2019

Journal of Orthopaedic & Sports Physical Therapy

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“…The value for vibratory screening of CTS is controversial. Werner found that the test was not sensitive for early detection of CTS, 83 whereas Checkosky confirmed the test as sensitive for early detection of CTS 101 . Finally, Jeng reported that the gap detection tactility test was sensitive and specific for CTS diagnosis, where the mean gap detection for normal subjects was 0.20 mm vs. an mean of 0.40 mm for patients with CTS 102 …”

Section: Upper Quarter Work‐related Msdsmentioning

confidence: 99%

Ergonomic Pain––Part 2: Differential Diagnosis and Management Considerations

et al. 2004

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Work-related musculoskeletal disorders (MSDs) can produce ergonomic pain in several different regions of the body, including the shoulder, elbow, wrist and hand, lumbar spine, knee, and ankle/foot. Each family of disorders is distinctive in presentation and requires diagnosis-specific interventions. Because of the complex nature of these disorders, management approaches may not always eliminate symptoms and or completely restore patient function to a level found prior to symptom onset. As a consequence, ergonomic measures should be implemented to reduce the overload on tissue and contribute to patient recovery. However, functional limits may persist and the clinician must make further decisions regarding a person's functional status in the chronic stages of the patient's care.

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“…Nevertheless, the value of VST in the evaluation of nerve compression is controversial. Some studies find that VST is a sensitive diagnostic test in early nerve compression syndromes (Grunert et al 1990;Jetzer 1991;Lundborg et al 1986;Szabo et al 1984) whilst others do not support the use of VST in compression neuropathy (Checkosky et al 1996;Werner et al 1994).…”

Section: Introductionmentioning

confidence: 99%