Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome.
Carpal tunnel syndrome
Clinical outcomes
Nerve conduction study
The disability of the arm, shoulder and hand questionnaire
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
16 Oct 2021
16 Oct 2021
Historique:
received:
21
04
2021
accepted:
04
10
2021
entrez:
17
10
2021
pubmed:
18
10
2021
medline:
21
10
2021
Statut:
epublish
Résumé
Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS. Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months postoperatively. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement. The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6-12 months, r = 0.67; 0-12 months, r = 0.60) and DASH (0-12 months, r = 0.77). Moreover, postoperative DML correlated with the change in DASH (6-12 months, r = - 0.33; 0-12 months, r = - 0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below. NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS.
Sections du résumé
BACKGROUND
BACKGROUND
Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS.
METHOD
METHODS
Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months postoperatively. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement.
RESULTS
RESULTS
The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6-12 months, r = 0.67; 0-12 months, r = 0.60) and DASH (0-12 months, r = 0.77). Moreover, postoperative DML correlated with the change in DASH (6-12 months, r = - 0.33; 0-12 months, r = - 0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below.
CONCLUSION
CONCLUSIONS
NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS.
Identifiants
pubmed: 34656102
doi: 10.1186/s12891-021-04771-y
pii: 10.1186/s12891-021-04771-y
pmc: PMC8520296
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
882Informations de copyright
© 2021. The Author(s).
Références
Int J Occup Saf Ergon. 2020 Jun;26(2):296-302
pubmed: 29644933
BMC Musculoskelet Disord. 2003 May 7;4:9
pubmed: 12734018
Br J Gen Pract. 2002 Aug;52(481):670-3
pubmed: 12171229
J Hand Surg Br. 2004 Apr;29(2):159-64
pubmed: 15010164
J Hand Surg Am. 1989 Sep;14(5):863-4
pubmed: 2794407
Muscle Nerve. 1999 Apr;22(4):497-501
pubmed: 10204785
JAMA. 1999 Jul 14;282(2):153-8
pubmed: 10411196
NeuroRehabilitation. 2019;44(2):199-205
pubmed: 30856127
J Hand Surg Am. 1992 Nov;17(6):1020-3
pubmed: 1430928
J Clin Epidemiol. 1992 Apr;45(4):373-6
pubmed: 1569433
Arthritis Rheum. 2009 May 15;61(5):623-32
pubmed: 19405008
Hand (N Y). 2012 Sep;7(3):242-6
pubmed: 23997725
Clin Orthop Relat Res. 2015 Mar;473(3):1120-32
pubmed: 25135849
South Med J. 1992 Sep;85(9):897-900
pubmed: 1523450
J Hand Surg Asian Pac Vol. 2020 Sep;25(3):320-327
pubmed: 32723040
Rehabil Nurs. 2017 May/Jun;42(3):139-145
pubmed: 25557054
J Orthop Sci. 2005 Jul;10(4):353-9
pubmed: 16075166
Muscle Nerve. 2001 Jul;24(7):935-40
pubmed: 11410921
Muscle Nerve. 2000 Aug;23(8):1280-3
pubmed: 10918269
Chir Narzadow Ruchu Ortop Pol. 2005;70(1):21-6
pubmed: 16021819
J Hand Surg Br. 2002 Jun;27(3):259-64
pubmed: 12074615
J Neurol Neurosurg Psychiatry. 1971 Jun;34(3):243-52
pubmed: 5571311
J Orthop Sci. 2009 Jan;14(1):17-23
pubmed: 19214683
BMC Musculoskelet Disord. 2016 Apr 27;17:190
pubmed: 27121725
Acta Neurochir (Wien). 2019 Apr;161(4):663-671
pubmed: 30783807
J Hand Surg Eur Vol. 2011 Oct;36(8):642-7
pubmed: 21636619
Clin Neurophysiol. 2002 Jan;113(1):71-7
pubmed: 11801427
J Orthop Sports Phys Ther. 2014 Jan;44(1):30-9
pubmed: 24175606
J Clin Neuromuscul Dis. 2012 Mar;13(3):153-8
pubmed: 22538311
J Hand Surg Am. 2016 Jun;41(6):723-5
pubmed: 27113907