CTS Symptoms Research Articles

Evaluation of occupational and non-occupational risk factors associated with carpal tunnel syndrome-related symptoms in office workers

Abstract Background : While the main occupational and non-occupational risk factors associated with carpal tunnel syndrome are known, we still need to understand which of these factors has a stronger correlation with carpal tunnel-related symptoms in office workers and to improve future work-space recommendations accordingly. Objective : This study aimed to investigate the relationship between occupational and non-occupational risk factors and carpal tunnel syndrome-related symptoms among office workers who use a computer in their dayto-day activities. Methods : The data used in this study were collected from May to September 2022 through an online questionnaire from one respondent to another through different forms of social media, using the snowball method. The recorded data were further analysed using an SPSS program. In this way, we analysed quantitative variables by calculating the means, the medians, the standard deviation and the normal distribution and qualitative variables by reporting them as absolute values and percentages of the total. We compared different subgroups of samples using the chi-square test and the binary regression method. A p-value of less than 0.05 was the threshold of statistical significance. Results : This study evaluated 130 office workers and identified and analysed the complex relationships between occupational and non-occupational risk factors of CTS and CTS symptoms grouped as pain, sensory function impairment and motor function impairment. Through data analysis and further logistic regression analysis, we concluded that while sensory function impairment is mostly associated with occupational factors such as computer typing with one hand, pain and motor function impairment are associated with both non-occupational, well-known risk factors (female sex, high BMI) and number of hours on the computer outside of work, and occupational risk factors like using both a mouse and an external keyboard, having a chair with adequate arm support and typing with one hand. Conclusion : Both occupational and non-occupational risk factors contribute to the development of CTS-related symptoms. Our dataset highlights the complex relationship between CTS occupational and non-occupational risk factors in office workers, thus providing insights for future workplace recommendations and preventive strategies.

577 Risk Factors Associated with the Reported Scores on Symptoms Severity and Functional Limitations Scales of the Boston Carpal Tunnel Questionnaire: A Cross-Sectional Study

Abstract Aim We aim to identify risk factors associated with higher scores of CTS symptoms severity and functional limitations on the BCTQ. Method This cross-sectional study was conducted among 366 female participants. The data was mainly collected using the BCTQ. Demographics and risk factors of CTS were added to the study's complete questionnaire; Risk factors included: Rheumatoid Arthritis (RA), Diabetes Mellitus (DM), hypothyroidism, number of pregnancies, usage of Oral Contraceptive Pills (OCPs), use of smartphones and keyboards. A P-value of < 0.05 was considered statistically significant. Results Most participants were in their thirties (44%) and housewives. RA, DM, hypothyroidism, and pregnancy were associated with reporting symptoms and functional limitations on BCTQ. OCPs and smartphone use were associated with functional limitations only. Conclusions Different risk factors are associated with reporting symptoms and functional limitations of CTS on the BCTQ. For example, RA, DM, hypothyroidism, pregnancy, OCPs and smartphone use have all been found statistically affect the outcome of the BCTQ in this study. Clinical confirmation of CTS diagnosis is required in future studies to make sure that these symptoms and functional limitations are associated with CTS pathology itself rather than other risk factors pathologies for proper targeted treatment plans and outcomes.

Comparison between the Effects of Ultrasound Guided Local Insulin Injections versus Hydrodissection of Normal Saline in Carpal Tunnel Syndrome Patients with Diabetes Mellitus

