Association Between Manual Loading and Newly Developed Carpal Tunnel Syndrome in Subjects with Physical Disabilities: a Follow-up Study

Publication date: Available online 9 March 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Yen-Nung Lin, Chun-Chieh Chiu, Shih-Wei Huang, Wen-Yen Hsu, Tsan-Hon Liou, Yi-Wen Chen, Kwang-Hwa Chang
ObjectiveTo identify the association between body composition and newly developed carpal tunnel syndrome (CTS) and search for the best probabilistic cutoff value of associated factors to predict subjects with physical disabilities developing new CTS.DesignLongitudinal.SettingA serial yearly physical check-up program for full-time employees of an organization.ParticipantsForty-seven subjects with physical disabilities (mean age ±SD, 42.1±7.7 years).InterventionsNil.Main Outcome MeasuresMedian and ulnar sensory nerve conduction velocity (SNCV) was measured at the initial and follow-up tests (interval, >2 years). Total and regional body composition was measured with dual-energy x-ray absorptiometry at the initial test. Leg lean tissue percentage (LT%) was calculated to delineate each participant's manual loading degree during locomotion. Leg LT%= lean tissue mass of both legs/body weight.ResultsBased on median SNCV changes, we divided all participants into three groups: subjects (n=10) with bilateral CTS (a median SNCV value of <45 m/s plus a normal ulnar SNCV value of >37.8 m/s) in the initial test, subjects (n=8) with newly developed CTS in the follow-up test, and subjects (n=27) without additional CTS in the follow-up test. Eight of 35 subjects not having bilateral CTS initially developed new CTS (8.8%/year; mean follow-up period, 2.6 years). The leg LT% was associated with the probability of newly developed CTS (adjusted odds ratio=0.64, p<0.05). Subjects with a leg LT% of >12.0% were less likely to have developed new CTS at the follow-up test (sensitivity=0.75, specificity=0.85, area under the curve=0.88, p<0.005).ConclusionsThe leg LT% may be useful for the early identification of developing new CTS in subjects with physical disabilities. Thus, a preventive program for those subjects at risk can start early.



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