ARE JOINT POSITION SENSE, TWO-POINT DISCRIMINATION, FINE MOTOR CONTROL, GRIP STRENGTH, LIGHT TOUCH SENSATION, PAIN, AND FUNCTIONALITY AFFECTED BILATERALLY IN UNILATERAL CARPAL TUNNEL SYNDROME?

Öz

Objective: This study aimed to evaluate joint position sense, two-point discrimination, fine motor control, grip strength, light touch sensation, pain, and functionality in patients with unilateral carpal tunnel syndrome and to determine whether these variables change in the unaffected hands of patients with unilateral carpal tunnel syndrome. Materials and Methods: The study was planned as a single-blind, cross-sectional case-control study. Individuals between the ages of 20-65 who were diagnosed with carpal tunnel syndrome (n=22) and healthy (n=22) were included. The device was designed for the study of measurements; discriminator; 9-hole peg test, dynamometer, and pinch meter, Semmens Weinstein monofilament test; The visual analog scale was evaluated bilaterally with the Boston questionnaire. Results: There was a significant difference between all measurements in the affected and unaffected hands between the CTS group and the control group (p<0.05). There was no significant difference between the joint position sense, two-point discrimination, fine motor control, grip strength, light touch sense, and functionality between the affected and unaffected hand in the CTS group (p>0.05). Conclusion: This is the first study evaluating joint position sense in the wrist, metacarpophalangeal joints, and interphalangeal joints in unilateral CTS syndrome. It was noteworthy that patients with unilateral carpal tunnel syndrome had deficiencies in joint position sense, fine motor control, two-point discrimination, light touch sense, and grip strength compared to the healthy control group, as well as deficiencies in the unaffected sides.

Anahtar Kelimeler

• Carpal tunnel syndrome
• proprioception
• motor skills
• grip strength

TEK TARAFLI KARPAL TÜNEL SENDROMUNDA EKLEM POZİSYON HİSSİ, İKİ NOKTA AYRIMI, İNCE MOTOR KONTROL, KAVRAMA KUVVETİ, HAFİF DOKUNMA DUYUSU, AĞRI VE İŞLEVSELLİK BİLATERAL OLARAK ETKİLENİR Mİ?

Öz

Amaç: Bu çalışmanın amacı, tek taraflı karpal tünel sendromlu hastalarda eklem pozisyon hissi, iki nokta ayırt etme, ince motor kontrol, kavrama kuvveti, hafif dokunma hissi, ağrı ve fonksiyonelliği değerlendirmek ve hastaların etkilenmeyen ellerinde de bu değişkenlerin değişip değişmediğini belirlemektir. Gereç ve Yöntem: Çalışma tek kör, kesitsel vaka-kontrol çalışması olarak planlandı. 20-65 yaş aralığında karpal tünel sendromu tanısı alan (n=22) ve sağlıklı (n=22) bireyler dahil edildi. Ölçümler çalışma için tasarlanan cihaz; diskriminatör; 9 delikli peg test, dinamometre ve pinchmetre, semmens weinstein monoflament test; visuel analog scale, Boston anketi ile bilateral değerlendirildi. Bulgular: Karpal tünel sendromu grubu ile kontrol grubu arasında etkilenen ve etkilenmeyen ellerinde tüm ölçümler arasında anlamlı farklılık vardı (p<0.05). KTS grubunda etkilenen el ve etkilenmeyen el arasında eklem pozisyon hissi, iki nokta diskriminasyonu, ince motor kontrol, kavrama kuvveti, hafif dokunma duyusu, fonksiyonellik arasında anlamlı fark bulunmadı (p>0.05). Sonuç: Bu çalışma tek taraflı KTS sendromunda el bileği, metakarpofalangeal eklemler ve interfalangeal eklemlerde eklem pozisyon hissini değerlendiren bildiğimiz kadarıyla ilk çalışmadır. Tek taraflı karpal tünel sendromlu hastaların eklem pozisyon hissi, ince motor kontrol, iki nokta diskriminasyonu, hafif dokunma duyusu ve kavrama kuvveti sağlıklı kontrol grubuna göre eksik bulunmasının yanı sıra etkilenmeyen taraflarında da eksikliklikler olması dikkat çekici bulundu.

