Author:
Geere Jo,Chester Rachel,Kale Swati,Jerosch-Herold Christina
Abstract
Abstract
Background
Objective assessment of motor function is frequently used to evaluate outcome after surgical treatment of carpal tunnel syndrome (CTS). However a range of outcome measures are used and there appears to be no consensus on which measure of motor function effectively captures change. The purpose of this systematic review was to identify the methods used to assess motor function in randomized controlled trials of surgical interventions for CTS. A secondary aim was to evaluate which instruments reflect clinical change and are psychometrically robust.
Methods
The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical interventions for CTS. Data on instruments used, methods of assessment and results of tests of motor function was extracted by two independent reviewers.
Results
Twenty-two studies were retrieved which included performance based assessments of motor function. Nineteen studies assessed power grip dynamometry, fourteen studies used both power and pinch grip dynamometry, eight used manual muscle testing and five assessed the presence or absence of thenar atrophy. Several studies used multiple tests of motor function. Two studies included both power and pinch strength and reported descriptive statistics enabling calculation of effect sizes to compare the relative responsiveness of grip and pinch strength within study samples. The study findings suggest that tip pinch is more responsive than lateral pinch or power grip up to 12 weeks following surgery for CTS.
Conclusion
Although used most frequently and known to be reliable, power and key pinch dynamometry are not the most valid or responsive tools for assessing motor outcome up to 12 weeks following surgery for CTS. Tip pinch dynamometry more specifically targets the thenar musculature and appears to be more responsive. Manual muscle testing, which in theory is most specific to the thenar musculature, may be more sensitive if assessed using a hand held dynamometer – the Rotterdam Intrinsic Handheld Myometer. However further research is needed to evaluate its reliability and responsiveness and establish the most efficient and psychometrically robust method of evaluating motor function following surgery for CTS.
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Rheumatology
Reference45 articles.
1. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosn I: Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999, 282 (2): 153-158. 10.1001/jama.282.2.153.
2. de Krom MC, Knipschild PG, Kester AD, Thijs CT, Boekkooi PF, Spaans F: Carpal tunnel syndrome: prevalence in the general population. J Clin Epidemiol. 1992, 45 (4): 373-376. 10.1016/0895-4356(92)90038-O.
3. Sunderland S: Nerve Injuries and Their repair. A Critical Appraisal. 1991, Edinburgh , Churchill Livingstone
4. Jerosch-Herold C: An evidence-based approach to choosing outcome measures: a checklist for the critical appraisal of validity, reliability and responsiveness studies. BJOT. 2005, 68 (8): 347-353.
5. Portney LG, Watkins MP: Foundations of Clinical Research: Application to Practice. 2000, Upper Saddle River , Prentice Hall , 2nd
Cited by
61 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献