Electrophysiological assessment of hand elevation test in the diagnosis of carpal tunnel syndrome

Younes, Takwa B.; Elattar, Enas A.

doi:10.4103/1110-161x.123808

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Nerve conduction studies (NCS) are reported to be the most accurate method of diagnosing CTS (Sucher et al., 2014),with sensitivity greater than 90% and specificity greater than 95% (Priganc et al., 2003; Younes et al., 2013). Therefore, it has been recommended by some authors that NCS should be carried out on every patient with suspected CTS before commencing non‐conservative treatment (Erickson et al., 2019; Sonoo et al., 2018).…”

Section: Discussionmentioning

confidence: 99%

Advanced practice occupational therapy led triage and treatment clinic for patients with carpal tunnel syndrome in an Irish public hospital

O’Donnell

Eadie

Dorairaj

et al. 2023

Musculoskeletal Care

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IntroductionA pilot CTS Triage and Treat clinic led by an Advanced Practice Occupational Therapist was established to address the CTS wait list at a large urban hospital. The aims of this pilot were to develop a clinical triage and screening protocol to inform the stratification of patients for suitable treatment options and to reduce waiting time.MethodsA cross sectional study with follow up was conducted, patients on the wait list at time of commencement of the pilot and subsequent referrals over a 1‐year period were recruited. Triage consisted of tests of sensibility, self‐rating measures, provocative tests and detailed patient to inform the subsequent treatment stratification, conservative, injection, surgery, or further investigation. Nonparametric analyses were used to test relationships between the test scores and to complete subgroup comparisons.ResultsEighty‐nine patients were triaged over the pilot period, 62 (70%) had a positive Phalen's at triage. Following triage 48 (54%) patients were stratified for conservative management, injection (n = 23, 26%) and surgery/differential diagnosis (n = 18, 20%). Statistically significant differences in BCTQ (SSS and FSS) and Q‐DASH scores were noted across the three outcome groups, with lower scores among those commenced on conservative management. BCTQ (SSS) scores were aligned with the Semmes Weinstein Monofilaments sensibility thresholds. Wait times showed a marked decrease from 10 to 2 months over the period of the pilot.DiscussionFindings highlight the positive impact of occupational therapy led triage and treat approach in the reduction of wait time for assessment and treatment for patients with CTS.

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Section: Discussionmentioning

confidence: 99%

Advanced practice occupational therapy led triage and treatment clinic for patients with carpal tunnel syndrome in an Irish public hospital

O’Donnell

Eadie

Dorairaj

et al. 2023

Musculoskeletal Care

View full text Add to dashboard Cite

show abstract

“…Sonographic examination and electrodiagnostic evaluation are invasive tests for the diagnosis of CTS, but are expensive and not applicable in all health services. 8 The clinical diagnosis of CTS was established according to the criteria of Chang et al which includes numbness and tingling in the median nerve area, nocturnal paresthesias, positive Phalen's test, positive Tinel's sign, and wrist pain radiating to the shoulder. 9 According to Giannini et al, only one clinical scale for CTS is available in the scientific literature, the clinical historical-objective scale (Hi-Ob).…”

Section: Introductionmentioning

confidence: 99%

The effect of nerve gliding on clinical outcome in batik workers of Yogyakarta with carpal tunnel syndrome

