Ultrasonographic Measurements of the Median Nerve Before and After Splinting for Carpal Tunnel Syndrome
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A prospective cohort follow-up study design is undertaken. Both males and females with mild to moderate carpal tunnel syndrome will receive standard-of-care wrist splint for 6 weeks and undergo follow up studies for data collection. Controls will also be seen for a one time visit.
Cross sectional area of median nerve using ultrasound [ Time Frame: 6 weeks ]
Secondary Outcome Measures :
Patient-reported outcome measures using NeuroQOL and CTSAQ [ Time Frame: 6 weeks ]
Motor latency, motor amplitude, sensory velocity and sensory amplitude with electrodiagnostic study [ Time Frame: 6 weeks ]
cross sectional area, electrodiagnostic study, age, gender, height, weight, BMI, wrist circumference, wrist width. smoking and handedness as predictors of improvement (or no improvement) in the NeuroQOL and CTSAQ-measured clinical severity scale. [ Time Frame: 6 weeks ]
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Ages Eligible for Study:
18 Years and older (Adult, Senior)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Those with diagnosis of carpal tunnel syndrome, and healthy control subjects with no symptoms of CTS.
18 years or older and;
Diagnosis of mild to moderate CTS with median motor latency at 8 cm is greater than 4.5 milliseconds or Combined Sensory Index > 0.9 where first line therapy is indicated to include nocturnal wrist bracing
Control subjects without symptoms of carpal tunnel syndrome.
Evidence of severe CTS as seen with electromyographic changes in the body of the muscle
Untreated hypothyroidism, Rheumatologic disorders
Diagnosed Severe CTS or Chronic symptoms of carpal tunnel, greater than 1 year, this includes wasting of the hand muscles
Undergoing or previously treated for carpal tunnel on affected side. This includes surgery (carpal tunnel release), corticosteroid injections, bracing within the last 3 months while wearing the brace consistently every night, or any other intervention.
Currently pregnant or < 3 months post partum
History of wrist, hand fracture or severe trauma to affected hand and/or wrist
Known tumor, mass or deformity of the hand/wrist
Inflammatory articular disease of the joints or tendons Existing cervical radiculopathy or previous surgeries to the neck for radicular symptoms
History of electrodiagnostic evidence of generalized polyneuropathy or evidence of denervation
Diagnosed neuromuscular disorders which may complicate CTS diagnosis