Bilateral deficits in fine motor control and pinch grip force in patients with unilateral carpal tunnel syndrome

Abstract

Subjects with carpal tunnel syndrome (CTS) typically describe self-perceived pinch grip deficits, clumsiness sensations and difficulty with grasping small objects, which suggest the existence of a fine motor control deficit. No previous studies have investigated fine motor control and pinch grip force bilaterally in patients diagnosed with moderate CTS. Our aim was to investigate differences in fine motor control ability and pinch grip force between patients with unilateral CTS and healthy controls. Subtests of the Purdue Pegboard Test (one-hand, bilateral and assembly) and pinch grip force were evaluated bilaterally in 20 women with unilateral CTS (aged 22-66 years), and 20 age and hand dominance-matched healthy women. Differences between sides (affected/unaffected or dominant/non-dominant) and groups (patients or controls) were analysed with an analysis of variance (ANOVA). The ANOVA found significant differences between both groups (F = 65.7; P < 0.001) and between sides (F = 5.4; P = 0.02) for the one-hand pin placement subtest: CTS patients showed bilateral worse scores on one-hand pin placement than controls (P < 0.001). Patients also showed significantly lower scores in bilateral pin placement and assembly subtests when compared to healthy controls (P < 0.001). The ANOVA also revealed significant differences between groups (F = 141.2; P < 0.001), and fingers (F = 142.2; P < 0.001), but not between sides (F = 0.9; P = 0.4) for pinch grip strength: CTS patients showed bilateral lower pinch grip force levels in all fingers when compared to controls (P < 0.001). Fine motor control and pinch grip were negatively related to the hand pain intensity and duration of symptoms history (all, P < 0.01). Our findings revealed bilateral deficits in fine motor control ability and pinch grip force in patients with unilateral moderate CTS when compared to controls.

Specific Mechanical Pain Hypersensitivity Over Peripheral Nerve Trunks in Women With Either Unilateral Epicondylalgia or Carpal Tunnel Syndrome

“…These results are similar to those previously reported for individuals with chronic whiplash 57,59 and unilateral migraine. 29 In addition, the results of the current study are consistent with those…”

“…70 Several studies have demonstrated that LE is characterized by bilateral sensory 21,22,53 and motor 6,54 changes, suggesting central sensitization mechanisms. Furthermore, vibration, 63 thermal, 19 and motor 29 impairments have been identified bilaterally in patients with unilateral CTS, which also suggests the presence of central mechanisms. A recent study demonstrated that LE is different to CTS in some sensory disturbances, as no deficit in thermal and vibration detection thresholds were found in individuals with LE.…”

Force requirements in topical medicine use—the squeezability factor

“…Rheumatoid arthritis, 8 osteoarthritis, 9 carpal tunnel disease 10 and stroke 11 have all been reported as having lower finger strengths. In addition to neurological disease causing lower strengths these can also cause deficits in control and direction of force application, 11 which are also required to co-ordinate functional tasks such as squeezing a bottle.…”

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

“…For instance, it has been reported that women with unilateral moderate CTS exhibit bilateral deficits in fine motor control and pinch tip grip force compared to healthy women. 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.…”

“…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.…”