Background Hydrodissection is a minimally invasive procedure of injecting fluid into anatomic spaces to facilitate dissection and adhesiolysis in peripheral nerve entrapments. The near-nerve local insulin injection is thought to promote neuronal growth and regeneration, and could be important in restoring nerve function following metabolic or vascular damage. Aim of the Work to compare the short-term effects of insulin and normal saline local injections in the treatment of patients with diabetes mellitus who have mild-to-moderate carpal tunnel syndrome. Patients and Methods A comparative study was conducted on 30 carpal tunnel syndrome patients with diabetes mellitus during recruited from Ain Shams University Hospital, Neurosonology, neurology department during the period January 2020 to March 2021 according to the regulation of Ain Shams University ethical and scientific committee. The privacy of participants and confidentiality of the data were guaranteed during various phases of the study. Results the Hydrodissection (10 ml of normal saline) of the median nerve is significantly effective in the treatment of mild to moderate carpal tunnel syndrome in patients with diabetes mellitus and alleviates the symptoms of CTS. Also the study showed that the local insulin injection (10 IU of NPH) alone is significantly effective in the management of mild to moderate carpal tunnel syndrome of diabetic patients, which shows significant response within two weeks of follow up. The study shows that Hydrodissection is slightly superior to insulin for treatment of CTS. Furthermore our current study compares the failure rate of both treatment modalities which implies that Hydrodissection group are less failure rate than insulin group, but this difference is insignificant due small sample size of both groups. Conclusion Hydrodissection and local insulin injection are effective methods in the management of mild to moderate Carpal Tunnel Syndrome of diabetic patients with superiority of ultrasound guided hydrodissection to Insulin. It is noteworthy this study is considered a pioneer in comparing HD and Insulin in managing CTS.

Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients

Abstract Background Carpal tunnel syndrome (CTS) is one of the most frequent extra-articular manifestations of rheumatoid arthritis (RA). Aim and objectives to assess the presence and severity of Carpal tunnel syndrome in rheumatoid arthritis patients and its relation to disease activity. Patients and Methods This is observational cross sectional study, was carried out 30 rheumatoid arthritis patients recruited from Ain Shams University Hospital)inpatient internal medicine department and rheumotology outpatient clinic) in the period from November (2018) till November (2020). Result Only ultrasound assesment of CTS by measuring Of CSA>10 at wrist showed significant positive correlation with RA Patients ages, RA disease duration, CTS symptoms duration, CRP, RF and anti ccp positivity and negative correlation with HB% indicating association with disease compare to others activity. Conclusion CTS frequency in RA is found higher than normal population, especially in patients with additional risk factors of CTS. There was no relationship between CTS and disease activity, and CTS group had long disease duration and worse functional status. CTS could be a result of the chronic course in RA.

Carpal Tunnel Syndrome: As Seen from the Perspective of the Patient.

An online crowdsourcing platform was used to recruit participants for this study. Study participants were first led through a clinical scenario in which the symptoms of CTS were explained. They were then asked a series of questions regarding what was important to them when deciding upon treatment. A Likert scale was used for responses. In total, 268 participant responses were included in the study. A majority of patients responded that all surveyed factors were either very important or important when considering treatment. The risk of surgery was most important, whereas postoperative pain was least important. The risk of surgery was significantly more important to patients than postoperative pain and time out of work. The cost of surgery was significantly more important to patients than postoperative pain. Given the lack of consensus regarding an algorithm for the treatment of CTS, the patient's preference is increasingly important when formulating a treatment plan. The results of this study may better help physicians frame the discussion of treatment options for CTS with their patients.

Assessment of Carpal Tunnel Syndrome Symptoms and Functional Status among Medical Students: A Cross-Sectional Survey in Lahore, Pakistan.

Background: Medical students may be at a higher risk for developing CTS due to the repetitive nature of their work and prolonged use of computers. This survey investigated the severity of CTS symptoms and functional status among medical students.
 Methodology: Among medical students, a quantitative observational cross-sectional survey was carried out in Lahore, Pakistan. A total of 112 students of both gender, aged between 19 to 27 years, participated in this study. A demographic questionnaire and a Boston carpel tunnel syndrome questionnaire were used, and questions related to moderate and strenuous exercise were included in the survey. 
 Results: The functional status of a medical student is categorized as 22.3% in the asymptomatic category, 40.2% in the mild category, 19.6% in the moderate category, and 17.9% fall in the severe category. An association was found between symptom severity and prolonged hand use & functional status. The study results provide insights into the risk factors and potential preventive measures for CTS in this population.
 Conclusion: The study has collected data on the prevalence of CTS among medical students, the severity of their symptoms, the impact of CTS on their academic performance, and the factors associated with the development and severity of CTS among medical students. Our survey results show that medical students of the study site have not been classified as high-risk.

