• Journal of Korean Neurosurgical Society
• /
• v.29 no.11
• /
• pp.1451-1455
• /
• 2000

Objective : The goal of this study is to present whether endoscopic release(ER) is superior to open release(OR) for the treatment of carpal tunnel syndrome(CTS). Method and Material : Fifty-nine wrists in 43 patients who had clnical signs and symptoms consistent with CTS, not responded to non-operative management, were entered into the study. Authors retrospectively compared 27 wrists treated with ER(February 1999-June 1999) with 32 wrists treated with OR(October 1997-March 1999). We performed conventional open surgery in 25 patients(mean age ; 46 years) and Brown's two-portal technique in 18 patients(mean age ; 53 years) under intravenous regional block or general anesthesia. Results : Sixteen patients had CTS on both hands and left hands were affected more frequently than right hand, 34 and 25 respectively. Successful and poor results of ER were similar to those of OR. For patients in OR group, mean duration of symptoms was 5 years(range 1 month-30 years), and postoperative outcome was good in 27(84.4%) of wrists and poor in 5(15.6%). For patients in ER group, mean duration of symptoms was 7 months (range 2 months-25 years), outcome was good in 23(85.2%) of wrists and poor in 4(14.8%). The average time for complete relief of pain was 1.3 weeks and 7.6 weeks, respectively for OR and ER groups. No complication was noted in either group. Conclusion : This preliminary analysis suggests that faster relief of pain was achieved when the endoscopic method was used, although there were no significant differences in their efficacies regarding the improvement of symptoms.

• Annals of Clinical Neurophysiology
• /
• v.3 no.1
• /
• pp.15-20
• /
• 2001

Background : Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy that refers to a group of signs and symptoms resulting from compression of the median nerve at the wrist. The course of CTS in older patients is different from the younger patients. This difference may be the result of different underlying mechanisms. The different nerve conduction studies of CTS may signify different approaches in management. This study was done to assess the differences in nerve conduction study of CTS in younger and older patients. Methods : This study involved 224 patients who visited Gachon Medical School, Gil Medical Center and was diagnosed by nerve conduction study from October 1997 to October 1999. We compared the results of nerve conduction study to age, especially in between those under 60 years and those 60 years or over CTS patients. Nerve conduction study consists of motor studies of both median nerves(terminal latency, compound action potential) and sensory studies(nerve conduction velocity, nerve action potential). And we also evaluated the variables between younger and older patients group. Those variables include sex, symptom period, laterality, abnormal physical findings and radiculopathy. Results : We found that a significant increase of terminal latency(p<0.1), but a decrease in compound motor action potential(p<0.05) in older patient's group. There was no significant differences in sensory nerve conduction velocity and action potential between those under 60 years and those 60 years or even patients. And also there was no significant difference in sex, symptom period, laterality, abnormal physical findings, radiculopathy between older and younger patients. Conclusions : This study showed a significant increase in the terminal latency and a decrease in compound action potential in older patients. The different nerve conduction studies of CTS by age effect may need different approaches in management.

• Physical Therapy Korea
• /
• v.16 no.1
• /
• pp.61-69
• /
• 2009

The objective of this study was to investigate the relationship between addiction to online games and carpal tunnel syndrome (CTS) in college students. A total of 377 (205 male and 172 female) college students completed an online game addiction scale, a Symptom Severity Scale (SSS), and a Function Status Scale (FSS) for CTS. It was found that five (1.3%) students were diagnosed with an online game addiction, 74 (19.6%) students were diagnosed with a pre-addiction to online games, and 298 (79.0%) students were diagnosed as being average users. The pre-addiction group had significantly higher scores on the SSS than did the average user group (p<.05). The average user group scored significantly lower than did the online game addiction group (p<.05). Symptoms of wrist pain and hand numbness in the daytime were common in the addiction group. There were statistically significant but poor positive relationships between the online game addiction scale and the SSS (r=.312, p<.01), and between the online game addiction scale and the FSS (r=.149, p<.01). The information about online game addiction and CTS identified in this study could contribute to the prevention of online game addiction and CTS in college students.

