한 콘돔공장근로자들의 수근관증후군에 관한 연구

강중구,백도명,이윤정,마효일,손미아,이홍기,최정근,Kang, Joong-Koo,Paek, Do-Myung,Lee, Young-Jung,Ma, Hyeo-Il,Son, Mi-A,Lee, Hong-Ki,Choi, Jung-Keun 대한예방의학회 1996 예방의학회지 Vol.29 No.3

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

방아쇠수지가 손목터널증후군 환자의 악력, 통증 및 상지기능에 미치는 영향: 단면적 연구

김명권 ( Myoung-kwon Kim ),윤다은 ( Da-eun Yun ) 대한물리의학회 2021 대한물리의학회지 Vol.16 No.1

PURPOSE: The purpose of this study was to investigate the effects of trigger finger on pain, muscle strength and function in carpal tunnel syndrome (CTS) patients. METHODS: A total of 60 subjects (30 carpal tunnel syndrome with trigger finger and 30 carpal tunnel syndrome without trigger finger) were assessment for pain, muscle strength (power grip, key pinch , tip to tip pinch, three jaw pinch) and function. The effect sizes of the two groups were compared, and the correlation between the trigger finger and each variable was analyzed. RESULTS: The results showed that there were significantly difference in the pain, muscle strength excluding three jaw pinch and function (p < .05). The results also showed correlation between trigger finger and pain (r = .552), muscle strength excluding three jaw pinch (power grip r = -.296, key pinch r = -.260, tip to tip pinch r = -.285), and function (r = .375). The function of carpal tunnel syndrome patients was related to pain (r = .550) and power grips (r = -.324) of muscle strength. CONCLUSION: In carpal tunnel syndrome patients with trigger finger compared to carpal tunnel syndrome, muscle weakness, pain increase, and function reduction were shown. In addition, trigger finger are correlated with muscle strength, pain and function, and muscle weakness and increased pain affect the daily living of carpal tunnel syndrome patients with triggers finger. Therefore, physical therapy interventions of carpal tunnel syndrome patients with trigger finger should be combined with treatment for muscle strength enhancement as well as pain reduction.

모 사업장 포장부서 근로자들에서 발생한 수근터널증후군에 대한 조사연구

이원진,이은일,차철환,Lee, Won-Jin,Lee, Eun-Il,Cha, Chul-Whan 대한예방의학회 1992 예방의학회지 Vol.25 No.1

The carpal tunnel syndrome is one of the most common peripheral nerve entrapment syndromes. The typical symptoms are pain, numbness and paresthesia in the median nerve territory of the hand. Recently, it is widely recognized that occupational factor is regarded as the important cause of the carpal tunnel syndrome. Clinical study is performed in the 42 female workers who is repetitively working at packing department in a rayon manufacturing factory from November 1991 till March 1992. The study included a questionnaire, physical examinations, and the neurophysiological test. The summary of the results obtained was as follows : 1. Among 42 packing workers, 9 workers(21.4%) were diagnosed as carpal tunnel syndrome by electromyography. The affected side was bilateral in 4 workers(9.5%), right in 4 workers(9.5%), and left in one worker(2.4%). 2. Among 42 subjects, 28 workers(66.7%) complained the clinical symptoms related to carpal tunnel syndrome, 11 workers(26.2%) showed positive Phalen sign, and 7 workers(16.7%) showed positive Tinel sign. 3. Researchers regard electromyographic finding as the gold standard for diagnosis of carpal tunnel syndrome. The sensitivity and specificity of the clinical symptoms to diagnose the carpal tunnel syndrome were 0.89, 0.39 respectively. If the carpal tunnel syndrome is diagnosed by the combination of the positive findings of the symptoms and the physical examinations, either Tinel or Phalen sign, the sensitivity and specificity were 0.67 and 0.76 respectively. Considering above results, though this small number of workers is not adequate for epidemiologic conclusions, carpal tunnel syndrome seems to be an important occupational disorder among packing workers in a rayon manufacturing factory.

