Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl
Preferences help
Polish version English version Language
enabled [disable] Abstract
Number of results

Results found: 5

Number of results on page
first rewind previous Page / 1 next fast forward last

Search results

Search:
in the keywords:  Carpal Tunnel Syndrome
help Sort By:

help Limit search:
first rewind previous Page / 1 next fast forward last
1
Publication available in full text mode
Content available

An evaluation of sensitivity of provocative tests used in the carpal tunnel syndrome diagnosis depending on clinical severity of the syndrome

100%
Georgiew F., Otfinowska E., Adamczyk T.
Medical Rehabilitation
|
2009
|
vol. 13(2)
17-22
EN
Background: Using popular provocative tests to diagnose the carpal tunnel syndrome (CTS) facilitates referring patients for specialist treatment and is indispensable to the performance of epidemiologic studies. Patients with severe carpal tunnel syndrome (CTS) are frequently referred for surgery, whereas people with mild CTS are commonly referred for conservative therapy. Finding out which provocative tests are most effective in diagnosing mild cases can aid clinicians in making decisions about further treatment.Objectives: The purpose of this study was to evaluate the sensitivity of provocative tests used for diagnosis of CTS such as Phalen’s, Durkan’s and Tinel’s sign and to find out if the time of paresthesia occurrence during the tests depended on the severity of the syndrome assessed using Levine’s Questionnaire.Material and methods: The study involved 130 women and 33 men with carpal tunnel syndrome confirmed by ENG. 52 patients had bilateral symptoms so a total number of cases examined was 215. Subjects were tested using four CTS provocative tests in random order: Phalen’s, Durkan’s, Provocative and Tinel’s sign. The examiner waited 2 – 3 minutes between each provocative test to ensure that any nerve irritation caused by previous test had abated. Severity level of CTS was assessed using Levine’s Questionnaire .Results: Sensitivity values were: for Phalen’s Test – 85.6%, Durkan’s Test – 86.5%, Provocative Test 84.6%, and Tinel’s sign – 46%. Sensitivity values for Phalen’s, Durkan’s and Provocative tests are higher than 93,1% for moderate, severe and extreme CTS. There is a relationship between testing positive on CTS provocative tests and severity of clinical symptoms. As the severity of CTS increases, the average time of paresthesia occurrence in median nerve distribution decreases. Conclusions: (1) Tinel’s sign should not be recommended as a CTS diagnostic tool because of its low sensitivity. (2) If Levine’s Questionnaire reveals small progression of CTS the sensitivity of the tests is insufficient to confirm CTS. (3) In the case of patients with moderate, severe or extreme CTS according to Levine’s Questionnaire, the diagnosis can be confirmed using valid provocative tests such as Phalen’s, Durkan’s and Provocative.
2
Publication available in full text mode
Content available

Provocative tests used in the diagnosis of carpal tunnel syndrome

100%
Georgiew F.
Medical Rehabilitation
|
2007
|
vol. 11(4)
15-25
EN
The carpal tunnel syndrome (CTS) is the most often diagnosed compressive neuropathy of the upper limb. As a result of the changes within the tunnel of the median nerve, the disease is associated with hypersensitivity to some external factors such as: an increase in pressure within the carpal tunnel, direct or indirect pressure on the wrist level, hypoxia. These factors are used in provocative tests. The aim of this article is to make a distinction between functional test’s classifications used in the CTS diagnosis, depending on the method of ailment provocation. Different modifications used in common tests and their average sensitivity and specificity are also presented. Carpal tunnel syndrome should be diagnosed clinically; although electro-diagnostic studies are a standard method of establishing the diagnosis, they do have limitations. Clinical diagnostic skill must be reinforced by a valuable provocative test: the Provocative Test, the Phalen test + mCCT, Tinel’s sign, Phalen’s and reverse Phalen’s test, Durkan Carpal Compression Test (mCCT). There are also tests, which, due to their low sensitivity and specificity, be not applied in the CTS diagnostics. Provocative tests are more easily performed than electro-diagnostic studies and are the most appropriate diagnostic tools in the ambulatory setting. Provocative tests are commonly needed for establishing the diagnosis for treatment, screening and determining aetiology. To improve the efficiency of provocative tests, we should apply univocal standards for their performance and interpretation. A combination of tests might be more powerful than a single test in establishing the diagnosis. Taking medical history and performing physical examination should be the primary methods of diagnosing CTS. The combination of hand diagram, questionnaires, abnormal sensibility and positive provocative tests will provide a diagnostic tool for CTS with high sensitivity and specificity. The addition of nerve conduction studies is unnecessary in most cases.
3
Publication available in full text mode
Content available