• Annals of Clinical Neurophysiology
• /
• v.16 no.1
• /
• pp.21-26
• /
• 2014

Background: Electrophysiological study has been known as a useful method to evaluate the therapeutic effect of operation in idiopathic carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the clinical and electrophysiological changes after carpal tunnel release (CTR) compared to the preoperative results. Methods: We analyzed the changes of nerve conduction study (NCS) before and after minimal open carpal tunnel release in 18 patients (25 hands) with CTS. Follow-up study was performed over 6 months after operation. Results: Clinical improvement was seen in all cases after CTR. In contrast, electrophysiological improvement was various depending on the parameters; the mean median sensory latency and nerve conduction velocity (NCV) improved significantly (p = 0.001). The mean median motor latency also improved, but NCV and compound muscle action potential (CMAP) amplitude did not change. The extent of improvement was evident in moderate CTS, but not in severe CTS. Conclusions: In this preliminary study, all subjects who underwent CTR achieved a clinical relief along with a significant improvement of electrophysiological parameters such as median sensory latency, sensory NCV and median distal motor latency. After CTR, a number of cases with mild to moderate CTS showed a prominent improvement of clinical and electrophysiological parameters, while fewer improvements were seen in severe CTS, although it did not reach the statistical significance.

• Journal of the Korean Society of Physical Medicine
• /
• v.4 no.2
• /
• pp.107-115
• /
• 2009

Purpose：This study was to determine whether median nerve mobilization has any effect on the recovery of muscle power and the reduction of pain for the patients with carpal tunnel syndrome. Methods：20 patients suffering from carpal tunnel syndrome were randomly divided into two groups: 10 subjects treated both with electrical therapy and median nerve mobilization(experimental group) and the other 10 subjects treated only with electrical therapy(control group). The therapy was taken three times a week for 3 weeks. Results：The grip strength increased in both groups. However, the experimental group showed more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. In terms of pain, both groups showed significant effects. But the experimental group showed but more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. Conclusions：It was significantly more effective for the patients with carpal tunnel syndrome to apply median nerve mobilization during the electrical therapy in order to reduce pain and to increase grip strength, compared with the method only using electrical therapy. Further research should be conducted to generalize these results in terms of the clinical effectiveness of the nerve mobilization.

• Korean Journal of Clinical Laboratory Science
• /
• v.37 no.3
• /
• pp.212-215
• /
• 2005

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in clinical practice, with a 0.1% life time risk in the general population. Conventional neurophysiological studies have been useful in the diagnosis of this condition, as have a number of more specialized procedures. Therefore, we evaluated the diagnostic sensitivities of several parameters in nerve conduction technique for CTS patients. We analyzed 100 patients (159 hands) who were diagnosed with CTS clinically and electrophysiolosically. Median motor and sensory nerve conduction velocities (MCV and SCV) with wrist, palm, and finger stimulation were performed in traditional methods. Sensitivities of each test were calculated and compared to normal control data. The sensitivities of existing nerve conduction method were noted in terminal latency on median nerve, 2nd finger-wrist segment, 3rd finger-wrist segment, palm-wrist segment and distoproximal ratio, as 72.96%, 92.45%, 94.34%, 94.97%, and 97.48%, respectively. In the early course of CTS, sensory nerve conductions in the median nerve are more valuable than motor nerve conduction. Sensory nerve conductions are usually affected before motor nerve conductions in CTS. In this study, we detected that slowing of median SCV was the most frequent in the distoproximal ratio.