손목부담 작업 노출빈도에 따른 수근관증후군의 특성 비교

정석철(Sukchul Jung),채유미(Yoomi Chae),노상철(Sangchul Roh) 대한직업환경의학회 2010 대한직업환경의학회지 Vol.22 No.2

Objective: We investigated the differences among the patients who were diagnosed with carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work by using carpal tunnel syndrome surveillance system. Methods: The study subjects were a total of 855 patients from 1,017 patients who were diagnosed with carpal tunnel syndrome in 9 university hospitals from May, 2001 to October, 2004, and we excluded 161 patients who had no clear information for their occupational status. The subjects were classified into three groups according to four types of wrist-burdening work: 1) repetitive use of wrists, 2) inappropriate posture of the hand, 3) use of vibrating tools, and 4) overpressure work on the hand or palm, - as defined in the operational definition by the National Institute for Occupational Safety and Health (NIOSH). The subjects with two or more types of wrist-burdening work were classified as ‘high risk group’, the subjects with one type of wrist-burdening work were classified as ‘intermediate risk group’, and the subjects with none of the types of wrist-burdening work were classified as ‘low risk group’. We used chi-square test, Fisher’s exact test and ANOVA for comparing the characteristics according to the 3 subgroup. Results: The mean age in the high risk group was the lowest(53 years), and there was a significant difference among the groups for the mean age(p<0.05). The high risk group included the most males with 39(22.0%). The subjects in the high risk group had significantly more jobs in agricultureㆍforestryㆍfisheries, factory work, and simple labor and less comorbidities, including diabetes and rheumatoid arthritis(p<0.05). The subjects in the intermediate risk group had a higher proportion of service workers. There were significant differences for the symptoms of carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work. The subjects in the high risk group showed the highest proportion of work-related aggravation of symptoms with 88(76.5%) and the highest mean number of days absent from work(6 days) as related to carpal tunnel syndrome. Conclusion: Worker in agricultureㆍforestryㆍfisheries, factory work, and simple labor showed significantly more frequent carpal tunnel syndrome, and so management strategies are needed to prevent them from developing carpal tunnel syndrome.

수근관증후군에 대한 도침치료의 효과: 체계적 문헌 고찰과 메타분석

정재민,설재욱,김선종,선윤권,최지민,노희정,최진봉 한방재활의학과학회 2022 한방재활의학과학회지 Vol.32 No.3

Objectives The objective of this study was to assess the effectiveness of acupotomy for carpal tunnel syndrome. Methods Based on seven domestic and foreign databases. We analyzed the randomized controlled trials using acupotomy for carpal tunnel syndrome. The treatment group was treated with acupotomy and the control group was no restrictions on treatment methods. Results In this study, the effect of acupuncture treatment for carpal tunnel syndrome was investigated. Each study reported that acupotomy could be an effective treatment for carpal tunnel syndrome. However, as a result of meta-analysis of Levine carpal tunnel syndrome questionnaire scores, visual analog scale, and sensory nerve conduction velocity, the results were more clinically significant than those of the control group. Due to the small number of randomized controlled trial studies and the nature of acupotomy treatment, blinding of interventions was impossible, resulting in a high risk of bias. Conclusions In this regard, it is thought that well-planned randomized controlled studies on patients with carpal tunnel syndrome are needed in the future to secure the clinical evidence for acupotomy treatment.

오공약침(蜈蚣藥鍼)을 이용한 수근관 증후군(Carpal tunnel syndrome) 치료의 임상적 연구

임정아,김성남,이성용,문형철,김성철,Lim, Jeong-A,Kim, Sung-Nam,Lee, Sung-Young,Moon, Hyung-Cheol,Kim, Sung-Chul 대한약침학회 2005 Journal of pharmacopuncture Vol.8 No.1

Objectives : This study is performed for the purpose of examining into the efficacy of the scolopendrid herbal acupucture which has been used among the Korean people for the Carpal tunnel syndrome. Methods : 40 carpal tunnel syndrome patients who visited Won-kwang University Hospital during the period from January 1998 to December 2004 were analysed for clinical manifestations. After we divided patients into two classes at random, we treated them with scolopendrid herbal acupucture or not. Treatment efficiency was monitored through VAS(Visual Analog Scale) and clinical symptom. Conclusion : We brought to the conclusion that the scolopendrid herbal acupucture has possibility to be efficient to cure the carpal tunnel syndrome patients. So we suggest the possibility to use this new remedy for the carpal tunnel syndrome.

