Abstract
To investigate whether sensorimotor control of the hand could be an outcome indicator after carpal tunnel release (CTR), this work examined changes in the results of patients’ manual tactile test (MTT), pinch-holding-up activity (PHUA), two-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) tests. Participants included 30 predominantly sensory neuropathy CTS patients, as confirmed by a nerve conduction study. The MTT, precision pinch performance in PHUA and traditional sensibility (2PD and SWM) tests were used to examine different aspects of sensory status at the time-points of two weeks before operation and one month post-operation, with a single-blind design. The results showed significant improvements in the sensory function as detected by the 2PD and SWM tests (p<0.001) and sensorimotor function as detected by the MTT (p<0.001) and PHUA test (p<0.05) for patients receiving CTR. The responsiveness of the SWM, MTT and PHUA tests (effect size>0.5, p<0.01) are better than that of two-point discrimination test (effect size<0.5, p<0.001). However, pinch strength saw a decline compared to baseline with a moderate effect sizes (effect size = 0.7, p<0.001). This cohort study found that the MTT and PHUA test can both meet all the statistical criteria with regard to assessing treatment outcomes for patients with CTS. In addition, the results of this work provide clinicians with the information that the sensorimotor functions of the hands, as assessed by MTT and PHUA, are responsive to clinical changes due to CTR.
Highlights
Carpal tunnel syndrome (CTS) is a condition with a high prevalence worldwide [1, 2], and has been shown to negatively influence the health-related quality of life [3] and sensorimotor functioning [4] of patients
The time-requirement of the three subtests of the manual tactile test (MTT) meant that the CTS patients showed significant differences before and after carpal tunnel release (CTR) (p
This study investigated the responsiveness of the MTT, pinch-holding-up activity (PHUA) and traditional sensory tests for CTS patients who received CTR
Summary
Carpal tunnel syndrome (CTS) is a condition with a high prevalence worldwide [1, 2], and has been shown to negatively influence the health-related quality of life [3] and sensorimotor functioning [4] of patients. For early CTS, the combined use of the Semmes-Weinstein monofilament (SWM) test and nerve conduction studies (NCS) has been shown to provide the objective outcomes needed to identify sensory deficits in nerve compression disorders [7]. The stimulus is given in a very subjective way when executing traditional tests (i.e., 2PD and SWM), and these are seen as very subjective measurements,[10] with more objective methods being needed in clinical practice to directly estimate the sensorimotor function with regard to the patient's hand capabilities [11]. A new manual tactile test (MTT) was developed to evaluate the integrated ability of perception with regard to object characteristics and functional hand uses [16]. The ability to adjust the hand pinch force according to the inertial load of the object being handled has been shown to be an objective evaluation of hand performance,[17,18,19,20], and one which correlates strongly with hand functioning [21]
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