Carpal tunnel syndrome secondary to tumoral calcinosis: a case report and review of the literature

BackgroundCarpal Tunnel Syndrome (CTS) is the most prevalent peripheral nerve entrapment disease. Its pathophysiology is multifactorial and defined as idiopathic in most cases. We present a rare case of CTS secondary to tumoral calcinosis and then searched the English literature to present the details of all published cases with this entity.Case presentation.A 52-year-old woman presented for a one-year history of numbness and paresthesia in her right hand. The patient’s signs, symptoms, physical examination, and nerve electrodiagnostic testing suggested median nerve compression at the level of the carpal tunnel. However, a confirmatory magnetic resonance imaging of the wrist showed a localized calcareous lesion in the carpal tunnel. Subsequently, carpal tunnel release and mass excision were successfully performed with no recurrence at a 3-month interval.ConclusionCTS secondary to tumoral calcinosis is a rare benign condition. Physicians should remain vigilant and include it in their differential diagnosis when facing a previously healthy patient presenting for chronic CTS symptoms.

Prevalence of Carpal Tunnel Syndrome Among Dentists Working in Tertiary Care Hospitals of Peshawar, Pakistan

Objective: To determine the prevalence of Carpal Tunnel Syndrome among dentists working in tertiary care hospitals of Peshawar Methodology: A cross-sectional survey was conducted on 132 dentists working in tertiary care hospitals of Peshawar, Pakistan. The data was collected from four public and three private tertiary care hospitals via convenience sampling technique. A standard Boston Carpal Tunnel Questionnaire, Kamath and Stothard Carpal Tunnel Questionnaire, Numeric Pain Rating Scale and Phalen’s Test were used. The data was collected and analyzed by using SPSS version 25. Frequency and percentage were calculated for categorical variables and chi-square test was applied to find the association between variables. Results: A total of 132 dentists participated in this research out of whom 65 (49.2%) were males while 67 (50.8%) were females. Twenty-eight (21.2%) respondents reported the symptoms of Carpal Tunnel Syndrome. Fifteen (11.4 %) respondents had mild pain and 13 (9.8%) had moderate pain. The participants’ ages ranged between 25 and 30 years (66.7%), and 107 (81.1%) had a working experience of less than 10 years. Ninety-one (68.9%) dentists were working for 6-8 hours per day and 57 (43.2%) of the participants had a normal body mass index (BMI) ratio. Conclusion: Dentists who work in hospitals of Peshawar appear to suffer from Carpal Tunnel Syndrome. Dentists who have more hours of contact time with patients per day have increased risk of CTS symptoms but no association was found between gender and CTS symptoms. Furthermore, the symptoms of CTS increased with age.

Occupational hand and wrist disorders among forestry workers: An exposed-control study to investigate preventive strategies.

In the arboriculture sector, some activities are still manually performed by forestry workers, which result consequently exposed to a high risk of developing muscle skeletal disorders. The Italian Compensation Authority reported an increase of work-related tendinopathies and carpal tunnel syndrome in loggers, but screening protocols are not available yet. The objectives were: a) to evaluate the prevalence of tendinopathies and carpal tunnel syndrome in a sample of loggers and b) identify a sound screening approach. 41 loggers and 41 paired control workers were recruited for a total of 164 hands. The protocol included 1) demographic data; 2) medical history; 3) identification of CTS symptoms through a questionnaire and a hand-chart; 4) upper limbs clinical examination; 5) Raynaud's diseases questionnaire; 6) wrists ultrasound; 7) NCS of the distal median nerve. The prevalence of tendinopathies was statistically significant only in the non-dominant hand (75, 5% in the exposed group and 53, 6% in the non-exposed group). The prevalence of CTS was 32, 2% in the exposed group and 15, 5% in the non-exposed group. The questionnaire had a sensitivity of 56, 7% and a specificity of 75%. The hand-chart had a sensitivity of 30% and a specificity of 92%. The clinical examination had sensitivity of 30% and specificity of 80%. The ultrasound had a sensitivity of 70% and a specificity of 56%. Loggers are a population at risk of occupational hand and wrist disorders. The hand-chart could be considered, together with the questionnaire, as the best secondary prevention tool to diagnose CTS.

