RESEARCH PAPER
Patient-reported outcomes of carpal tunnel syndrome surgery in a non-industrial area
 
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1
Medical Diagnostic Imaging Center, Puławy, Poland
2
Medical University, Warsaw, Poland
3
Polish Telemedicine and eHealth Society, Warsaw, Poland
 
KEYWORDS:
TOPICS:
ABSTRACT:
Introduction and objective:
This study aimed to determine the environmental conditions for the occurrence of carpal tunnel syndrome (CTS) in a non-industrial area, and patient-reported outcomes after surgical release.

Material and methods:
This observational study utilized convenience sampling to screen 100 consecutive patients for carpal tunnel syndrome at the Orthopedic Clinic, using two questionnaires. Data were collected from the Disability of Arm Shoulder and Hand (DASH) questionnaire, and the PROMIS® (Patient-Reported Outcomes Measurement Information System) Upper Extremity and PROMIS® SF 3a questionnaire (Pain Intensity). The relationship of various repetitive musculoskeletal disorders to CTS was validated by questionnaire scores, PROMIS® T-score, and correlation coefficients.

Results:
Finally, CTS was confirmed by electromyography in 69 patients (55 females and 14 males; average age: 47.5 years). Aging significantly influenced the occurrence of symptoms associated with pain (neck, thoracic, lower back, shoulder, and CTS (p<0.001)). Those employed for longer more frequently declared performing exercises to prevent overload pain (p<0.001). DASH results significantly correlated with the PROMIS Upper Extremity score (r = -0.64; p<0.05).

Conclusions:
Geographical and environmental conditions indicate that even though working with a computer is described as an essential risk factor for CTS, the study group showed a predominance of elements that were unrelated to working at a computer. CTS also occurred among people working physically, and even among unemployed individuals. The existence of a statistically significant, strong, negative correlation (r=-0.64; p < 0.05) between the results obtained in the questionnaires DASH and PROMIS Upper Extremity has been demonstrated.

CORRESPONDING AUTHOR:
Wojciech Michał Glinkowski   
Medical University of Warsaw, Banacha 1a, 02-097 Warszawa, Poland
 
