Bilateral Deficits in Fine Motor Control and Pinch Grip Force Are Not Associated with Electrodiagnostic Findings in Women with Carpal Tunnel Syndrome

de-la-Llave-Rincón, Ana I; Fernández‐de‐las‐Peñas, César; Pérez-de-Heredia-Torres, Marta; Martínez-Pérez, Almudena; Valenza, Maríe Carmen; Pareja, Juan A.

doi:10.1097/phm.0b013e31821a7170

Cited by 22 publications

(21 citation statements)

References 29 publications

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“…Additionally, bilateral involvement, found in the majority of our patients, may be the cause of the inconsistency between functional status and severity of CTS. The results of de la Llave-Rinco et al (25) were similar to ours and those authors have suggested that the reason for being unable to fi nd any relationship between the seriousness of functional impairment in the hand and CTS severity was the variations in the innervation of muscle groups. Pinch and hand grip strength may be valuable for the assessment of hand disability.…”

Section: Discussionsupporting

confidence: 78%

Karpal Tünel Sendromunda Elektrodiagnostik Bulguların Klinik ve Fonksiyonel Durum Üzerine Etkisi

Bozbaş¹,

Iyiyapici²,

Şendur³

et al. 2017

Akd Med J

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Objective: The purpose of this study was to assess the relationship between electrodiagnostic fi ndings and hand functions, clinical severity and examination fi ndings of carpal tunnel syndrome (CTS). In addition, we aimed to determine the diagnostic value of provocative tests such as tinel, phalen and reverse phalen tests in the diagnosis of CTS. Material and Methods:We evaluated 79 wrists of 44 patients who were diagnosed as CTS on the basis of clinical history, physical examination and abnormalities of median nerve sensory and motor conduction velocities and 50 healthy volunteers. Physical evaluation included the tinel, phalen and reverse phalen tests. The clinical severity of CTS was scored in terms of a historic and objective scale and hand function was evaluated through the Boston carpal tunnel questionnaire and Duruoz Hand Index. Results: It was determined that the severity of CTS and the electrophysiological assessment was correlated with the severity of symptoms, pain and hand strength whereas it was not correlated with functional status. Functional status is affected by hand and pinch grip strength. Sensitivities of the tinel, phalen and reverse phalen tests were 62%, 54.4%, and 57% respectively, whereas their specifi cities were 92%, 86%, and 88% respectively in our study group. There was no association between CTS severity and the positivity of provocative tests. Conclusion: Electrophysiological evaluation is quite important for the diagnosis of CTS disease. However, this investigative method cannot be carried out everywhere and patient appointments to evaluate their condition are arranged for later times. In such situations, provocative tests, symptoms and functional status are important for the diagnosis. Key Words: Carpal tunnel syndrome, Disease severity, Hand function, Provocative test ÖZ Amaç: Çalışmamızın amacı karpal tünel sendromunda elektrodiyagnostik bulgular ile el fonksiyonları, semptomlar ve muayene bulguları arasındaki ilişkiyi değerlendirmektir. Ayrıca KTS tanısında kullanılan tinel, phalen ve ters phalen gibi provakatif testlerin tanısal değerini de saptamayı amaçladık. Gereç ve Yöntemler: Öykü, fi zik muayene ve median sinir duysal ve motor ileti hızlarının değerlendirilmesi sonucunda KTS tanısı konan 44 hastanın 79 eli ve 50 sağlıklı gönüllü değerlendirildi. Fizik muayenede tinel, phalen ve ters phalen testleri kullanıldı. Semptomların şiddeti "semptom şiddet skalası" ve el fonksiyonları ise "Boston karpal tünel anketi" ve "Duruöz el indeksi" ile değerlendirildi. Bulgular: Karpal tünel sendromunun elektrodiyagnostik şiddeti semptomların şiddeti, ağrı ve el kavrama güçleri ile korele bulunurken, el fonksiyonları ile korelasyon saptanmamıştır. Fonksiyonel durum, el ve başparmak kavrama gücünden etkilenmiştir. Tinel, phalen ve ters phalen testlerinin sensitiviteleri sırasıyla %62, %54.4 ve %57 bulunurken, spesifi teleri %92, %86 ve %88 olarak saptanmıştır. KTS'nin şiddeti ile provakatif testlerin pozitifl iği arasında ise korelasyon saptanmamıştır. Sonuç: KTS tanısında elektro...

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Section: Discussionsupporting

confidence: 78%

Karpal Tünel Sendromunda Elektrodiagnostik Bulguların Klinik ve Fonksiyonel Durum Üzerine Etkisi

Bozbaş¹,

Iyiyapici²,

Şendur³

et al. 2017

Akd Med J

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“…19 In fact, these deficits seem to be similar in individuals with minimal, moderate, or severe CTS. 15 Deficiencies in sensory and motor processes often result in alteration in force adaptations, which can lead to the inability to adequately perform functional activities with the upper limb. 1 Patients with CTS exhibit physical and psychological 25 impairments before surgical intervention.…”

Section: T T Backgroundmentioning

confidence: 99%

“…The patients were asked to watch the screen for visual feedback. 15,19 They performed the pinch with the thumb below and either the index or little finger on top of the pinch grip dynamometer. The mean of 3 trials with each finger was calculated and used for the analysis.…”

