The role of the nine-hole peg test and neurophysiological tests in the classification of carpal tunnel syndrome
Abstract
Introduction: The aim of this study was to investigate the effectiveness of the use of the nine-hole nail test and neurophysiological tests in the diagnosis and classification of carpal tunnel syndrome (CTS).
Methods: This study was planned as a prospective cross-sectional study. Age, gender, occupation, height (cm), weight (kg), body mass index (BMI-kg/m2) values of all patients included in the study were recorded. In addition to the nine-hole nail test, LANNS, DN4 model was applied to CTS patients. In addition, the duration of the patients' complaints (months), the classification of their clinical findings and electrophysiological staging were recorded. The sensory and muscle strength examination of the hand was evaluated with Phalen and Tinel tests. Nerve conduction study (NCS) was performed with Cadwell Sierra EMG in our Neurophysiology Laboratory and normal values from our Clinical Neurophysiology Laboratory were used.
Results: A positive (linear) moderate correlation was found between the BCTQ FSS value and the left nine-hole nail test, the defective nine-hole nail test, the BCTQ SSS, LANNS and DN 4 values (r=0.387; r=0.350; r=0.649; r=0.431; r=0.490, respectively). A positive (linear) moderate correlation was found between the LANNS value and the defective nine-hole wooden nail test and DN 4 values (r=0.395; r=0.666, respectively). A positive (linear) moderate correlation was found between the DN 4 value and the BCTQ SSS, the BCTQ FSS and LANNS values (r=0.599; r=0.490; r=0.666, respectively).
Conclusion: It is possible to say that the nine-hole nail test and BCTQ tests are effective and reliable tools in the clinical and functional evaluation of CTS.
Ethical Statement
Etik Kurul Onayı alınmıştır.
Supporting Institution
Yoktur.
Thanks
Herhangi bir kişi kurum teşekkürünü gerektiren bir durum yoktur.
References
- 1.Gerritsen AA, de Krom MC, Struijs MA, Scholten RJ, de Vet HC, Bouter LM. Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials. J Neurol. 2002;249(3):272-280. [Crossref]
- 2. Provinciali L, Giattini A, Splendiani G, Logullo F. Usefulness of hand rehabilitation after carpal tunnel surgery. Muscle Nerve. 2000;23(2):211-216. [Crossref]
- 3. Cirakli A, Ulusoy EK, Ekinci Y. The role of electrophysiological examination in the diagnosis of carpal tunnel syndrome: Analysis of 2516 patients. Niger J Clin Pract. 2018;21(6):731-734. [Crossref]
- 4.Civi Karaaslan T, Berkoz O, Tarakci E. The effect of mirror therapy after carpal tunnel syndrome surgery: A randomised controlled study. Hand Surg Rehabil. 2020;39(5):406-412. [Crossref]
- 5.Mathiowetz V, Weber K, Kashman N, Volland G. Adult Norms for the Nine Hole Peg Test of Finger Dexterity. The Occupational Therapy Journal of Research. 1985;5(1):24-38. [Crossref]
- 6.Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153-158. [Crossref]
- 7.Alanazy MH. Clinical and electrophysiological evaluation of carpal tunnel syndrome: approach and pitfalls. Neurosciences (Riyadh). 2017;22(3):169-180. [Crossref]
- 8.Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-1284. [Crossref]
- 9.Spallone V, Morganti R, D'Amato C, Greco C, Cacciotti L, Marfia GA. Validation of DN4 as a screening tool for neuropathic pain in painful diabetic polyneuropathy. Diabet Med. 2012;29(5):578-585. [Crossref]
- 10.Stütz NM, Gohritz A, Novotny A, Falkenberg U, Lanz U, van Schoonhoven J. Clinical and electrophysiological comparison of different methods of soft tissue coverage of the median nerve in recurrent carpal tunnel syndrome. Neurosurgery. 2008;62(3 Suppl 1):194-200. [Crossref]
- 11.Alanoglu E, Gurcay E, Tuncay R, Noyan S, Cakci A. The Comparison of The Symptoms, Grip Strength, Pinch Strength, Nine Hole Peg Test and The Electrophysiological Findings of Carpal Tunnel Syndrome Patients. J PMR Sci. 2003;6(1):9-13.
Abstract
Giriş: Bu çalışma ile dokuz delikli çivi testi ile nörofizyolojik testlerin kullanımının karpal tünel sendromu (KTS) tanısında ve sınıflamasında etkinliğini araştırmak amaçlanmıştır.