Anahtar Kelimeler

• Karpal tünel sendromu
• propriosepsion
• motor beceri
• kavrama kuvveti

Kaynakça

1. 1. Luckhaupt SE, Dahlhamer JM, Ward BW, Sweeney MH, Sestito JP, Calvert GM. Prevalence and work-relatedness of carpal tunnel syndrome in the working population, United States, 2010 national health interview survey. Am J Ind Med 2013;56(6):615-24. [CrossRef] google scholar
2. 2. Rothwell JC, Traub MM, Day BL, Obeso JA, Thomas PK, Marsden CD. Manual motor performance in a deafferented man. Brain 1982;105(3):515-42. [CrossRef] google scholar
3. 3. Talu B, Bazancir Z. The Effects of Sensory Therapy on Pain, Upper Extremity Functions and Sleep Quality in Patients with Carpal Tunnel Syndrome. Ann Yoga Phys Ther 2016;1(2):1007. google scholar
4. 4. Lowe BD, Freivalds A. Effect of carpal tunnel syndrome on grip force coordination on hand tools. Ergonomics 1999;42(4):550-64. [CrossRef] google scholar
5. 5. Thonnard J, Saels P, Van den Bergh P, Lejeune T. Effects of chronic median nerve compression at the wrist on sensation and manual skills. Exp Brain Res 1999;128(1-2):61-4. [CrossRef] google scholar
6. 6. Tamburin S, Cacciatori C, Marani S, Zanette G. Pain and motor function in carpal tunnel syndrome: a clinical, neurophysiological and psychophysical study. J Neurol 2008;255(11):1636-43. [CrossRef] google scholar
7. 7. Hillier S, Immink M, Thewlis D. Assessing proprioception: a systematic review of possibilities. Neurorehabil neural repair 2015;29(10):933-49. [CrossRef] google scholar
8. 8. Moseley GL, Gallace A, Spence C. Bodily illusions in health and disease: physiological and clinical perspectives and the concept of a cortical ‘body matrix.’ Neurosci Biobehav Rev 2012;36(1):34-46. [CrossRef] google scholar

