title: Assessment from Functional Perspectives: Using Sensorimotor Control in the Hand as an Outcome Indicator in the Surgical Treatment of Carpal Tunnel Syndrome.
abstract: To investigate whether sensorimotor control of the hand could be an outcome indicator after carpal tunnel release (CTR), this work examined changes in the results of patients' manual tactile test (MTT), pinch-holding-up activity (PHUA), two-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) tests. Participants included 30 predominantly sensory neuropathy CTS patients, as confirmed by a nerve conduction study. The MTT, precision pinch performance in PHUA and traditional sensibility (2PD and SWM) tests were used to examine different aspects of sensory status at the time-points of two weeks before operation and one month post-operation, with a single-blind design. The results showed significant improvements in the sensory function as detected by the 2PD and SWM tests (p<0.001) and sensorimotor function as detected by the MTT (p<0.001) and PHUA test (p<0.05) for patients receiving CTR. The responsiveness of the SWM, MTT and PHUA tests (effect size>0.5, p<0.01) are better than that of two-point discrimination test (effect size<0.5, p<0.001). However, pinch strength saw a decline compared to baseline with a moderate effect sizes (effect size = 0.7, p<0.001). This cohort study found that the MTT and PHUA test can both meet all the statistical criteria with regard to assessing treatment outcomes for patients with CTS. In addition, the results of this work provide clinicians with the information that the sensorimotor functions of the hands, as assessed by MTT and PHUA, are responsive to clinical changes due to CTR.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, 138 Shengli Rd., Tainan, 704, Taiwan; Department of Biomedical Engineering, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan.
authors.forename: Hsiu-Yun
authors.initials: HY
authors.lastname: Hsu
authors.affiliation: Department of Biomedical Engineering, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan; Medical Device Innovation Center, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan.
authors.forename: Fong-Chin
authors.initials: FC
authors.lastname: Su
authors.affiliation: Section of Plastic Surgery, Department of Surgery, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan.
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Kuo
authors.affiliation: Department of Orthopedics, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan.
authors.forename: I-Ming
authors.initials: IM
authors.lastname: Jou
authors.affiliation: Section of Plastic Surgery, Department of Surgery, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan.
authors.forename: Haw-Yen
authors.initials: HY
authors.lastname: Chiu
authors.affiliation: Medical Device Innovation Center, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan; Department of Occupational Therapy, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan.
authors.forename: Li-Chieh
authors.initials: LC
authors.lastname: Kuo
mesh_terms: D001696:Biomechanical Phenomena; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology* / Q000601:surgery*; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D009043:Motor Activity; D052581:Pinch Strength; D066191:Sensorimotor Cortex / Q000503:physiopathology*; D016896:Treatment Outcome; D016474:Weight-Bearing