REFERENCES (54):
1. Aroui H, Merchaoui I, Adnene Henchi M, Rassas I, Belhadj N, Chaari N, et al. Medical and professional consequences of occupational carpal tunnel syndrome. Ann Phys Rehabil Med. 2016; 59S: e114. doi: 10.1016/j.rehab.2016.07.256. PubMed PMID: 27676736.
2. Mediouni Z, Bodin J, Dale AM, Herquelot E, Carton M, Leclerc A, et al. Carpal tunnel syndrome and computer exposure at work in two large complementary cohorts. BMJ Open. 2015; 5(9): e008156. doi: 10.1136/bmjopen-2015–008156. PubMed PMID: 26353869; PubMed Central PMCID: PMCPMC4567686.
3. Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Pract Res Clin Rheumatol. 2015; 29(3): 440–53. doi: 10.1016/j.berh.2015.04.026. PubMed PMID: 26612240; PubMed Central PMCID: PMC4759938.
4. Zyluk A. Is carpal tunnel syndrome an occupational disease? A review. Pol Orthop Traumatol. 2013; 78: 121–6. PubMed PMID: 23708319.
  Pubmed
5. Spahn G, Wollny J, Hartmann B, Schiele R, Hofmann GO. [Metaanalysis for the evaluation of risk factors for carpal tunnel syndrome (CTS) Part II. Occupational risk factors]. Zeitschrift fur Orthopadie und Unfallchirurgie. 2012; 150(5): 516–24. doi: 10.1055/s-0032–1315346. PubMed PMID: 23076750.
6. Giersiepen K, Spallek M. Carpal tunnel syndrome as an occupational disease. Dtsch Arztebl Int. 2011; 108(14): 238–42. doi: 10.3238/arztebl.2011.0238. PubMed PMID: 21547163; PubMed Central PMCID: PMCPMC3087121.
7. Shiri R, Falah-Hassani K. Computer use and carpal tunnel syndrome: A meta-analysis. J Neurol Sci. 2015; 349(1–2): 15–9. doi: 10.1016/j.jns.2014.12.037. PubMed PMID: 25582979.
8. Bena A, Mamo C, Argentero O, Baratti A, Bruno S, Ferraris F, et al. [Carpal tunnel syndrome (CTS) in the Piedmont Region: regional incidence and prevalence of CTS based on hospital records of patients who underwent surgery]. Med Lav. 2007; 98(4): 320–30. PubMed PMID: 17679345.
  Pubmed
9. Dale AM, Harris-Adamson C, Rempel D, Gerr F, Hegmann K, Silverstein B, et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scandinavian journal of work, environment & health. 2013; 39(5): 495–505. doi: 10.5271/sjweh.3351. PubMed PMID: 23423472; PubMed Central PMCID: PMC4042862.
10. Ferry S, Pritchard T, Keenan J, Croft P, Silman AJ. Estimating the prevalence of delayed median nerve conduction in the general population. Br J Rheumatol. 1998; 37(6): 630–5. PubMed PMID: 9667616.
  Pubmed
11. Conzen C, Conzen M, Rubsamen N, Mikolajczyk R. Predictors of the patient-centered outcomes of surgical carpal tunnel release – a prospective cohort study. BMC Musculoskelet Disord. 2016; 17: 190. doi: 10.1186/s12891–016–1046–3. PubMed PMID: 27121725; PubMed Central PMCID: PMCPMC4848854.
12. Khan AA, Ali H, Ali K, Muhammad G, Rashid B, Gul N, et al. Outcome of Open Carpal Tunnel Release Surgery. J Ayub Med Coll Abbottabad. 2015; 27(3): 640–2. PubMed PMID: 26721028.
  Pubmed
13. Louie DL, Earp BE, Collins JE, Losina E, Katz JN, Black EM, et al. Outcomes of open carpal tunnel release at a minimum of ten years. J Bone Joint Surg Am. 2013; 95(12): 1067–73. doi: 10.2106/JBJS.L.00903. PubMed PMID: 23783202; PubMed Central PMCID: PMCPMC3748987.
14. Kohanzadeh S, Herrera FA, Dobke M. Outcomes of open and endoscopic carpal tunnel release: a meta-analysis. Hand (N Y). 2012; 7(3): 247–51. doi: 10.1007/s11552-012-9413-5. PubMed PMID: 23997726; PubMed Central PMCID: PMCPMC3418358.
15. Louie D, Earp B, Blazar P. Long-term outcomes of carpal tunnel release: a critical review of the literature. Hand (N Y). 2012; 7(3): 242–6. doi: 10.1007/s11552–012–9429-x. PubMed PMID: 23997725; PubMed Central PMCID: PMCPMC3418353.
16. Golicki D, Krzysiak M, Strzelczyk P. Translation and cultural adaptation of the Polish version of the Disabilities of the Arm, Shoulder and Hand (DASH) and QuickDASH questionnaires. Ortopedia, traumatologia, rehabilitacja. 2014; 16(4): 387–95. doi: 10.5604/15093492.1119616. PubMed PMID: 25404628.
17. Overbeek CL, Nota SP, Jayakumar P, Hageman MG, Ring D. The PROMIS physical function correlates with the QuickDASH in patients with upper extremity illness. Clin Orthop Relat Res. 2015; 473(1): 311–7. doi: 10.1007/s11999-014-3840-2. PubMed PMID: 25099262; PubMed Central PMCID: PMC4390943.
