Impact of distal median neuropathy on handwriting performance for patients with carpal tunnel syndrome in office and administrative support occupations.
OBJECTIVE
This study investigates the handwriting performance of patients with carpal tunnel syndrome (CTS) and healthy controls in office and administrative support occupations, adopting both biomechanical and functional perspectives. This work also explores how surgical intervention altered the performance of the CTS patients.


METHODS
Fourteen CTS patients and 14 control subjects were recruited to complete a self-reported survey and participate in sensory tests, hand strength, dexterity and handwriting tasks using a custom force acquisition pen along with motion capture technology. Based on the results of these, the sensory measurements, along with functional and biomechanical parameters, were used to determine the differences between the groups and also reveal any improvements that occurred in the CTS group after surgical intervention.


RESULTS
The CTS patients showed significantly poorer hand sensibility and dexterity than the controls, as well as excessive force exertion of the digits and pen tip, and less efficient force adjustment ability during handwriting. After surgery and sensory recovery, the hand dexterity and pen tip force of the CTS patients improved significantly. The force adjustment abilities of the digits also increased, but these changes were not statistically significant.


CONCLUSIONS
This study provides the objective measurements and novel apparatus that can be used to determine impairments in the handwriting abilities of office or administrative workers with CTS. The results can also help clinicians or patients to better understand the sensory-related deficits in sensorimotor control of the hand related to CTS, and thus develop and implement more suitable training or adaptive protocols.
Department of Occupational Therapy, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan, jkkuo@mail.ncku.edu.tw.
Li-Chieh
LC
Kuo
Hsiao-Man
HM
Hsu
Po-Ting
PT
Wu
Sheng-Che
SC
Lin
Hsiu-Yun
HY
Hsu
I-Ming
IM
Jou
D000288:Administrative Personnel; D000328:Adult; D001696:Biomechanical Phenomena; D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005385:Fingers / Q000503:physiopathology; D018737:Hand Strength / Q000502:physiology; D006236:Handwriting; D006801:Humans; D008297:Male; D020423:Median Neuropathy / Q000209:etiology / Q000503:physiopathology*; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D009784:Occupational Diseases / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D011312:Pressure; D011795:Surveys and Questionnaires; D014110:Touch / Q000502:physiology