Predictive Variables for Sonographically Guided Corticosteroid Injection in Mild-to-Moderate Carpal Tunnel Syndrome

정성윤,곽정민,강석,손성호,김재두,윤준식 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.2

Objective To assess the predictive variables after sonographically guided corticosteroid injection in carpal tunnel syndrome. Methods A prospective, observational study was carried out on 25 wrists of 20 consecutive patients with carpal tunnel syndrome, confirmed by the American Association of Neuromuscular and Electrodiagnostic Medicine criteria, which includes clinical history, symptoms, and evidence of slowing of distal median nerve conduction. Visual analogue scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) were asked to the patients before and 4 weeks after the procedure. On a basis of VAS difference before and after the procedure, we divided the patients into two groups: more than 50% of VAS improving (good response group) and less than 50% of VAS improving (poor response group). Also, nerve conduction studies and ultrasound evaluations were performed prior to sonographically guided corticosteroid injection and at 4 weeks after the procedure. The cross-sectional area (CSA) of median nerve at maximal swelling point around wrist was measured by manual tracing using ultrasonography. With assessments mentioned above, we tried to assess predictive variables for prognosis after sonographically guided corticosteroid injection in carpal tunnel syndrome. Results The CSA of median nerve at wrist measured before the procedure was significantly larger in good response group than in poor response group. Furthermore, the CSA of median nerve at wrist, symptom severity scale of BCTQ, motor/sensory latency and sensory amplitude were correlated with VAS improving. Conclusion The CSA of median nerve at wrist is the strongest predictive value for sonographically guided corticosteroid injection in mild-to-moderate carpal tunnel syndrome.

수근관 공간확장테이핑치료를 실시한 수근관증후군 환자 6례 보고

허수영,Heo, Su-Young 척추신경추나의학회 2012 척추신경추나의학회지 Vol.7 No.1

Objectives : The purpose of this study is to evaluate the korean medical treatment for carpal tunnel syndrome, especially taping therapy for carpal space expansion. Methods : Six patients were treated with acupuncture, moxibustion and kinesio taping therapy. To evaluate the pain and numbness of the palm and finger, visual analogue scale(VAS) and Phalen's test were used. Results : After about 10 to 20 times treatment, the pain and numbness of almost cases were remarkably removed. Also the VAS of post-treatment was reduced by 1.33(means). And the time being required to response to Phalen's test was signally prolonged, as 5 cases took over one minute. Conclusions : Korean medical treatment including expansion taping of carpal space as kinesio correction therapy is remarkably effective for carpal tunnel syndrome. But further studies are required to concretely prove the effectiveness of correction taping on other compressive neuropathy.

