Pruebas funcionales de recuperación en liberación de túnel carpiano. (Inglés)

"Pruebas funcionales cuantificadoras de recuperación siguiente a la liberación del túnel carpiano."

Robert G. Radwin, PhD1, Mary E. Sesto, PhD, PT1 and Stefan V. Zachary, DO2

1 University of Wisconsin, 1550 Engineering Drive, Madison, WI 53706. E-mail address for R.G. Radwin: radwin@engr.wisc.edu 2 One South Park, Madison, WI 53715

Background:
An objective test is needed to evaluate outcome following carpal tunnel release. A method to evaluate sensory and motor function related to carpal tunnel syndrome was investigated.

Methods:
Thirty-six candidates for carpal tunnel surgical procedures underwent a physical examination and nerve-conduction studies and completed a survey regarding symptoms. A battery of psychomotor and sensory tests was administered bilaterally immediately before surgery and again six weeks after surgery. The outcome variables included dynamic sensory gap-detection thresholds and rapid pinch-and-release rates.

Results:
The average gap-detection threshold for the index finger in the surgical-treatment group demonstrated a 43% improvement, decreasing from 0.14 mm preoperatively to 0.08 mm at six weeks postoperatively (p < 0.01). The average gap-detection threshold for the index finger in the non-surgical-treatment group demonstrated no significant improvement, decreasing from 0.10 mm preoperatively to 0.08 mm postoperatively (p = 0.10). With the upper force level set at 10% of the maximum voluntary contraction, the average pinch rate in the surgical-treatment group demonstrated a 20% improvement, increasing from 6.65 pinches per second preoperatively to 7.96 pinches per second postoperatively (p < 0.001). The average pinch rate in the non-surgical-treatment group demonstrated a 7% improvement, increasing from 6.89 pinches per second preoperatively to 7.37 pinches per second at six weeks postoperatively (p < 0.05).

Conclusions:
Measurable and significantly greater improvement was observed when the surgical-treatment group was compared with the non-surgical-treatment group in terms of these two sensory and psychomotor functional testing outcomes at six weeks.

The Journal of Bone and Joint Surgery (American). 2004;86:2614-2620.