Management of carpal tunnel syndrome in the working population

Kasdan, Morton L.; Lewis, Kathleen

doi:10.1016/s0749-0712(01)00004-x

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…Trained animals participated in the task less as time progressed, and after 12 weeks, their median nerves showed marked fibrosis and macrophage infiltration. While the relationship between work activities and cumulative trauma has been questioned, 25,43 our results provide clear evidence of a causal relationship between repetitive motion and CTS in an animal model.…”

Section: Conclusion and Clinical Considerationsmentioning

confidence: 52%

“…44 While epidemiological studies have identified a positive relationship between the intensity and duration of repetitive and forceful hand-intensive tasks and the prevelance and incidence of CTS, many questions remain concerning the causal effects of work in CTS. 25,43 For example, the precise dose-response relationship between exposure to individual or combinations of risk factors and CTS onset and severity is not known. The underlying pathophysiological mechanisms, particularly in the early, most preventable stages of work-related CTS are unclear.…”

mentioning

confidence: 99%

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Performance of a High-Repetition, High-Force Task Induces Carpal Tunnel Syndrome in Rats

Clark

Alshatti²,

Barr³

et al. 2004

J Orthop Sports Phys Ther

113

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Study Design: A randomized controlled prospective experimental study with some repeated measures. Objectives: To characterize behavioral, sensory, motor, and nerve conduction decrements, and histological changes in the median nerve in rats trained to perform a high-force repetitive task. Background: Understanding of work-related carpal tunnel syndrome is hampered by the lack of experimental studies of the causes and mechanisms of nerve compression induced by repetitive motion. Most animal models of nerve compression have not employed voluntary repetitive motion as the stimulus for pathophysiological changes. Methods and Measures: Thirty Sprague-Dawley rats served as controls for 1 or more studies. Ten rats were trained to pull on a bar with 60% maximum force 4 times per minute, 2 h/d, 3 d/wk for 12 weeks. Motor behavior and limb withdrawal threshold force were characterized weekly. Grip strength and median nerve conduction velocity were measured after 12 weeks. Median nerves were examined immunohistochemically for ED1-positive macrophages, collagen, and connective tissue growth factor. Results: Reach rate and duration of task performance declined over 12 weeks. Grip strength and nerve conduction velocity were significantly lower after 12 weeks than in controls. Limb withdrawal threshold increased between weeks 6 and 12. Median nerves at the level of the wrist showed increases in macrophages, collagen, and connective-tissue growth-factor-positive cells. These effects were seen in both the reach and nonreach limbs. Conclusions: This animal model exhibits all the features of human carpal tunnel syndrome, including impaired sensation, motor weakness, and decreased median nerve conduction velocity. It establishes a causal relationship between performance of a repetitive task and development of carpal tunnel syndrome.

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Section: Conclusion and Clinical Considerationsmentioning

confidence: 52%

mentioning

confidence: 99%

Performance of a High-Repetition, High-Force Task Induces Carpal Tunnel Syndrome in Rats

Clark

Alshatti²,

Barr³

et al. 2004

J Orthop Sports Phys Ther

113

View full text Add to dashboard Cite

show abstract

“…11 Definitive diagnosis of CTS has long been a conundrum both in the medical and workers' compensation arenas. 12 It is not well understood why some individuals in the population seem to be susceptible to the diagnostic group of repetitive stress injuries (CTS, lateral and medial epicondylitis, tendinitis, tendinosis), whereas others with similar lifestyles, body types, and vocational demands are not. 9 Although median nerve conduction slowing provides an objective diagnostic criterion in some cases, in other cases, patients report symptoms that cannot be confirmed by electrodiagnostic or other objective measurements.…”

mentioning

confidence: 99%

Effect of Occupational Keyboard Typing on Magnetic Resonance Imaging of the Median Nerve in Subjects with and without Symptoms of Carpal Tunnel Syndrome

Shafer-Crane

Meyer²,

Schlinger

et al. 2005

American Journal of Physical Medicine & Rehabilitation

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“…16 Associated systemic diseases such as diabetes and hypothyroidism should be recognized and appropriately managed. 16 Associated systemic diseases such as diabetes and hypothyroidism should be recognized and appropriately managed.…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%