Restitution of sensation and possibilities of daily living activities in patients after surgical treatment of carpal tunnel syndrome

100%
Szczechowicz J., Pieniążek M., Pelczar-Pieniążek M., Wątroba J.
Medical Rehabilitation
|
2008
|
vol. 12(1)
16-24
EN
Objectives: The aim of the study was to evaluate the effectiveness of applied rehabilitation program and compare sensation levels with functional possibilities of the operated hand in a group of patients after surgery due to carpal tunnel syndrome. Material and methods: Fourty patients who underwent rehabilitation were admitted to the hand rehabilitation centre after surgical release of the median nerve within the carpal tunnel. Fifty hands were treated and evaluated. The rehabilitation program was established on an individual basis for each patient and included patient’s education, home exercises and physiotherapy treatment in outpatient centers. Skin sensation of the hands was evaluated by static two-point discrimination test. Based on this examination, sensibility indices for the median and ulnar nerves were calculated. Final results were compared to the Alderson-McGall Hand Function Questionnaire for Patients with Carpal Tunnel Syndrome.Results: After rehabilitation, skin sensation in the area of the median nerve improved, as measured by the sensibility index. Improvement was observed for most of the evaluated functions of the rehabilitated hands, while a different degree of improvement was noted. Sensibility index showed weak correlation with functional status and was observed only for some functions. Conclusion: In patients operated because of carpal tunnel syndrome, improvement in skin sensibility and functional abilities are observed in the operated hands after a rehabilitation program involving education, home exercises and outpatient sessions.
4
Publication available in full text mode
Content available

A proposal for the application of the Carpal Tunnel Syndrome evaluation method using surface electromyography: A pilot study

