The prevalence of carpal tunnel syndrome among long-term manual wheelchair users with spinal cord injury: A cross-sectional study

Abstract

Context: Use of a handrim wheelchair could force the wrist into extreme excursions and encroachment of the median nerve.Objective: We performed a study of the prevalence of carpal tunnel syndrome in prolonged wheelchair users.Design and setting: A cross-sectional study was conducted for one year in an outpatient clinic of spinal cord injury.Participants: Patients had traumatic injury at the first thoracic level and below, with time since injury of at least 5 years.Outcome measure: The prevalence of carpal tunnel syndrome by history taking, clinical examinations and motor and sensory nerve conduction studies of median nerve performed for both hands.Results: Participants (N = 297) were all male. Mean (SD) age and duration since injury were 48 (8.5) and 23 (6.6) years, respectively. A significant difference in median duration of injury based on the severity of the syndrome (P < 0.001), and a significant trend in time since injury for the severity (P (one tailed) < 0.001) were seen. There was a significant difference in the median age among the groups (P = 0.009), and the median increased with the severity (P (one tailed) = 0.001).Conclusions: Carpal tunnel syndrome is a common side effect of the long time use of wheelchair, and its severity is associated with duration of wheelchair use and age. Alternative methods for wheelchair propulsion should be developed to diminish the likelihood of the syndrome.