Document Detail


Carpal tunnel syndrome in manual wheelchair users with spinal cord injury: a cross-sectional multicenter study.
MedLine Citation:
PMID:  19789435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate relationships between carpal tunnel syndrome, functional status, subject demographics, physical examination findings, and median nerve conduction study findings in manual wheelchair users with paraplegia. DESIGN: Multicenter cross-sectional study. One hundred twenty-six manual wheelchair-using individuals with chronic paraplegia answered self-administered questionnaires on demographics, symptoms, and functional status. They underwent physical examination specific for carpal tunnel syndrome and upper-limb nerve conduction studies. RESULTS: Fifty-seven percent of subjects had symptoms (72.2% bilateral); hand numbness was most common. Sixty percent of subjects had carpal tunnel syndrome physical examination findings (59.2% bilateral). Those with physical examination findings were more likely to have longer duration of injury (P = 0.003). Seventy-eight percent of subjects had electrophysiologic evidence of median mononeuropathy. Symptomatic subjects had significantly greater median-ulnar motor latency difference in the dominant hand (P = 0.02) and smaller compound muscle action potential amplitudes bilaterally (dominant hand, P = 0.01; nondominant hand, P = 0.04). Persons with carpal tunnel syndrome symptoms and physical examination findings had significantly worse functional status (symptoms, P < 0.001; physical examination, P = 0.02) and symptom severity scores (symptoms, P < 0.001; physical examination, P = 0.01), but a similar difference between subjects with and without median mononeuropathy was not seen. Logistic regression analysis revealed that the presence of symptoms was predicted by median-ulnar motor latency difference in the dominant hand (odds ratio, 4.38; 95% confidence interval 1.72-11.14) and sensory nerve action potential amplitude in the nondominant hand (odds ratio, 0.97; 95% confidence interval, 0.94-0.99). CONCLUSIONS: The interaction among symptoms, physical examination, and nerve conduction study findings is complex. Carpal tunnel syndrome and median mononeuropathy are highly prevalent and functionally significant. This study highlights the need for primary prevention and patient education for preserving upper-limb function.
Authors:
Jennifer Yang; Michael L Boninger; Janet D Leath; Shirley G Fitzgerald; Trevor A Dyson-Hudson; Michael W Chang
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists     Volume:  88     ISSN:  1537-7385     ISO Abbreviation:  Am J Phys Med Rehabil     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2009-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803677     Medline TA:  Am J Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1007-16     Citation Subset:  AIM; IM    
Affiliation:
Human Engineering Research Laboratories, Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15206, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Body Mass Index
Carpal Tunnel Syndrome / diagnosis,  etiology*
Cross-Sectional Studies
Electromyography
Female
Humans
Male
Middle Aged
Odds Ratio
Paraplegia
Risk Factors
Severity of Illness Index
Sex Factors
Spinal Cord Injuries / rehabilitation*
Wheelchairs / adverse effects*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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