80%
Oleksy Ł., Mika A., Pieniążek M., Marchewka A.
Medical Rehabilitation
|
2009
|
vol. 13(4)
9-16
PL
Wstęp: Zespół kanału nadgarstka (CTS) jako najczęstsza postać neuropatii uciskowej kończyny górnej, pomimo licznych objawów jest trudny w diagnostyce, szczególnie w początkowym okresie choroby, gdy uszkodzenie nerwu jest niewielkie i trudno jest jednoznacznie stwierdzić charakterystyczne objawy ubytkowe. Cel pracy: Ocena aktywności bioelektrycznej wybranych mięśni będąca podstawą do opracowania wstępnych wytycznych diagnostyki różnicowej zespołu kanału nadgarstka z wykorzystaniem sEMG. Materiał i Metoda: Przebadano 30 pacjentów ze zdiagnozowanym zespołem kanału nadgarstka, u których dokonano chirurgicznego uwolnienia nerwu pośrodkowego w kanale nadgarstka oraz 15 osób zdrowych. Ocenę sEMG mięśni przykręgosłupowych w odcinku szyjnym, mięśni mostkowo-obojczykowo-sutkowych, zginaczy promieniowych nadgarstka oraz prostowników promieniowych długich nadgarstka przeprowadzono w sekwencji testów funkcjonalnych dla odcinka szyjnego kręgosłupa, oraz podczas testu zmęczenia dla zginaczy promieniowych nadgarstka i prostowników promieniowych długich nadgarstka. Wyniki: W teście sekwencyjnym dla odcinka szyjnego kręgosłupa w grupie osób zdrowych zaobserwowano prawidłowy, asymetryczny wzorzec aktywności podczas rotacji i zgięcia bocznego, zarówno w obrębie mięśni mostkowo-obojczykowo-sutkowych jak i przykręgosłupowych w odcinku szyjnym. Natomiast u pacjentów z CTS mięśnie mostkowo-obojczykowo-sutkowe wykazywały podobną aktywność bioelektryczną po obu stronach, zarówno podczas ruchów rotacji jak i podczas zgięć bocznych, a różnica pomiędzy prawym i lewym mięśniem w danym ruchu nie była istotna statystycznie (p>0,05). W obrębie mięśni przykręgosłupowych nie zaobserwowano statystycznie istotnej różnicy w aktywności po prawej i lewej stronie podczas rotacji. Natomiast podczas zgięć bocznych różnica była istotna statystycznie, lecz mniejsza niŜ u osób zdrowych. U pacjentów z CTS obserwowano po zmęczeniu statystycznie istotnie zwiększoną aktywność spoczynkową prostowników promieniowych długich nadgarstka i statystycznie istotnie zmniejszoną aktywność tych mięśni u osób zdrowych. Wnioski: Pomimo, iŜ za pomocą sEMG nie jesteśmy w stanie jednoznacznie zdiagnozować zespołu kanału nadgarstka, jednakŜe obserwowana po zmęczeniu u pacjentów z CTS zwiększona aktywność spoczynkowa prostowników promieniowych nadgarstka i zmniejszona aktywność tych mięśni u osób zdrowych pozwala przypuszczać, Ŝe ocena zmęczenia mięśni za pomocą sEMG jest właściwą metodą diagnostyczną zaburzeń ich aktywności bioelektrycznej.
EN
Background: Carpal Tunnel Syndrome (CTS), frequently considered to be an occupational disease, is difficult to diagnose because of the many additional factors which may mask its real symptoms. A significant part of differential diagnosis is to find a method that is adequately sensitive and noninvasive.Aim: Evaluation of selected muscles’ bioelectrical activity in order to attain preliminary guidelines in a differential diagnosis of CTS.Material and method: 30 patients with CTS after surgical carpal tunnel release and 15 healthy controls were examined. Thebioelectrical activity of the cervical paraspinal muscles, sternocleidomastoideus, flexores carpi radialis and extensors carpi radialis longus were measured during cervical functional tests, and during a fatigue test for flexores carpi radialis and extensors carpi radialis longus.Results: In the cervical sequence test the correct asymmetrical activity pattern was observed in the control group during cervical rotation and cervical flexion both in the sternocleidomastoideus and cervical paraspinal muscles. In CTS patients no significant difference (p>0,05) between the right and left sternocleidomastoideus was observed in cervical rotation and cervical flexion. In cervical paraspinal there was no significant difference during rotation, but during the flexion activity of the right and left side muscles there was noted significant difference, though less than in the control group. After the fatigue test there was observed a significant increase in the CTS group and a significant decrease in the control group in extensors carpi radialis activity.Conclusion: Even if we are unable to unambiguously diagnose CTS symptoms using sEMG, the increased resting extensors carpi radialis bioelectrical activity observed after fatigue test in CTS patients, yet decreased in the control group, allow us to suggest that the evaluation of muscles fatigue using sEMG is an appropriate method in the evaluation of muscles’ bioelectrical activity disorders.
5
Publication available in full text mode
Content available

Evaluation of the degree of subjective pain intensification accompanying carpal tunnel syndrome in relation to the intensification of changes confirmed by electroneurographic (ENG) testing