Is psychological distress associated with carpal tunnel syndrome symptoms and nerve conduction study findings? Acase-control study from Syria.

BackgroundCarpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve at the wrist which causes severe symptoms. However, psychological aspects can affect patients' perception of this pain and can cause similar pain in some instances. This study aims to determine the association between symptoms severity, functional status, and nerve conduction studies (NCS) of adult patients with CTS and their anger, anxiety, and depression status.MethodsThis case–control study was conducted in clinics in Damascus, Syria. Controls were frequency matched by gender and age from a general clinic. Interviews based on questionnaires were used that included the Boston Carpal Tunnel Questionnaire (BCTQ‐A), Hospital Anxiety and Depression Scale (HADS), Dimensions of Anger Reactions Scale‐5 (DAR‐5), and NCS.ResultsOverall, 242 patients (121 cases) were included in this study. Cases with CTS had significantly higher anxiety and depression when compared to controls, but not higher anger. Cases with higher anxiety, depression, and anger had significantly more CTS symptoms and less functional status. Anxiety was also higher in cases with normal NCS in the case group. When using regression, anxiety and depression remained significantly associated with having CTS.ConclusionAnxiety and depression are more prominent with CTS. Furthermore, having anxiety and depression were associated with more CTS symptoms in the hand. Having anger was also associated with more CTS symptoms among cases. These findings emphasize the importance of psychological aspects when having hand pain or CTS symptoms as these patients might have these symptoms despite having normal NCS.

CARPAL TUNNEL SYNDROME-A NARRATIVE REVIEW

Introduction: Carpal tunnel syndrome is the most common musculoskeletal disorder resulting from ischemic response to the median nerve in the carpal tunnel. The thumb, index finger and middle finger are particularly affected by the compression of the median nerve through the carpal tunnel at the wrist. Methodology: There are several methods for diagnosing CTS, including history taking, physical examinations, diagnostic questionnaires, electro diagnostic testing, and ultrasound. Provocative tests can be a part of the CTS diagnostic tools and are crucial components of the physical examination. Result: Physiotherapy intervention is widely applied as a conservative treatment and a non-invasive method in clinical settings. Conclusion: For patients with mild to moderate CTS symptoms, conservative treatment is beneficial and recommended by numerous studies.

Impact of Wrist Posture on Potential CTS Symptoms Using Chi-Square Test and Odds Ratio

Impact of Wrist Posture on Potential CTS Symptoms Using Chi-Square Test and Odds Ratio

The Most Important Risk Factors for Carpal Tunnel Syndrome

Background: The aim of this study was to determine the risk factors for carpal tunnel syndrome and its relationship with the severity of the disease. Methods: A total of 131 patients with clinical symptoms of CTS and 131 normal subjects were enrolled, of whom 121 were female both in the CTS cases and the controls. All cases were electro diagnostically confirmed and assigned to three severity groups. BMI, wrist ratio, shape index, digit index and hand length/height ratio were measured in all participants. Mean values for each item were compared between cases and controls and severity subgroups. A logistic regression analysis was performed to determine independent CTS risk factors. Results: The mean values of BMI, wrist ratio and shape index were significantly higher in all CTS patients and females compared to controls, whereas in males only BMI and wrist ratio were higher. The patients in the mild severity subgroup had a significantly lower age and wrist ratio. BMI, wrist ratio and shape index were found to be independent risk factors of CTS development in all patients and females. Conclusion: Our study showed BMI, wrist ratio and shape index as independent risk factors for CTS. These findings are important anatomically and clinically and these are the risk factors of anatomical malfunction of the wrist in CTS.

