Women with carpal tunnel syndrome show restricted cervical range of motion

De-la-Llave-Rincón AI,et al.
J Orthop Sports Phys Ther. 2011 May;41(5):305-10. doi: 10.2519/jospt.2011.3536. Epub 2011 Apr 6.

Key Points

Findings
Women with minimal, mild/ moderate, or severe CTS exhibited less cervical range of motion, as compared to controls, suggesting that restricted cervical range of motion is a common feature of women with CTS, independent of severity subgroups defined on the basis of electrodiagnosis.

Implications
Correction of impairments in the cervical spine maybe helpful for the management of women with CTS.

Caution
We recruited women from 1 specialized hospital. The study design does not allow us to make inferences about a cause-and-effect relationship between cervical range of motion and CTS.


Abstract

STUDY DESIGN: A case control, blinded study.

OBJECTIVES: To compare the amount of cervical range of motion in women with minimal, mild/moderate, and severe carpal tunnel syndrome (CTS) to that of healthy control participants. We also assessed the relationships between cervical range of motion and clinical variables related to the intensity and temporal profile of pain within each CTS group.

BACKGROUND: It is plausible that the cervical spine may be involved in individuals with CTS. No study has investigated the relationship between cervical range of motion and symptoms associated with CTS severity.

METHODS: Cervical range of motion was assessed in 71 women with CTS (18 with minimal, 18 with mild/moderate, and 35 with severe signs and symptoms) and in 20 similar, healthy women. Those with CTS were aged 35 to 59 years (mean ± SD, 45 ± 8 years) and those in the healthy group were aged 31 to 60 years (45 ± 8 years). An experienced therapist, blinded to the participants’ conditions, used a cervical range-of-motion (CROM) device to assess cervical range of motion. Mixed-model analyses of variance (ANOVAs) were conducted to evaluate the differences in cervical range of motion among the 3 groups of patients with CTS and healthy controls. A corrected P value of less than .025 was used as threshold for significance (Bonferroni correction).

RESULTS: The mixed-model ANOVAs revealed that the individuals with CTS exhibited restricted cervical range of motion compared to healthy controls (P<.001), with no significant differences among the groups with minimal, mild/moderate, or severe CTS (P>.356). A significant negative correlation between pain intensity and cervical spine lateral flexion away from the affected side was identified: the greater the mean pain intensity, the lesser the cervical lateral flexion away from the affected side.

CONCLUSIONS: Women with minimal, mild/moderate, or severe CTS exhibited less cervical range of motion compared to women of a similar age, suggesting that restricted cervical range of motion may be a common feature in individuals with CTS, independent of severity subgroups, as defined by electrodiagnosis. Future research should investigate cervical range of motion as a possible consequence or causative factor of CTS and related symptoms.

PubMed Reference:  http://www.ncbi.nlm.nih.gov/m/pubmed/21471650/

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