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Carpal tunnel syndrome diagnosis: validation of a clinic-based nerve conduction measurement device

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DOI: 10.4236/jbise.2011.44038    4,186 Downloads   9,046 Views   Citations

ABSTRACT

Background: Carpal Tunnel Syndrome (CTS) is the commonest upper limb nerve entrapment syndrome seen in practice. In many centres, nerve conduction studies (NCS) have been adopted as a routine part of the diagnostic process. In the United Kingdom, the time taken to access diagnostic tests has been likened to a “hidden waiting list”, lengthening the time taken for a patient to access treatment. In the current healthcare climate with a centrally driven aim to reduce patient waiting time to a maximum of eighteen weeks, including tests, such waiting is even more unacceptable. Aim. This study was performed in order to evaluate a simple handheld device for quantifying median nerve lesions in CTS. Design of study: A prospective blinded cohort study. Setting: Leicester General Hospital, Carpal Tunnel Service Method: Participants were recruited from the nor-mal referral stream. If the clinical findings were consistent with a diagnosis of CTS, they were for-mally consented to the study in which results from the new handheld device were compared with traditional NCS. Final test group consisted of 63 participants. Results: For the new device the correct positive detection rate for abnormal nerve conduction was 91% (74/81 hands). Of the seven abnormal results not picked up by the new device, four were in asymptomatic hands (positive per cent agree-ment in symptomatic hands 95%). There were no false positives with the new system. (Negative per cent agreement 100%) Conclusion: We conclude that this new device demonstrates a high degree of concordance with currently available traditional NCS. The study suggested ways in which the accuracy could be further improved.

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Green, T. , Kallio, M. , Clarke, M. , Pathak, P. , Lesonen, V. and Tolonen, U. (2011) Carpal tunnel syndrome diagnosis: validation of a clinic-based nerve conduction measurement device. Journal of Biomedical Science and Engineering, 4, 282-288. doi: 10.4236/jbise.2011.44038.

References

[1] Atroshi, I., Gummeson, C., Johnsson, R., Ornstein, E., Ranstam, J. and Rosen, I. (1999) Prevalence of carpal tunnel syndrome in a general population. Journal of the American Medical Association, 282, 153-158.
[2] Bland, J.D.P. and Rudolfer, S.M. (2003) Clinical surveillance of carpal tunnel syndrome in two areas of the United Kingdom, 1991-2001. Journal of Neurol Neurosurg Psychiatry, 74, 1674-1679. doi:10.1136/jnnp.74.12.1674
[3] American Academy of Neurology and the American Academy of Physical Medicine and Rehabilitation. Practice parameter (2002) Electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine. Neurology, 58, 1589-1592.
[4] Padua, L., LoMonaco, M., Gregori, B., Valente, E.M., Padua, R. and Tonali, P. (1997) Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurologica Scandinavica, 96, 211-217. doi:10.1111/j.1600-0404.1997.tb00271.x
[5] Department of Health (2007) Transforming Clinical Neurophysiology Diagnostic Services to deliver 18 Weeks. A Good Practice Guide.
[6] Uncini, A., Di Muzio, A., Awad, J., Manente, G., Tafuro, M. and Gambi, D. (1993) Sensitivity of three median- to-ulnar comparative tests in diagnosis of mild carpal tunnel syndrome. Muscle Nerve, 16, 1366-1373. doi:10.1002/mus.880161215
[7] Tolonen, U., Kallio, M., Ryh?nen, J., Raatikainen, T., Honkala, V. and Lesonen, V. (2007) A handheld nerve conduction measuring device in carpal tunnel syndrome. Acta Neurologica Scandinavica, 115, 390-397.
[8] Levine, D.W., Simmons, B.P., Koris, M.J., et al. (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. Journal of Bone and Joint Surgery, 75, 1585- 1592.
[9] Bland, J.M. and Altman, D.G. (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1, 307-310.
[10] Hobby, J.L. and Dias, J.J. (2006) A review of hand surgery provision in England. Journal of Hand Surgery, 2, 230-235.
[11] Repaci, M., Torrieri, F., Di Blasio, F. and Uncini, A. (1999) Exclusive electrophysiological motor involvement in carpal tunnel syndrome. Clinical Neurophysiology, 110, 1471-1474. doi:10.1016/S1388-2457(99)00071-1
[12] Chang, M.H., Liu, L.H., Lee, Y.C., Wei, S.J., Chiang, H.L. and Hsieh, P.F. (2006) Comparison of sensitivity of transcarpal median motor conduction velocity and conventional conduction techniques in electro diagnosis of carpal tunnel syndrome. Clinical Neurophysiology, 117, 984-991. doi:10.1016/j.clinph.2006.01.015
[13] Eisen, A., Schulzer, M., Pant, B., MacNeil, M., Stewart, H., Trueman, S. and Mak, E. (1993) Receiver operating characteristic curve analysis in the prediction of carpal tunnel syndrome: A model for reporting electrophysiological data. Muscle Nerve, 16, 787-796. doi:10.1002/mus.880160715

  
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