Effect of exercise on nerve conduction study of Carpal tunnel syndrome patients

Background: Carpal tunnel syndrome is the most common entrapment neuropathy of the median nerve at the wrist. In general population CTS is known to be a very common disease and the prevalence of CTS is estimated to be 2.7% as confirmed by clinical and electrophysiological findings. Typical symptoms of CTS are tingling, numbness and parasthesia in thumb, index, middle finger and radial half of ring finger which is often exaggerated at night. Previously research studies have been done on pain control, grip strength, wrist function. Very little research work has been done on effect of exercise on NCS of CTS patients. So the aim of the study is to find the short term (6weeks) effects of exercise on NCS of CTS patients. Methodology: Bilateral sensory and motor nerve conduction studies were carried out in 50 CTS patients before and after 6weeks of exercise. Exercise treatment was given to patients under the guidance of trained physiotherapist. Clinical examination was also done after 6 weeks. RMS machine from Chandigarh was used. Statistical analysis was done by INSTAT- 3.6 software. Result: DML, DML (diff.) DSL, DSL (diff.) showed significant decrease after 6 weeks of exercise in symptomatic (Rt.) hand, but no significant difference was found in SCV, CMAP, SNAP of median nerve. Whereas in Lt. hand only DML (diff.) between median and ulnar nerve showed significant change. There was also improvement in clinical signs and symptoms and pain scale. Conclusion: It was concluded that exercise treatment for 6 weeks under the proper guidance of trained physiotherapist showed significant improvements in clinical as well as electrophysiological parameters in symptomatic hands. So, exercise treatment can be suggested as choice of treatment for CTS patients.

Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: a cross-sectional study

BackgroundCarpal tunnel syndrome (CTS) is a common cause of pain, numbness and tingling in the wrist and hand region and is associated with repetitive wrist and hand use in office workers. However, scarce knowledge exists about the epidemiology of clinically confirmed CTS among Chinese office workers. This study aimed to investigate the prevalence of wrist/hand symptoms and CTS in office workers in China and to identify associated risk factors.MethodsA cross-sectional survey was carried out in a metropolitan city in China involving 969 respondents (aged 17–49 years) from 30 workplaces. A questionnaire was distributed to each participant to collect their demographic, work-related physical and psychosocial factors, and wrist and hand symptoms. The wrist and hand pain/numbness symptoms were marked on a body chart and the nature and intensity of symptoms, nocturnal symptoms, as well as aggravating activities were also recorded. Clinically confirmed CTS cases were screened based on the history, Phalen’s test, Tinel Sign and skin sensation testing among symptomatic respondents. Logistic regression was employed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for the occurrence of self-reported wrist and hand symptoms and clinically confirmed CTS.ResultsThe clinically confirmed CTS prevalence was 9.6%. The prevalence of wrist and hand symptoms were 22 and 15%, respectively. Frequently working in pain was associated with higher odds of CTS. Multivariate modelling adjusted for age and gender showed that prolonged computer use time and working without breaks were associated with presence of wrist/hand symptoms (adjusted ORs: 1.11 (95% CI 1.02–1.22) and 1.88 (95% CI 1.12–3.14)). Educational level was inversely associated with CTS and smoking was associated with wrist/hand complaints (adjusted OR: 2.20 (95% CI 1.19–4.07)).ConclusionsThe prevalence of work-related clinically confirmed CTS symptoms among young office workers in China is high. Frequently working in pain is closely associated with clinically confirmed CTS. Intense computer use and no breaks at work are associated with wrist and hand symptoms.

Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale: a Rasch analysis one year after surgery

BackgroundThe Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among patients who had undergone surgery for treatment of carpal tunnel syndrome.MethodsThe data for this cross-sectional analysis were obtained from 217 adult patients who had undergone carpal tunnel release surgery 1 year earlier. All patients completed the CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ at 12 months after surgery. The Rasch Measurement Theory (RMT) was applied to investigate the unidimensionality, residual correlation, differential item functioning, scale coverage/targeting, and person separation of the CTS-6, SSS and FSS of the BCTQ.ResultsThe FSS showed unidimensionality and good scale and item fit. All items showed ordered response category thresholds. Eight of the FSS items displayed differential item functioning favoring age or gender. The multidimensional structure of the CTS-6 was absorbed by creating a testlet for frequency of symptoms or testlets for pain and numbness. The testlets supported unidimensionality in the BCTQ SSS. One item in the CTS-6 and two items in the BCTQ SSS showed differential item functioning favoring age or gender. Four items in the BCTQ SSS and two items in the CTS-6 exhibited disordered response category thresholds. Merging of the relevant response categories led to ordered response category thresholds. The person separation indices were 0.73, 0.86 and 0.77 for the CTS-6, BCTQ SSS and FSS, respectively.ConclusionsBased on the RMT analysis, the CTS-6 has superior psychometric properties compared to the BCTQ SSS in surgically treated patients. The CTS-6 might be more accurate when separated into item sets measuring pain or numbness. The FSS of the BCTQ has acceptable construct validity, although gender differences at some ages were observed in responses.

Comparative efficacy of the dorsal application of Kinesio tape and splinting for carpal tunnel syndrome: A randomized controlled trial

BackgroundCarpal tunnel syndrome (CTS) symptoms are problematic especially when signs and symptoms are not substantial enough to require surgical intervention. Conservative treatments have mixed effectiveness, yet are one of the best options for mild to moderate CTS. Kinesio tape is an emerging modality, as it provides biomechanical support while allowing movement. PurposeThe purpose of this study was to determine the efficacy of dorsal application of Kinesio tape on occupational performance as measured by pain and function in individuals with mild to moderate CTS, as compared with the accepted nonsurgical intervention of general cockup orthosis and lumbrical stretching exercises versus sham tape. Study DesignSingle-blind randomized controlled trial. MethodsForty-four participants (68 wrists) with CTS were randomized to one of three interventions: Kinesio tape group, sham group, or standard protocol group. Each completed baseline and four subsequent measurements of numeric pain rating scale, visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), grip and pinch, with application of intervention every three days. Daily symptom journals were completed, standard protocol group recorded wearing schedule and exercises. ResultsIn the forearm and wrist, a significant reduction in median numeric pain rating scale pain scores in Kinesio tape group was observed (r = 0.76, P = .01; r = 0.77, P = .01; respectively), but not in the standard protocol group (r = 0.51, P = .17; r = 0.53, P = .11) and sham group (r = 0.46, P = .30; r = 0.39, P = .43) with a minimal clinically important difference of 1.0. In the Kinesio tape group, the forearm (24%) and wrist (36%) reached the clinical significance as compared with the standard protocol forearm (18%) and wrist (32%).The minimal clinically important difference for pain reduction on the visual analog scale was 1.64. Kinesio tape and sham group had significant improvement in function, but not the standard protocol group. DiscussionThis study provides promising evidence for the use of Kinesio tape as a possible conservative intervention for management of symptoms in individuals with mild to moderate CTS. The study also illuminates new considerations of younger, active individuals reporting signs and symptoms of CTS as well as mechanism of effects on pain reduction. ConclusionsKinesio tape provided additional improvement in pain and function as compared to the standard approach.

Treatment of carpal tunnel syndrome with wrist splinting: study protocol for a randomized placebo-controlled trial