80%
Georgiew F., Maciejczak A., Otfinowska E.
Medical Rehabilitation
|
2010
|
vol. 14(2)
17-22
PL
Wprowadzenia: Zespól kanału nadgarstka (ZKN) jest coraz częściej rozpoznawaną patologia występującą najczęściej u pacjentów pomiędzy 30-60 rokiem życia. Schorzenie to 2 do 3 razy częściej dotyczy kobiet. Cel: Sprawdzenie czy istnieje zaleSność pomiędzy stopniem nasilenia ZKN ocenianym na podstawie wyniku badania ENG a ich stanem klinicznym ocenianym jako nasilenie dolegliwości subiektywnych i sprawność funkcjonalna. Materiał i metoda: Zbadano 161 chorych (12S kobiet i 33 mężczyzn) leczonych z powodu ZKN w poradni przyszpitalnej i na oddziale neurochirurgicznym. U 49 chorych występujące objaw}' miały charakter obustronny, tak więc łączna ilość wszystkich zbadanych przypadków wyniosła 210. Wiek chorych w chwili badania wynosił od 25 do 81 lat, średnio 55,2 lat. Ciężkość ZKN oceniono przy pomocy badania ENG a nasilenie objawów klinicznych określono jako ilość punktów uzyskaną przy pomocy kwestionariusza Levina (skala nasilenia objawów SSS + skala stanu funkcjonalnego FSS) oraz przy pomocy skali VAS. Wyniki: Pacjenci z ciężkim ZKN uzyskują średnio wyższe wyniki w pełnym kwestionariuszu Levina w porównaniu z grupa chorych z łagodnym ZKN. Przy pomocy skali SSS wskazano istotne statystycznie różnice nasilenia objawów subiektywnych pomiędzy umiarkowanym i ciężkim stopniem ZKN. Badanie nasilenia objawów bólu i/lub zdrętwienia przy pomocy skali VAS wykazało istotne różnice pomiędzy grupami o lekkim i ciężkim oraz grupami o umiarkowanym i ciężkim stopniu ZKN. Wnioski: Wynik uzyskany przy pomocy kwestionariusza według Levina (BQ) oraz wynik samooceny bólu i/lub zdrętwienia przy pomocy skali VAS może odzwierciedlać stopień uszkodzenia nerwu pośrodkowego jedynie w odniesieniu do chorych z ZKN z ciężkimi zaburzeniami w badaniu ENG.
EN
Introduction: Carpal tunnel syndrome (CTS) is an increasingly widespread pathology occurring in patients from the age of 30 to 60. This illness is 2 to 3 times more common in women.Aim of the study: verification of whether there exists a dependence between the degree of CTS intensification evaluated on the basis of ENG testing and the patients’ clinical state evaluated as an intensification of subjective discomfort and functional ability.Materials and methods: 161 patients were tested (128 women and 33 men) who were being treated for CTS at a hospital clinic and a neurosurgical ward. In 49 patients the symptoms were bilateral in nature hence the combined number of all the tested cases was 210. The age of the patients at the moment of testing was from 25 to 81, the average being 55,2. The severity of CTS was evaluated by means of ENG testing while the intensification of the clinical symptoms was defined as the number of points obtained via the Levin questionnaire (the scale of symptoms SSS (Severity Status Scale) + the functional state scale FSS) as well by means of the VAS scale. Results: Patients with severe CTS obtained on average higher results in the full Levin questionnaire when compared to the group of patients with mild CTS. Through the aid of SSS significant statistical differences were shown in the intensification of subjective symptoms between a moderate and severe degree of CTS. The testing of symptom intensification of pain and/or numbness through the help of the VAS scale showed significant differences between the groups with mild and severe degrees of CTS as well as between the groups with moderate and severe.Conclusions: The result obtained through the help of the Levin questionnaire (BQ) as well as the result of self evaluation of pain and/or numbness through the VAS scale can reflect the degree of damage to the median nerve only in relation to CTS patients with severe disturbances in the ENG test.
first rewind previous Page / 1 next fast forward last
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.