18. T.M. B. Abstracts iProceedings Booklet 2013. Available from: http://www.medicine20congress.....
19. Available from: http://www.healthmeasures.net/....
20. Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years. Med Care. 2007; 45(5 Suppl 1): S3-S11. doi: 10.1097/01.mlr.0000258615.42478.55. PubMed PMID: 17443116; PubMed Central PMCID: PMCPMC2829758.
21. Reeve BB, Hays RD, Bjorner JB, Cook KF, Crane PK, Teresi JA, et al. Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care. 2007; 45(5 Suppl 1): S22–31. doi: 10.1097/01.mlr.0000250483.85507.04. PubMed PMID: 17443115.
22. Amtmann D, Cook KF, Jensen MP, Chen WH, Choi S, Revicki D, et al. Development of a PROMIS item bank to measure pain interference. Pain. 2010; 150(1): 173–82. doi: 10.1016/j.pain.2010.04.025. PubMed PMID: 20554116; PubMed Central PMCID: PMCPMC2916053.
23. Cook KF, Schalet BD, Kallen MA, Rutsohn JP, Cella D. Establishing a common metric for self-reported pain: linking BPI Pain Interference and SF-36 Bodily Pain Subscale scores to the PROMIS Pain Interference metric. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation. 2015; 24(10): 2305–18. doi: 10.1007/s11136-015-0987-6. PubMed PMID: 25894063; PubMed Central PMCID: PMCPMC4567433.
24. Cook KF, Jensen SE, Schalet BD, Beaumont JL, Amtmann D, Czajkowski S, et al. PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions. Journal of clinical epidemiology. 2016; 73: 89–102. doi: 10.1016/j.jclinepi.2015.08.038. PubMed PMID: 26952842; PubMed Central PMCID: PMCPMC5131708.
25. Jensen RE, Moinpour CM, Potosky AL, Lobo T, Hahn EA, Hays RD, et al. Responsiveness of 8 Patient-Reported Outcomes Measurement Information System (PROMIS) measures in a large, community-based cancer study cohort. Cancer. 2016. doi: 10.1002/cncr.30354. PubMed PMID: 27696377.
26. Askew RL, Cook KF, Keefe FJ, Nowinski CJ, Cella D, Revicki DA, et al. A PROMIS Measure of Neuropathic Pain Quality. Value Health. 2016; 19(5): 623–30. doi: 10.1016/j.jval.2016.02.009. PubMed PMID: 27565279; PubMed Central PMCID: PMCPMC5002873.
27. Hung M, Clegg DO, Greene T, Saltzman CL. Evaluation of the PROMIS physical function item bank in orthopaedic patients. Journal of orthopaedic research: official publication of the Orthopaedic Research Society. 2011; 29(6): 947–53. doi: 10.1002/jor.21308. PubMed PMID: 21437962.
28. Witter JP. The Promise of Patient-Reported Outcomes Measurement Information System-Turning Theory into Reality: A Uniform Approach to Patient-Reported Outcomes Across Rheumatic Diseases. Rheum Dis Clin North Am. 2016; 42(2): 377–94. doi: 10.1016/j.rdc.2016.01.007. PubMed PMID: 27133496.
29. Terwee CB, Roorda LD, de Vet HC, Dekker J, Westhovens R, van Leeuwen J, et al. Dutch-Flemish translation of 17 item banks from the patient-reported outcomes measurement information system (PROMIS). Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation. 2014; 23(6): 1733–41. doi: 10.1007/s11136–013–0611–6. PubMed PMID: 24402179.
30. Polska S. Statistica. Available from: http://www.statsoft.pl/Program....
31. Valachi B. Musculoskeletal health of the woman dentist: distinctive interventions for a growing population. Journal of the California Dental Association. 2008; 36(2): 127–32. PubMed PMID: 18411975.
  Pubmed
32. Ricco M, Cattani S, Signorelli C. Personal risk factors for carpal tunnel syndrome in female visual display unit workers. International journal of occupational medicine and environmental health. 2016; 29(6): 927–36. doi: 10.13075/ijomeh.1896.00781. PubMed PMID: 27869243.
33. Bongers FJ, Schellevis FG, van den Bosch WJ, van der Zee J. Carpal tunnel syndrome in general practice (1987 and 2001): incidence and the role of occupational and non-occupational factors. Br J Gen Pract. 2007; 57(534): 36–9. PubMed PMID: 17244422; PubMed Central PMCID: PMCPMC2032698.
  Pubmed
34. Newington L HE, Walker-Bone K. Carpal Tunnele Syndrome and Work 2015. Available from: http://www.ncbi.nlm.nih.gov/pu....
35. Lewańska M. W-KE, Walusiak-Skorupa J. Analiza czynników etiologicznych zespołu cieśni nadgarstka w populacji osób pracujących z zawodowo z użyciem komputera 2013. Available from: http://www.imp.lodz.pl/upload/....
