FIGURE 1
Hand positions in visual and kinesthetic cues.
Source publication
Objectives:
This study aims to investigate the deterioration in kinesthetic kinesthesia (KKS) and visual kinesthesia (VKS) of the hand as a component of proprioception in patients with idiopathic carpal tunnel syndrome (CTS).
Patients and methods:
This study included a total of 90 hands of 60 patients (9 males, 51 females; mean age: 47.6±9.4 yea...
Contexts in source publication
Context 1
... scores range from 8 to 49, with higher scores indicating greater impairment of hand function. [17] Assessment of VKS and KKS tests: The participants' kinesthetic awareness level in their hands as the ability to copy different hand positions, as previously described by Grant and Watter [18] (Figure 1). The test was performed using two different methods, by providing visual and kinesthetic cues. ...
Context 2
... visual cues, the participant's hand to be tested was positioned with the help of a masking plate, so that the patient could not see it. The physician, then, visually presented eight different hand positions, and the patient was asked to copy these figures with his or her hand to be assessed ( Figure 1). In the kinesthetic assessment, the physician places the patient's hands behind an obstacle out of sight. ...
Context 3
... the kinesthetic assessment, the physician places the patient's hands behind an obstacle out of sight. The physician, then, passively positions one hand of the participant according to the test scheme, and asks the participant to copy it with the other hand ( Figure 1). Each cue was scored between one and three points for accuracy. ...
Citations
... In this way, it is possible to evaluate the functional aspects of the APB muscle. [2] Direct stimulation of nerve fibers is needed during the exploration of multiple nerve fibers, e.g., brachial plexus surgery, and fascicular orientation, e.g., nerve transfer techniques. [6,7] Monopolar devices, such as nerve stimulators that utilize a controlled electrical potential, are the most commonly used tools for this purpose. ...
... There are studies about the recovery of symptoms after CTR investigating variables that can predict future clinical improvement. [2,18,19] Investigated diagnostic and clinical variables, including duration of symptoms, electrophysical severity, grip strength, thenar muscle atrophy, EMG abnormalities, Phalen's and Tinel's test results are used to predict clinical outcomes and classifying diseases severity, as well as to determine indication for opponensplasty. ...
... Opponensplasty is a surgical technique recommended for severe cases of CTS with lack of opposition. [2] The indications of this technique show variations, including disease severity, nerve conduction studies, thumb function score, functional tests and patient demand. [5,20] Kamiya et al. [21] and Hasegawa and Matsubara [18] concluded that motor unit potential (MUP) and distal motor latency of second lumbrical muscle are the predictors to decide opponensplasty. ...
Objectives
In this study, we aimed to investigate the relationship between intraoperative thenar muscle neurostimulation responses and postoperative thumb function recovery in patients with severe carpal tunnel syndrome (CTS).
Patients and methods
Between January 2019 and December 2021, a total of 21 severe CTS cases in 20 patients (7 males, 13 females; mean age: 56.3±19.3 years; range, 52 to 76 years) based on clinical and electrophysiological findings were retrospectively analyzed. The median nerve motor branch (MNMB) was stimulated intraoperatively with a nerve stimulator. The patients were divided into two groups according to contraction response on abductor pollicis brevis (APB) muscle: Group C (contractile, n=13) and Group NR (non-responsive, n=7) with and without muscular contraction. The Levine Functional Severity Scale (LFSS) was used to measure the functional status of CTS patients. The Manual Muscle Testing (MMT) was used to assess muscle strength. Clinical outcomes were compared between the groups at one year of follow-up.
Results
The mean total preoperative LFSS score was significantly higher in Group NR than in Group C (p=0.010). The mean postoperative MMT score was significantly higher in Group C than in Group NR (p<0.001). There was no positive result in pick-up, button fastening, and needle pinch tests in Group NR (p<0.001). However, there were significant improvements in postoperative LFSS scores in Group C (p<0.05), while the scores remained unchanged in Group NR (p>0.05).
Conclusion
Direct stimulation of the median nerve motor branch and observation of contraction response on APB muscle can be used to predict clinical recovery and facilitates making the decision for opponensplasty in severe CTS.