Section: Physical Outcomesmentioning

confidence: 99%

“…22 Although CTS is primarily considered a peripheral neuropathy, increasing evidence is showing that musculoskeletal disorders and sensitization mechanisms are related in this condition. 16 Previous studies have demonstrated the presence of widespread pressure pain hypersen-T T STUDY DESIGN: Cross-sectional study. …”

mentioning

confidence: 99%

“…Nevertheless, previous studies have found high reliability (ICC = 0.89-0.92) of PPT assessments over these specific points in women with CTS. 15,18 To avoid assessment variability, the physical and neurophysiological outcomes from all participants in the study were examined by the same physical therapist, who had 10 years of experience in CTS. …”

mentioning

confidence: 99%

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Clinical, Physical, and Neurophysiological Impairments Associated With Decreased Function in Women With Carpal Tunnel Syndrome

Fernández‐de‐las‐Peñas

Cleland²,

Plaza-Manzano³

et al. 2013

J Orthop Sports Phys Ther

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[ research report ] C arpal tunnel syndrome (CTS) is a disorder characterized by compres sion of the median nerve at the carpal tunnel, often as a result of repetitive activities. 40The clinical presentation of CTS includes motor and sensory deficits in the median nerve distribution and numbness, which may be worse during the night. 31 Women are most often afflicted with CTS, with a reported annual incidence of 139 per 100 000 females, compared to 67 cases per 100 000 males.6 CTS can result in considerable pain, loss of function, and disability. The societal burden of CTS is substantial, and it has been reported that individuals with CTS exhibit loss in productivity and monetary income. 22 Although CTS is primarily considered a peripheral neuropathy, increasing evidence is showing that musculoskeletal disorders and sensitization mechanisms are related in this condition. 16 Previous studies have demonstrated the presence of widespread pressure pain hypersen-T T STUDY DESIGN: Cross-sectional study. T T OBJECTIVE:To examine the associations between clinical (pain), physical (cervical range of motion [ROM] and pinch grip force), and neurophysiological (pressure pain thresholds) outcomes and self-reported function and disability in women with carpal tunnel syndrome (CTS). T T BACKGROUND:The association of physical and physiological variables with self-rated function and disability in patients with CTS has not been fully determined. A better understanding of the association between potentially modifiable risk factors, such as limited cervical ROM, could assist clinicians in optimizing therapeutic programs for this group of patients. T T METHODS:One hundred fifty-four women with CTS were recruited. Demographic information and data on duration of symptoms, pain intensity, depression, cervical ROM, pinch grip force, and pressure pain thresholds over the neck, hand, and leg were collected. Self-reported function and disability were measured with the functional status subscale of the Boston Carpal Tunnel Questionnaire. Correlation and regression analyses were performed to determine associations between variables. T T RESULTS:There were significant positive correlations between the functional status subscale score and pain intensity (r = 0.36, P<.001), depression (r = 0.32, P<.001), and duration of symptoms (r = 0.23, P = .005). Significant negative correlations were also observed between the functional status subscale score and pinch grip force of the index finger (r = -0.25, P = .002) and little finger (r = -0.28, P<.001), ROM in cervical flexion (r = -0.22, P = .003) and lateral flexion away from the side of CTS (r = -0.24, P = .002) and toward the side of CTS (r = -0.16, P = .045), and pressure pain threshold over C5-6 (r = -0.34, P<.001), the carpal tunnel (r = -0.35, P<.001), and the tibialis anterior muscle (r = -0.26, P<.001).Stepwise regression analyses revealed that pain intensity, thumb and little finger pinch grip force, severity of depression, and cervical ROM in lateral flexion away from the side of CTS expla...

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Quantitative evaluation of hand motor function using a gyrosensor in mild and moderate carpal tunnel syndrome

Seok

Kim

et al. 2019

Muscle and Nerve

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Introduction The objective of this study was to determine whether patients with carpal tunnel syndrome (CTS) manifest changes in early‐stage motor function and to investigate the utility of a gyrosensor for quantitative evaluation of motor function. Methods Angular velocity signal was measured during finger tapping in 52 patients with mild‐to‐moderate CTS and 45 controls. Four finger‐tapping performance (FTP) values—root‐mean‐squared (RMS) velocity, RMS angle, peak power, and total power—were derived from the signal. Results All FTP values were significantly lower in patients with CTS than in controls (P = 0.001 or P < 0.001). There were no significant differences between the mild and moderate CTS subgroups. Discussion FTP measurement with a gyrosensor represents a valuable tool for the evaluation of median nerve motor function in patients with CTS. It facilitates the detection of subclinical motor dysfunction in patients with early stage CTS. Muscle Nerve 59:465–469, 2019

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Bilateral Deficits in Fine Motor Control and Pinch Grip Force Are Not Associated with Electrodiagnostic Findings in Women with Carpal Tunnel Syndrome

Abstract: : The current study revealed similar bilateral deficits in fine motor control and pinch grip force in patients with minimal, moderate, or severe CTS, supporting that fine motor control deficits are a common feature of CTS not associated with electrodiagnostic findings.

Cited by 22 publications

References 29 publications

Karpal Tünel Sendromunda Elektrodiagnostik Bulguların Klinik ve Fonksiyonel Durum Üzerine Etkisi

Karpal Tünel Sendromunda Elektrodiagnostik Bulguların Klinik ve Fonksiyonel Durum Üzerine Etkisi

Clinical, Physical, and Neurophysiological Impairments Associated With Decreased Function in Women With Carpal Tunnel Syndrome

Quantitative evaluation of hand motor function using a gyrosensor in mild and moderate carpal tunnel syndrome

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