Setyaningrum,

Hidayati,

Astuti

et al. 2023

Anaesth. pain intensive care

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Background: The carpal tunnel syndrome (CTS), if left untreated, handicaps the manual workers and incurs heavy financial loss to them due to loss of their productivity and the cost on treatment. The nerve gliding exercises can speed up the rehabilitation process in these patients and improve their function. We aimed to observe the clinical efficacy of nerve gliding in reducing pain enhancing productivity in batik workers. Methodology: This study is a quasi-experimental and the subject were batik workers in Yogyakarta, Indonesia. Subjects who met the criteria were divided into Group I (n = 18) received nerve gliding with mecobalamin 3x500 μg and Group II (n = 17) as controls received 3x500 μg mecobalamin only. The pain relief was observed in the form of Visual Analog Scale (VAS) score and Boston Carpal Tunnel Questionnaire (BTCQ) score consisting of BTCQ symptom severity scale and functional status scale (FSS). Result: In paired t-test we found significant decrease in VAS scores in Group II on week 2 and 3. From the Wilcoxon test we found significanly decreased VAS scores on week I, 2 and 3 in Group I. From the Wilcoxon test we found significanly reduced BTCQ scores on week 3 in Group II, and significanly reduced BTCQ scores in Group I at week I, 2, and 3. The decrease in VAS and BTCQ was significantly higher in the Group I than Group II. Based on the multivariate analysis of model I, the nerve gliding gave significant effect on VAS (P = 0.001) and BTCQ (P = 0,000) scores. Conclusion: There is significant clinical improvement by using nerve gliding and mecobalamin for 3 weeks to batik workers in Yogyakarta. Abbreviations: BTCQ - Boston Carpal Tunnel Questionnaire; CTS - Carpal Tunnel Syndrome; FSS - Functional Status Scale; NSAIDS - Nonsteroidal Anti-Inflammatory Drugs; PO – Per Orum; ROM - Range of Motion; VAS - Visual Analog Scale Key words: Carpal Tunnel Syndrome; Clinical Outcome; Nerve Gliding; Safe Working Environment; Human Citation: Srie Setyaningrum CT, Hidayati HB, Astuti, Ayu Puspamaniar V, Indrihapsari EF. The effect of nerve gliding on clinical outcome in batik workers in Yogyakarta with carpal tunnel syndrome. Anaesth. pain intensive care 2023;27(5):579−584. DOI: 10.35975/apic.v27i5.2319 Received: November 23, 2021; Reviewed: January 07, 2022 ; Accepted: January 08, 2022 -----

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The Role of Ultrasound in Evaluating the Effect of Urate-lowering Drugs in Gout Patients

El-Mallah

Ibrahim

Attar

2022

CRR

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Background: Background: Gout is one of the most common inflammatory arthritis, where identification of MSU crystals in synovial fluid is a widely used diagnostic measure. Ultrasonography has a great sensitivity in detecting signs of MSU deposits, such as tophi and double contour (DC), as mentioned in the latest gout criteria, allowing early clinical diagnosis and therapy. Objective: The objective of this study was to evaluate the changes in ultrasound of gout patients’ knee and 1st metatarsophalangeal joint (MTP1) after initiation of urate-lowering therapy (ULT) drugs in the six-month period. Methods: Forty-three patients, fulfilling the ACR/EULAR 2015 criteria of gout with a score of >8, were enrolled; they were in between attacks and not on ULT for the last 6 months, or SUA concentration (SUA) of >6.0 mg/dL. Full examination, evaluation of joints pain by visual analog scale (VAS), ultrasonography (US) for tophus and DC at the knee, and MTP1 were performed at baseline and at 3 and 6 months (M3, M6) after starting ULT. Result: After 6 months of treatment, patients reached the target SUA level showed higher disappearance of DC sign (p<0.05) and a decrease in tophus size (p<0.05). The percentage of tophus size at 6th month was 26.4% and 3% for DC sign disappearance, which was more at MTP1. Conclusion: Ultrasound examination in screening for gout tophi or DC sign before starting ULT and during follow-up is important and complements clinical examination.

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Electrophysiological assessment of hand elevation test in the diagnosis of carpal tunnel syndrome

Abstract: BackgroundProvided that the hand elevation test can reproduce the symptoms of carpal tunnel syndrome (CTS), this phenomenon prompted the idea of developing a simple test to diagnose CTS.

Cited by 3 publications

References 21 publications

Advanced practice occupational therapy led triage and treatment clinic for patients with carpal tunnel syndrome in an Irish public hospital

Advanced practice occupational therapy led triage and treatment clinic for patients with carpal tunnel syndrome in an Irish public hospital

The effect of nerve gliding on clinical outcome in batik workers of Yogyakarta with carpal tunnel syndrome

The Role of Ultrasound in Evaluating the Effect of Urate-lowering Drugs in Gout Patients

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