From the data obtained in this project, plots that can provide the therapist with information about the forces needed for exercises with Thera-Band Tubing were generated. These data should allow therapists to make better choices about which size of tubing to use for each patient.

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When examining a patient with suspected carpal tunnel syndrome (CTS), clinicians should use Semmes-Weinstein monofilament testing (SWMT), using the 2.83 or 3.22 monofilament as the threshold for normal light touch sensation and static 2-point discrimination on the middle finger to aid in determining the extent of nerve damage. In those with suspected moderate to severe CTS, clinicians should assess any radial finger using the 3.22 filament as the threshold for normal. Semmes-Weinstein monofilament testing should be repeated by the same provider. BIn those with suspected CTS, clinicians should use the Katz hand diagram, Phalen test, Tinel sign, and carpal compression test to determine the likelihood of CTS and interpret examination results in the context of all clinical exam findings.Clinicians should assess and document patient age (older than 45 years), whether shaking their hands relieves their symptoms, sensory loss in the thumb, the wrist ratio index (greater than 0.67), and scores from the Boston Carpal Tunnel Questionnairesymptom severity scale (CTQ-SSS) (greater than 1.9). The presence of more than 3 of these clinical findings has shown acceptable diagnostic accuracy. D There is conflicting evidence on the diagnostic accuracy and clinical utility of the upper-limb neurodynamic tests, scratch-collapse test, and tests of vibration sense in the diagnosis of CTS, and therefore no recommendation can be made. EXAMINATION -OUTCOME MEASURES: ACTIVITY LIMITATIONS/SELF-REPORTED MEASURES BClinicians should use the CTQ-SSS to assess symptoms and the Boston Carpal Tunnel Questionnaire functional scale (CTQ-FS) or the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to assess function when examining patients with CTS. Clinicians should use the CTQ-SSS to assess change in those undergoing nonsurgical management. EXAMINATION -ACTIVITY LIMITATIONS/ PHYSICAL PERFORMANCE MEASURES C Clinicians may use the Purdue Pegboard (PPB) or the Dellon-modified Moberg pick-up test (DMPUT) to quantify dexterity at the onset of treatment and compare scores with established norms. Clinicians should not use the PPB test, Jebsen-Taylor Hand Function Test, or the Nine-Hole Peg Test to assess clinical change following carpal tunnel release (CTR) surgery. Clinicians may use the DMPUT to assess change following CTR surgery. EXAMINATION -ACTIVITY LIMITATIONS/ PHYSICAL IMPAIRMENT MEASURES Strength MeasuresA Clinicians should not use lateral pinch strength as an outcome measure for patients with nonsurgically or surgically managed CTS. B Clinicians should not use grip strength when assessing short-term (less than 3 months) change in individuals following CTR surgery.C Clinicians may assess grip strength and 3-point or tip pinch strength in individuals presenting with signs and symptoms of CTS and compare scores with established norms. D There is conflicting evidence on the use of tip and 3-point pinch strength and abductor pollicis brevis muscle strength testing in individuals following CTR surgery. Sensory and Provocative MeasuresC C...

This cross-sectional study aimed to assess the impact of age and gender on 4 measures of grip and pinch force of well elderly community dwellers and to provide normative values. The hypotheses were that age and gender affect pinch and grip force and that these 2 factors might interact. Hand strength of 224 seniors 65–92 years old was tested. Grip and pinch force decreased in successively older age groups past 65 years. Men’s grip force exceeded that of women in all age groups. Men’s hand-force decline was steeper than that of women over successive age groups, suggesting that gender differences in force decreased with age. Trends were the same for all 4 types of grip- and pinch-force measurement but were most clearly visible in grip and key-pinch force. Norms were provided for seniors age 65–85+ years in 5-yr increments.