BackgroundCarpal tunnel syndrome (CTS) is a common cause of pain, weakness, sensory loss, and activity limitations. Currently, the most common initial treatment is use of a rigid splint immobilizing the wrist, usually during night-time, for several weeks. Evidence regarding the efficacy and effect durability of wrist splinting is weak. The treatment is associated with costs and may cause discomfort and limit daily and work activities. No placebo-controlled trials have been performed.MethodsThis is a randomized controlled trial designed to assess the efficacy of a rigid wrist splint compared with soft wrist bandage (placebo) in patients with primary idiopathic CTS. The trial will be conducted at an orthopedic department. Patients, 25 to 65 years old, who seek primary health-care with symptoms of CTS will be screened, and potentially eligible patients will be referred to the study center. Patients who fulfill the trial’s eligibility criteria will be invited to participate. A total of 112 patients who provide informed consent will be randomly assigned to treatment with either a rigid wrist splint or a soft bandage to be used initially for 6 weeks at night and, if possible, during the day. The splints and bandages will be fitted with a temperature-monitoring device to measure the total time during which they have actually been worn. The trial participants will complete a questionnaire that includes the 6-item CTS symptoms scale (CTS-6); the 11-item disabilities of the arm, shoulder, and hand (QuickDASH) scale; and the EuroQol 5-dimension (EQ-5D) health status and quality-of-life measure at baseline and at 6, 12, 24, and 52 weeks after treatment start. The participants will undergo physical examination and nerve conduction testing at baseline and at 52 weeks. The trial’s primary outcomes are the change in the CTS-6 score from baseline to 12 weeks and the rate of carpal tunnel release surgery at 52 weeks.DiscussionThis is the first placebo-controlled randomized trial with electronic monitoring of actual splint use and will provide evidence regarding the efficacy of wrist splinting in patients with CTS.Trial registrationISRCTN Registry, ISRCTN81836603. Registered on May 5, 2018.

Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients.

The Boston Carpal Tunnel Questionnaire is the most commonly used outcome measure in the assessment of carpal tunnel syndrome. The purpose of this study was to translate the original Boston Carpal Tunnel Questionnaire into Finnish and validate its psychometric properties. We translated and culturally adapted the Boston Carpal Tunnel Questionnaire into Finnish. Subsequently, 193 patients completed the Finnish version of the Boston Carpal Tunnel Questionnaire, 6-Item CTS Symptoms Scale, and EuroQol 5 Dimensions 12 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire was re-administered after a 2-week interval. We calculated construct validity, internal consistency, test-retest reliability, and coefficient of repeatability. We also examined floor and ceiling effects. The cross-cultural adaptation required only minor modifications to the questions. Both subscales of the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Functional Status Scale) correlated significantly with the CTS-6 and EuroQol 5 Dimensions, indicating good construct validity. The Cronbach's alpha was 0.93 for both the Symptom Severity Scale and Functional Status Scale, indicating high internal consistency. Test-retest reliability was excellent, with an intraclass correlation coefficient greater than 0.8 for both scales. The coefficient of repeatability was 0.80 for the Symptom Severity Scale and 0.68 for the Functional Status Scale. We observed a floor effect in the Functional Status Scale in 28% of participants. Our study shows that the present Finnish version of the Boston Carpal Tunnel Questionnaire is reliable and valid for the evaluation of symptom severity and functional status among surgically treated carpal tunnel syndrome patients. However, owing to the floor effect, the Functional Status Score may have limited ability to detect differences in patients with good post-operative outcomes.

Work-related risk factors for Carpal Tunnel Syndrome among Majmaah University female touchscreen users.

Objectives:This study aimed to explore the prevalence of carpal tunnel syndrome symptoms among female touchscreen users at Majmaah University, Saudi Arabia and to make a comparison for the wrist range of motion between probable CTS and non-CTS female touchscreen users.Methods:Two hundred and twenty-two female touchscreen users were enrolled in the present study. Among this cohort, fifty-two were academic members, 40 were employees and 130 were undergraduates. A Digital Inclinometer device was used to assess ROM of the wrist movements. A computer-based questionnaire, Phalen’s test, and Tinel’s sign were used to investigate the presence of CTS symptoms. The study was conducted between November 2018 and February 2019 at Majmaah University.Results:The prevalence of probable CTS was 34.2% among touchscreen users; the percent of probable CTS was significantly higher in undergraduates compared to other touchscreen users. There was a significant reduction in wrist flexion between the tested groups.Conclusion:Female touchscreen users at Majmaah University tended to have a high-risk for CTS. Wrist ROM measurements, particularly wrist flexion, could be a beneficial indicator for anticipating deviations in wrist posture after long-term touchscreen use. It is necessary to consider the job nature, age, BMI, and duration of using touchscreen as risk factors for CTS symptoms.