Functional tests to quantify recovery following carpal tunnel release.
Radwin RG; Sesto ME; Zachary SV
J Bone Jt Surg 2004 Dec; 86-A(12):2614-2620
BACKGROUND: An objective test is needed to evaluate outcome following carpal tunnel release. A method to evaluate sensory and motor function related to carpal tunnel syndrome was investigated. METHODS: Thirty-six candidates for carpal tunnel surgical procedures underwent a physical examination and nerve-conduction studies and completed a survey regarding symptoms. A battery of psychomotor and sensory tests was administered bilaterally immediately before surgery and again six weeks after surgery. The outcome variables included dynamic sensory gap-detection thresholds and rapid pinch-and-release rates. RESULTS: The average gap-detection threshold for the index finger in the surgical-treatment group demonstrated a 43% improvement, decreasing from 0.14 mm preoperatively to 0.08 mm at six weeks postoperatively (p < 0.01). The average gap-detection threshold for the index finger in the non-surgical-treatment group demonstrated no significant improvement, decreasing from 0.10 mm preoperatively to 0.08 mm postoperatively (p = 0.10). With the upper force level set at 10% of the maximum voluntary contraction, the average pinch rate in the surgical-treatment group demonstrated a 20% improvement, increasing from 6.65 pinches per second preoperatively to 7.96 pinches per second postoperatively (p < 0.001). The average pinch rate in the non-surgical-treatment group demonstrated a 7% improvement, increasing from 6.89 pinches per second preoperatively to 7.37 pinches per second at six weeks postoperatively (p < 0.05). CONCLUSIONS: Measurable and significantly greater improvement was observed when the surgical-treatment group was compared with the non-surgical-treatment group in terms of these two sensory and psychomotor functional testing outcomes at six weeks. LEVEL OF EVIDENCE: Therapeutic study, Level II-1 (prospective cohort study). See Instructions to Authors for a complete description of levels of evidence.
Workplace-monitoring; Carpal-tunnel-syndrome; Ergonomics; Injuries; Musculoskeletal-system-disorders; Sensory-disorders; Cumulative-trauma-disorders; Cumulative-trauma; Sensory-motor-system; Neuromuscular-function; Neuromotor-function; Peripheral-nervous-system; Arm-injuries
Robert G. Radwin, University of Wisconsin, 1550 Engineering Drive, Madison, WI 53706
Disease and Injury: Musculoskeletal Disorders of the Upper Extremities
Journal of Bone and Joint Surgery
University of Wisconsin, Department of Biomedical Engineering, Madison, WI