Carpal Tunnel Syndrome In Manual Wheelchair Users
- Signs Of Carpal Tunnel Syndrome In Hands
- Carpal Tunnel Syndrome Thumb
- Causes Of Carpal Tunnel Syndrome
Context: Use of a handrim wheelchair could force the wrist into extreme excursions and encroachment of the median nerve.
Signs Of Carpal Tunnel Syndrome In Hands
Objective: We performed a study of the prevalence of carpal tunnel syndrome in prolonged wheelchair users.
Design and setting: A cross-sectional study was conducted for one year in an outpatient clinic of spinal cord injury.
Carpal tunnel syndrome (CTS) is an overuse injury that develops in 49 to 63 percent of conventional manual wheelchair (CMW) users 1–4. CTS is caused by compression of the median nerve in the carpal tunnel and is characterized by pain and numbness in the hand and wrist that progressively worsens if. Published on December 01, 2010. With arms churning, shoulders lurching, and wrists twisting for the essential grip on the handrim, it’s easy to see why manual wheelchair users have high rates of carpal tunnel syndrome and shoulder injuries. Specialty board examination has been used to assess the knowledge and competency of a practitioner to provide high quality care to patients in a particular area of expertise. 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.
Participants: Patients had traumatic injury at the first thoracic level and below, with time since injury of at least 5 years.
Carpal Tunnel Syndrome Thumb
Outcome measure: The prevalence of carpal tunnel syndrome by history taking, clinical examinations and motor and sensory nerve conduction studies of median nerve performed for both hands.
Results: Participants (N = 297) were all male. Mean (SD) age and duration since injury were 48 (8.5) and 23 (6.6) years, respectively. A significant difference in median duration of injury based on the severity of the syndrome (P < 0.001), and a significant trend in time since injury for the severity (P (one tailed) < 0.001) were seen. There was a significant difference in the median age among the groups (P = 0.009), and the median increased with the severity (P (one tailed) = 0.001).
Conclusions: Carpal tunnel syndrome is a common side effect of the long time use of wheelchair, and its severity is associated with duration of wheelchair use and age. Alternative methods for wheelchair propulsion should be developed to diminish the likelihood of the syndrome.
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Model System:
SCIAccession No.:
J57863Journal:
American Journal of Physical Medicine & RehabilitationYear, Volume, Issue, Page(s):
09, 88, 12, 1007-16Abstract:
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% bilateraJ). 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 medianulnar
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 mononeuropathy are highly prevalent and functionally significant. This study highlights the need for primary prevention and patient education for preserving upper-limb function. Spinal Cord Injuries, Paraplegia, Carpal Tunnel Syndrome, Median Nerve, Neuropathy, Cumulative Trauma Disorders, Wheelchairs.