수근관 증후군의 진단에서 자가 기입식 수부 증상 도표의 유용성

오차재,조병만 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 수근관 증후군(carpal tunnel syn-drome)의 진단에 있어서 자가 기입식 수부증상 도표의 유용성을 평가해 보고자 하였다. 방법 : 한 대학병원에 상지 불편감을 호소하여 내원한 85명을 대상으로 문진과 이학적 검사를 시행한 후 자가 기 입식 hand symptom diagram (HSD)을 작성하고 신경전도검사를 실시하였다. 신경전도검사결과를 기준으로 자가 기입식 HSD, Tinel sign,Phalen sign, 야간 증상과 무지구 위축 등 임상검사 소견의 수근관 증후군에 대한 진단 능력을 평가하고 신경전도검사 결과와의 연관성을 평가하였다. 결과 : 연구대상자 85명 중에서 수근관 증후군으로 진단받은 사람은 48명(56.5 %)이었다. HSD에서 수근관 증후군으로 진단할 수 있는 기준을 Clas-sic 또는 probable의 등급으로 정의하였을 때 HSD의 민감도, 특이도, 양성 예측도 및 음성 예측도는 각각 75.6 %, 59.6 %, 73.8 % 및 62.0 %이었다. Tinel sign의 민감도, 특이도, 양성 예측도, 음성 예측도는 각각 65.4 %, 78.8 %, 82.3 % 및60.3 %이었으며 Phalen sign의 민감도, 특이도,양성 예측도, 음성 예측도는 61.5 %, 71.2 %,76.2 % 및 55.2 %이었다. 또한 HSD의 신경전도검사와의 관련성은 교차비 4.58로 통계학적으로 의미가 있었다(p(0.05). 결론 : HSD는 비용이 적게 들고 쉽게 그릴 수 있으며, 기존의 수근관 증후군 진단 방법에 비해 민감도가 높았으므로 수근관 증후군의 선별검사와 조기진단을 위해 유용하게 사용할 수 있을 것으로 생각된다. Objectives : This study was conducted to compare a self-administered hand symptom diagram with other diagnostic tests and to assess its value in the diagnosis of carpal tunnel syndrome. Methods : A self-administered hand symptom diagram has been developed for the eval-uation of upper extremity paresthesias. A rating system was devised to classify the dia-grams into four categories : classic, probable, possible, or unlikely carpal tunnel syndrome. Before nerve conduction testing, a medical history and demographic data were collected, a physical examination was conducted, and a hand symptom diagram was obtained from each patient. The diagram ratings of 85 patients (130 hands) were evaluated by an occupational and environmental medicine physician and a nerve conduction study was administered and interpreted by a rehabilitation medicine physician. Results : Of 85 patients, 48(56.5 %) had carpal tunnel syndrome confirmed by nerve conduction study. A hand symptom diagram rating of classic or probable CTS had a sensitivity of 75.6 %, a specificity of 59.6 %, a positive predictive value of 73.8 % and a negative predictive value of 62.0 %. Of the combinations of clinical findings in carpal tunnel syndrome, a classic or probable hand symptom diagram or a positive Tinel's sign showed the highest sensitivity. Conclusions : A self-administered hand symptom diagram is valuable in the diagnosis of carpal tunnel syndrome among patients with upper extremity paresthesias. It is a use-ful diagnostic tool and may be valuable for occupational or population screening.

On the Severity of Carpal Tunnel Syndrome: Diabetes or Metabolic Syndrome

Fatma Gul Yurdakul,Hatice Bodur,Özgu¨r Öztop Çakmak,Filiz Sivas,Filiz Eser,Özlem Yılmaz Taşdelen 대한신경과학회 2015 Journal of Clinical Neurology Vol.11 No.3

Background and Purpose Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Although its etiology is unknown, certain conditions are commonly associated with CTS, such as obesity, arthritis, hypothyroidism, diabetes mellitus, trauma, mass lesions, amyloidosis, and sarcoidosis. We aimed to determine the association between metabolic syndrome and CTS, and we compared the severity of CTS between patients with diabetes (and no concomitant metabolic syndrome) and patients with metabolic syndrome. Methods Two hundred patients with a clinically and electrophysiological confrmed diagnosis of CTS were included in the study. Teir demographic characteristics and severity of CTS were analyzed according to the presence or the absence of metabolic syndrome. Diferences in the electrophysiological fndings were evaluated between the following four groups: 1) metabolic syndrome alone (n=52), 2) diabetes alone (n=20), 3) combined metabolic syndrome and diabetes (n=44), and 4) no metabolic syndrome or diabetes (n=84). Results CTS was more severe in the patients with metabolic syndrome than those without this syndrome. Te electrophysiological fndings were worse in patients with metabolic syndrome alone than in those with diabetes alone and those without diabetes and metabolic syndrome. Conclusions CTS appears to be more severe in patients with metabolic syndrome than patients with diabetes. Diabetes is one of the well-known risk factors for CTS, but other components of metabolic syndrome may have a greater efect on the severity of CTS.