Metot: Bu çalışma prospektif kesitsel bir çalışma olarak planlandı. Çalışmaya alınan tüm hastaların yaş, cinsiyet, meslek, boy (cm), kilo (kg), vücut kitle indeksi (VKİ-kg/m2), değerleri kaydedildi. Dokuz delikli çivi testine ek olarak KTS hastalarına LANNS, DN4 modeli uygulandı. İlaveten hastaların şikayetlerinin süresi (ay), klinik bulgularının sınıflaması ve elektrofizyolojik evrelemeleri kaydedildi. Elin duyu ve kas gücü muayenesi Phalen ve Tinel testleriyle değerlendirildi. Sinir iletim çalışması (SİÇ) Nörofizyoloji Laboratuvarımızda bulunan Cadwell Sierra EMG ile yapıldı ve Klinik Nörofizyoloji Laboratuvarımıza ait normal değerler kullanıldı.
Bulgular: Boston Semptom Ciddiyet Ölçeği (BSCÖ) fonksiyon değerlendirme skoru (FDS) değeri ile solda dokuz delikli çivi testi, bozuk olan dokuz delikli çivi testi, BSCÖ semptom şiddet skoru (SŞS), LANNS ve DN 4 değerleri arasında pozitif (doğrusal) yönlü orta düzey bir ilişki olduğu saptandı (sırasıyla r=0,387; r=0,350; r=0,649; r=0,431; r=0,490). LANNS değeri ile bozuk olan dokuz delikli tahta çivi testi ve DN 4 değerleri arasında pozitif (doğrusal) yönlü orta düzey bir ilişki tespit edildi (sırasıyla r=0,395; r=0,666). DN 4 değeri ile BSCÖ SŞS, BSCÖ FDS ve LANNS değerleri arasında pozitif (doğrusal) yönlü orta düzey bir ilişki saptandı (sırasıyla r=0,599; r=0,490; r=0,666).
Sonuç: Dokuz delikli çivi testi ve BSCÖ testlerinin KTS'nin klinik ve fonksiyonel değerlendirilmesinde etkin ve güvenilir araçlar olduğunu söylemek mümkündür.
References
- 1.Gerritsen AA, de Krom MC, Struijs MA, Scholten RJ, de Vet HC, Bouter LM. Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials. J Neurol. 2002;249(3):272-280. [Crossref]
- 2. Provinciali L, Giattini A, Splendiani G, Logullo F. Usefulness of hand rehabilitation after carpal tunnel surgery. Muscle Nerve. 2000;23(2):211-216. [Crossref]
- 3. Cirakli A, Ulusoy EK, Ekinci Y. The role of electrophysiological examination in the diagnosis of carpal tunnel syndrome: Analysis of 2516 patients. Niger J Clin Pract. 2018;21(6):731-734. [Crossref]
- 4.Civi Karaaslan T, Berkoz O, Tarakci E. The effect of mirror therapy after carpal tunnel syndrome surgery: A randomised controlled study. Hand Surg Rehabil. 2020;39(5):406-412. [Crossref]
- 5.Mathiowetz V, Weber K, Kashman N, Volland G. Adult Norms for the Nine Hole Peg Test of Finger Dexterity. The Occupational Therapy Journal of Research. 1985;5(1):24-38. [Crossref]
- 6.Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153-158. [Crossref]
- 7.Alanazy MH. Clinical and electrophysiological evaluation of carpal tunnel syndrome: approach and pitfalls. Neurosciences (Riyadh). 2017;22(3):169-180. [Crossref]
- 8.Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-1284. [Crossref]
- 9.Spallone V, Morganti R, D'Amato C, Greco C, Cacciotti L, Marfia GA. Validation of DN4 as a screening tool for neuropathic pain in painful diabetic polyneuropathy. Diabet Med. 2012;29(5):578-585. [Crossref]
- 10.Stütz NM, Gohritz A, Novotny A, Falkenberg U, Lanz U, van Schoonhoven J. Clinical and electrophysiological comparison of different methods of soft tissue coverage of the median nerve in recurrent carpal tunnel syndrome. Neurosurgery. 2008;62(3 Suppl 1):194-200. [Crossref]
- 11.Alanoglu E, Gurcay E, Tuncay R, Noyan S, Cakci A. The Comparison of The Symptoms, Grip Strength, Pinch Strength, Nine Hole Peg Test and The Electrophysiological Findings of Carpal Tunnel Syndrome Patients. J PMR Sci. 2003;6(1):9-13.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Articles |
| Authors | |
| Publication Date | June 30, 2025 |
| Submission Date | March 24, 2025 |
| Acceptance Date | June 9, 2025 |
| Published in Issue | Year 2025 Volume: 8 Issue: 2 |