EVALUATIONS OF PROGNOSTIC FACTORS IN PATIENTS WITH CARPAL TUNNEL SYNDROME

Soon B.¹, Vicenzino B.², Coppieters M.³

¹Singapore Institute of Technology, Academic Programme, Singapore, Singapore, ²The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia, ³VU University Amsterdam, Faculty of Human Movement Sciences, Amsterdam, Netherlands

Background: Carpal tunnel syndrome (CTS) is a common upper limb neurological entrapment. A more comprehensive study of prognostic indicators of success with different domain of CTS evaluation is needed.

Purpose: The objective of the study was to identify prognostic indicators associated with long-term outcomes of Boston carpal tunnel questionnaire (BCTQ) in patients with CTS.

Methods: A prospective follow-up study was conducted with 120 participants. Electrodiagnostic tests, quantitative sensory tests, ultrasonography, hand function and demographical information of participants were investigated for their prognostic ability on outcome of BCTQ at 52 weeks. Variables with significant univariate association (p 0.1) were entered into multivariate linear regression (P 0.05).

Results: In the multivariate model, longer duration of symptoms, (β=0.002, 95% CI= 0.001 to 0.003, p=0.009), higher BCTQ symptom (β=0.25, 95% CI= 0.007 to 0.494, p=0.044) and function scores (β= 0.0239, 95%CI= 0.068 to 0.411, p=0.007) at baseline were associated with higher BCTQ symptom score at 52 weeks. For BCTQ function score at 52 weeks, multivariate analysis showed body mass index (β= 0.018, 95%CI= 0.001 to 0.036, p=0.048), BCTQ function score (β=0.452, 95%CI= 0.298 to 0.606, p 0.001), and vibration detection threshold (β=0.039, 95% CI= 0.001 to 0.078, p=0.048) as prognostic indicators. Overall, the two prognostic models on BCTQ symptoms and functional scores had R2 value of 21.3% and 38.2% respectively.

Conclusion(s): Baseline scores of the BCTQ, duration of CTS, body mass index and vibration detection threshold are prognostic indicators to outcome of BCTQ in the long-term. The findings provided further insight on the different domains of CTS assessment which are prognostic indicators of success in conservative CTS management.

Implications: Somatosensory testing of vibration detection threshold, measurement of body mass index and duration of symptoms could be taken into consideration to predict the long term outcome of BCTQ scores in patients undergoing conservative CTS management.

Funding acknowledgements: National Health and Medical Research Council (NHMRC) of Australia, project grant 511161.

Topic: Musculoskeletal: upper limb

Ethics approval: Ethics approval UQ medical research ethics committee Number: 2008000007

All authors, affiliations and abstracts have been published as submitted.