9. 9. Caseiro M, Dos Reis FJJ, Barbosa AM, Barbero M, Falla D, de Oliveira AS. Two-point discrimination and judgment of laterality in individuals with chronic unilateral non-traumatic shoulder pain. Musculoskelet Sci Pract 2021;56:102447. [CrossRef] google scholar
10. 10. Ngomo S, Mercier C, Bouyer LJ, Savoie A, Roy J-S. Alterations in central motor representation increase over time in individuals with rotator cuff tendinopathy. Clin Neurophysiol 2015;126(2):365-71. [CrossRef] google scholar
11. 11. Wolny T, Saulicz E, Linek P, Mysliwiec A. Two-point discrimination and kinesthetic sense disorders in productive age individuals with carpal tunnel syndrome. J Occup Health 2016;58(3):289-96. [CrossRef] google scholar
12. 12. Arockiaraj J, Korula RJ, Oommen AT, Devasahayam S, Wankhar S, Velkumar S, et al. Proprioceptive changes in the contralateral knee joint following anterior cruciate injury. Bone Joint J 2013;95-b(2):188-91. [CrossRef] google scholar
13. 13. Provinciali L, Giattini A, Splendiani G, Logullo F. Usefulness of hand rehabilitation after carpal tunnel surgery. Muscle Nerve 2000;23(2):211-6. [CrossRef] google scholar
14. 14. De Krom M, Knipschild P, Kester A, Thijs C, Boekkooi P, Spaans F. Carpal tunnel syndrome: prevalence in the general population. J Clin Epidemiol 1992;45(4):373-6. [CrossRef] google scholar
15. 15. Cramer SC, Finklestein SP, Schaechter JD, Bush G, Rosen BR. Activation of distinct motor cortex regions during ipsilateral and contralateral finger movements. J Neurophysiol 1999;81(1):383-7. [CrossRef] google scholar
16. 16. Poole JL, Burtner PA, Torres TA, McMullen CK, Markham A, Marcum ML, et al. Measuring dexterity in children using the Nine-hole Peg Test. J Hand Ther 2005;18(3):348-51. [CrossRef] google scholar
17. 17. Geere J, Chester R, Kale S, Jerosch-Herold C. Power grip, pinch grip, manual muscle testing or thenar atrophy-which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review. BMC Musculoskelet Disord 2007;8(1):1-9. [CrossRef] google scholar
18. 18. Shiratori AP, lop Rda R, Borges Junior NG, Domenech SC, Gevaerd Mda S. Evaluation protocols of hand grip strength in individuals with rheumatoid arthritis: a systematic review. Rev Bras Reumatol 2014;54(2):140-7. [CrossRef] google scholar
19. 19. Borchers S, Hauser T-K, Himmelbach M. Bilateral hand representations in human primary proprioceptive areas. Neuropsychologia 2011;49(12):3383-91. [CrossRef] google scholar
20. 20. Rasmussen PV, Sindrup SH, Jensen TS, Bach FW. Symptoms and signs in patients with suspected neuropathic pain. Pain 2004;110(1-2):461-9. [CrossRef] google scholar
21. 21. Sezgin M, İncel NA, Sevim S, Çamdeviren H, As İ, Erdogan C. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and validity of the turkish version of the boston questionnaire. Disabil Rehabil 2006;28(20):1281-6. [CrossRef] google scholar
22. 22. Tong MH, Mousavi SJ, Kiers H, Ferreira P, Refshauge K, van Dieen J. Is there a relationship between lumbar proprioception and low back pain? A systematic review with meta-analysis. Arch Phys Med Rehabil 2017;98(1):120-36. [CrossRef] google scholar
23. 23. Stanton TR, Leake HB, Chalmers KJ, Moseley GL. Evidence of impaired proprioception in chronic, idiopathic neck pain: systematic review and meta-analysis. Phys Ther 2016;96(6):876-87. [CrossRef] google scholar
24. 24. Relph N, Herrington L. Knee joint position sense ability in elite athletes who have returned to international level play following ACL reconstruction: A cross-sectional study. The Knee 2016;23(6):1029-34. [CrossRef] google scholar
25. 25. Sahin E, Dilek B, Baydar M, Gundogdu M, Ergin B, Manisali M, et al. Shoulder proprioception in patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil 2017;30(4):857-62. [CrossRef] google scholar
26. 26. Lee M, Hinder MR, Gandevia SC, Carroll TJ. The ipsilateral motor cortex contributes to the cross-limb transfer of performance gains after ballistic motor practice. J Physiol 2010;588(1):201-12. [CrossRef] google scholar
27. 27. Wright TW, Glowczewskie Jr F, Wheeler D, Miller G, Cowin D. Excursion and strain of the median nerve. JBJS 1996;78(12):1897-903. [CrossRef] google scholar
28. 28. Wolny T, Saulicz E, Linek P, Mysliwiec A. Two-point discrimination and kinesthetic sense disorders in productive age individuals with carpal tunnel syndrome. J Occup Health 2016;58(3):289-96. [CrossRef] google scholar
29. 29. Breckenridge JD, Ginn KA, Wallwork SB, McAuley JH. Do people with chronic musculoskeletal pain have impaired motor imagery? A meta-analytical systematic review of the left/right judgment task. J Pain 2019;20(2):119-32. [CrossRef] google scholar
30. 30. Heerkens RJ, Köke AJA, Lötters FJB, Smeets RJEM. Motor imagery performance and tactile acuity in patients with complaints of arms, neck, and shoulder. Pain manag 2018;8(4):277-86. [CrossRef] google scholar
31. 31. Fernândez-De-Las-Penas C, Perez-de-Heredia-Torres M, Martınez-Piedrola R, de la Llave-Rincon Al, Cleland JAJEbr. Bilateral deficits in fine motor control and pinch grip force in patients with unilateral carpal tunnel syndrome Exp. Brain Res 2009;194(1):29-37. [CrossRef] google scholar
32. 32. Wolny T, Linek P, Saulicz E. Assessment of manual dysfunction in occupationally active women with carpal tunnel syndrome. lnt J Occup Med Environ Health 2019;32(2):185-96. [CrossRef] google scholar
33. 33. Baker NA, Moehling KK, Desai AR, Gustafson NP. Effect of carpal tunnel syndrome on grip and pinch strength compared with sex-and age-matched normative data. Arthritis Care Res 2013;65(12):2041-5. [CrossRef] google scholar
34. 34. Padua L, Padua R, Nazzaro M, Tonali P. lncidence of bilateral symptoms in carpal tunnel syndrome. J Hand Surg Eur 1998;23(5):603-6. [CrossRef] google scholar
35. 35. Wiebusch M, Coombes BK, Silva MF. Joint position sense, motor imagery, and tactile acuity in lateral elbow tendinopathy: A cross-sectional study. Musculoskelet Sci Pract 2021;55:102422. [CrossRef] google scholar
36. 36. Pelletier R, Paquette E, Bourbonnais D, Higgins J, Harris PG, Danino MA. Bilateral sensory and motor as well as cognitive differences between persons with and without musculoskeletal disorders of the wrist and hand. Musculoskelet Sci Pract 2019;44:102058. [CrossRef] google scholar