36. Ali KM, Sathiyasekaran BW. Computer professionals and Carpal Tunnel Syndrome (CTS). Int J Occup Saf Ergon. 2006; 12(3): 319–25. doi: 10.1080/10803548.2006.11076691. PubMed PMID: 16984790.
37. Andersen JH, Thomsen JF, Overgaard E, Lassen CF, Brandt LP, Vilstrup I, et al. Computer use and carpal tunnel syndrome: a 1-year follow-up study. JAMA. 2003; 289(22): 2963–9. doi: 10.1001/jama.289.22.2963. PubMed PMID: 12799404.
38. Andersen JH, Thomsen JF, Overgaard E, Lassen CF, Brandt LP, Vilstrup I, et al. [Computer use and carpal tunnel syndrome: a 1-year follow-up study]. Ugeskrift for laeger. 2004; 166(33): 2804–7. PubMed PMID: 15344861.
  Pubmed
39. Atroshi I, Gummesson C, Ornstein E, Johnsson R, Ranstam J. Carpal tunnel syndrome and keyboard use at work: a population-based study. Arthritis and rheumatism. 2007; 56(11): 3620–5. doi: 10.1002/art.22956. PubMed PMID: 17968917.
40. Bleecker ML. The frequency of carpal tunnel syndrome in computer users at a medical facility. Neurology. 2002; 58(8): 1313–4; author reply 4–5. PubMed PMID: 11973823.
  Pubmed
41. Eleftheriou A, Rachiotis G, Varitimidis SE, Koutis C, Malizos KN, Hadjichristodoulou C. Cumulative keyboard strokes: a possible risk factor for carpal tunnel syndrome. J Occup Med Toxicol. 2012; 7(1): 16. doi: 10.1186/1745-6673-7-16. PubMed PMID: 22856674; PubMed Central PMCID: PMC3480831.
42. Franklin GM. The frequency of carpal tunnel syndrome in computer users at a medical facility. Neurology. 2002; 58(8): 1314; author reply -5. PubMed PMID: 11973826.
  Pubmed
43. Hedge A. Computer use and risk of carpal tunnel syndrome. JAMA. 2003; 290(14): 1854; author reply -5. doi: 10.1001/jama.290.14.1854-a. PubMed PMID: 14532310.
44. Hettinger L. The frequency of carpal tunnel syndrome in computer users at a medical facility. Neurology. 2002; 58(8): 1313; author reply 4–5. PubMed PMID: 11971115.
  Pubmed
45. Nathan PA, Meadows KD, Istvan JA. Computer use and risk of carpal tunnel syndrome. JAMA. 2003; 290(14): 1853–4; author reply 4–5. doi: 10.1001/jama.290.14.1853-b. PubMed PMID: 14532309.
46. Thomsen JF, Gerr F, Atroshi I. Carpal tunnel syndrome and the use of computer mouse and keyboard: a systematic review. BMC Musculoskelet Disord. 2008; 9:134. Epub 2008/10/08. doi: 10.1186/1471-2474-9-134-1471-2474-9-134 [pii]. PubMed PMID: 18838001; PubMed Central PMCID: PMC2569035.
47. Stocks SJ, McNamee R, van der Molen HF, Paris C, Urban P, Campo G, et al. Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012. Occup Environ Med. 2015; 72(4): 294–303. doi: 10.1136/oemed-2014-102534. PubMed PMID: 25575531.
48. Thomsen J. F. GF, Atroshi I. Carpal tunnel syndrome and the use of computer mouse and keyboard: A systematic review 2008. Available from: http://www.ncbi.nlm.nih.gov/pm....
49. Soltani AM, Allan BJ, Best MJ, Mir HS, Panthaki ZJ. A systematic review of the literature on the outcomes of treatment for recurrent and persistent carpal tunnel syndrome. Plastic and reconstructive surgery. 2013; 132(1): 114–21. doi: 10.1097/PRS.0b013e318290faba. PubMed PMID: 23806914.
50. Shi Q, MacDermid JC. Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? A systematic review. J Orthop Surg Res. 2011; 6: 17. doi: 10.1186/1749-799X-6-17. PubMed PMID: 21477381; PubMed Central PMCID: PMC3080334.
51. Iida J, Hirabayashi H, Nakase H, Sakaki T. Carpal tunnel syndrome: electrophysiological grading and surgical results by minimum incision open carpal tunnel release. Neurol Med Chir (Tokyo). 2008; 48(12): 554–9. PubMed PMID: 19106493.
  Pubmed
52. Jerosch-Herold C, Leite JC, Song F. A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF) as a reference tool. BMC musculoskeletal disorders. 2006; 7: 96. doi: 10.1186/1471-2474-7-96. PubMed PMID: 17147807; PubMed Central PMCID: PMC1713237.
53. Hobby JL, Venkatesh R, Motkur P. The effect of age and gender upon symptoms and surgical outcomes in carpal tunnel syndrome. J Hand Surg. 2005; 30(6): 599–604. doi: 10.1016/j.jhsb.2005.07.005. PubMed PMID: 16143435.
54. DeStefano F, Nordstrom DL, Vierkant RA. Long-term symptom outcomes of carpal tunnel syndrome and its treatment. J Hand Surg. 1997; 22(2): 200–10. doi: 10.1016/S0363-5023(97)80152-9. PubMed PMID: 9195415.
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