• Journal of Korean Medicine Rehabilitation
• /
• v.32 no.3
• /
• pp.55-64
• /
• 2022

Objectives The objective of this study was to assess the effectiveness of acupotomy for carpal tunnel syndrome. Methods Based on seven domestic and foreign databases. We analyzed the randomized controlled trials using acupotomy for carpal tunnel syndrome. The treatment group was treated with acupotomy and the control group was no restrictions on treatment methods. Results In this study, the effect of acupuncture treatment for carpal tunnel syndrome was investigated. Each study reported that acupotomy could be an effective treatment for carpal tunnel syndrome. However, as a result of meta-analysis of Levine carpal tunnel syndrome questionnaire scores, visual analog scale, and sensory nerve conduction velocity, the results were more clinically significant than those of the control group. Due to the small number of randomized controlled trial studies and the nature of acupotomy treatment, blinding of interventions was impossible, resulting in a high risk of bias. Conclusions In this regard, it is thought that well-planned randomized controlled studies on patients with carpal tunnel syndrome are needed in the future to secure the clinical evidence for acupotomy treatment.

• Annals of Clinical Neurophysiology
• /
• v.6 no.2
• /
• pp.98-102
• /
• 2004

Background: Carpal tunnel syndrome (CTS) is a common condition characterized by entrapment neuropathy of the median nerves. Clinical manifestations are the most important findings for diagnosis and assessment of therapeutic effects. But, objective indicators, such as electrophysiological findings, are also valuable supplementary tools. This study investigated the relationship between clinical grading and sensory nerve conduction velocity (SNCV) of median proper palmar digital nerve (MPPDN) in CTS patients. Method: This study was done on 90 upper limbs of 53 patients with CTS (men: 6, women: 47, age: 26~69 years, mean age; 52 years). Each SNCV of MPPDN was recorded with bar electrode using antidromic method. Each SNCV was compared with clinical grading of CTS. The clinical grades of CTS were designated as follows; group 1 is mild symptoms, 2 is moderate symptoms, and 3 is severe and longstanding symptoms. Result: In thumb, the SNCV of MPPDN was not different significantly between 3 groups (p=0.817). In the index finger, the SNCV was the fastest in the group 1, but faster in group 3 than in group 2 (p=0.001). In the middle and ring fingers, SNCV was decreased in higher clinical grading groups (middle finger: p=0.015, ring finger: p=0.044). Conclusion: SNCV of MPPDN of middle and ring finger correlated with the clinical grading of CTS. SNCV of index finger was the fastest in group 1. But SNCV of thumb did not correlate with the clinical grading of CTS.

• Journal of Pharmacopuncture
• /
• v.8 no.2
• /
• pp.39-45
• /
• 2005

Objective : The purpose of the study was to evaluate if CF herbal acupuncture is more effective than simple acupuncture in the carpal tunnel syndrome. Methods : We classified two groups: CF group(patients treated by CF herbal acupuncture and then treated by acupuncture) and N-CF group(patients treated entirely by acupuncture without other treatment). We evaluated subjective symptoms and Phalen's test of patients after executing, and then analyzed those. Results : 1. Both CF group and N-CF group were statistically significant(p<0.05) in improvement of symptoms and Phalen's test since third times of treatment. 2. It appears that CF group was more effective than N-CF group for treatment of carpal tunnel syndrome. That was statistically significant(p<0.05) since third times of treatment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.18 no.1
• /
• pp.49-56
• /
• 2012

Background: When applying the upper limb neurodynamic treatment ULNT1 and upper limb neurodynamic treatment ULNT2, The object of this study evaluates the pain and grip strength, nerve conduction velocity and tries to present the treatment that is effective in the carpal tunnel syndrome through the comparison of effect between tests. Methods: The ULNT1 (n=10) and ULNT2 (n=10) was applied to the carpal tunnel syndrome in patient of 20 subject for 10 time 5 set during 4 weeks. Both groups received conventional physical therapy (hot pack with 30 minutes and ICT with 15 minutes and ultra sound with 15 minutes). Results: The ULNT1 showed the difference which the result of this study significantly in the median nerve motor latency, median nerve motor amplitude, median nerve sensory latency, median nerve sensory amplitude, grip strength and pain. ULNT2 showed the difference significantly in median nerve motor latency, median nerve motor amplitude, median nerve sensory latency, median nerve sensory amplitude and pain. Conclusions: If it implements by applying the traditional physiotherapy and ULNT1 and ULNT2 to the carpal tunnel syndrome subjects according to the subject state and function, the remedial value can be more enhanced.