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.
Level of Evidence: Therapeutic study, Level II-1
(prospective cohort study). See Instructions to Authors for a complete
description of levels of evidence.