• Title/Summary/Keyword: Phalen's test

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The Diagnostic Assessment of Hand Elevation Test in Carpal Tunnel Syndrome

  • Ma, HyunJin;Kim, Insoo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.472-475
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    • 2012
  • Objective : The aim of this study is to establish the value of hand elevation test as a reproducible provocative test for the diagnosis of carpal tunnel syndrome (CTS). Methods : We had a prospective study of 45 hands of 38 patients diagnosed with CTS between April 2005 and February 2009. The diagnosis of CTS was based on the American Academy of Neurology clinical diagnostic criteria. Experimental and control group patients underwent Tinel's test, Phalen's test, carpal compression test and hand elevation test as provocative tests for CTS. Results : We used chi-square analysis to compare Tinel's test and Phalen's test, carpal compression test with hand elevation test. The sensitivity and specificity of the hand elevation test is 86.7% and 88.9% each. Tinel's test had 82.2% sensitivity and 88.9% specificity. Phalen's test had 84.4% sensitivity and 86.7% specificity. Carpal compression test had 84.4% sensitivity 82.2% specificity. Comparisons of sensitivity and specificity between hand elevation test and Tinel's test, Phalen's test, and carpal compression test had no statistically significant differences. To compare the diagnostic accuracies of four tests, the area under the non-parametric receiver operating character curve was applied. Conclusion : The hand elevation test has higher sensitivity and specificity than Tinel's test, Phalen's test, and carpal compression test. Chi-square statistical analysis confirms the hand elevation test is not ineffective campared with Tinel's test, Phalen's test, and carpal compression test.

Six Cases of Carpal Tunnel Syndrome with Taping Therapy for Carpal Tunnel Expansion (수근관 공간확장테이핑치료를 실시한 수근관증후군 환자 6례 보고)

  • Heo, Su-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.7 no.1
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    • pp.67-74
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    • 2012
  • 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.

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The Effects of Acupotomy Therapy on Carpal Tunnel Syndrome: A Report of 4 Cases

  • Lee, Seongjin;Cha, Eunhye;Yang, Muhak;Lee, Jongdeok;Lee, Jiyoung;Lee, Sojin;Kim, Deokho;Kim, Sungchul
    • Journal of Acupuncture Research
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    • v.35 no.1
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    • pp.4-10
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    • 2018
  • The aim of this report was to show the effects of acupotomy in patients with carpal tunnel syndrome. Four patients were treated with acupotomy twice. Visual analogue scale (VAS), Tinel's sign, Phalen's test, Boston carpal tunnel syndrome questionnaire (BCTQ), muscular strength test, and a cross-sectional area of median nerve was measured using ultrasound before and after treatment. In all 4 cases, the VAS score, BCTQ score and cross-sectional area of median nerve, all decreased and muscular strength test score increased. Tinel's sign and the Phalen's test changed from a positive to a negative in most cases. This report shows that acupotomy is an effective treatment for carpal tunnel syndrome. Further larger are needed to fully evaluate the beneficial effects of this treatment.

A Case Report on Pregnancy-Related Carpal Tunnel Syndrome Worsened after Birth by Korean Medicine (임신 중 발생하여 출산 후 악화된 수근관 증후군 한방 치험 1례)

  • Im, Ji-Yeong;Han, Kuk-In;Lee, Eun-Hee;Lee, Ah-Yeong;Kim, Jong-Uk
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.4
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    • pp.65-76
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    • 2015
  • Objectives : This study is to report the effect of Korean medical treatment on a patient suffered from carpal tunnel syndrome (CTS) occurred in pregnancy and worsened after birth. Methods : We treated the patient diagnosed as carpal tunnel syndrome by Korean medical treatment such as acupuncture, pharmacopuncture and herbal medicine at ⃝⃝Hospital of Korean Medicine from July 31th 2015 to August 6th 2015. And we evaluated changes of symptoms by Visual Analog Scale (VAS), Tinel sign, Phalen’s test, and Digital Infrared Thermographic Imaging (DITI). Results : 1. Through Korean medical treatment, postpartum carpal tunnel syndrome was significantly improved. VAS was decreased from 4 to 2, Phalen’s test was manifested from 10 seconds to 26 seconds and Tinel sign was changed from positive to negative. 2. We compared the gap of temperature between palm and forearm before and after Korean medical treatment through DITI. The temperature on the right side was changed from 0.74℃ to 1.01℃ and the left one from 0.63℃ to 1.01℃. Conclusions : This case report shows that Korean medical treatment is useful to treat pregnancy-related carpal tunnel syndrome worsened after birth.

Carpal Tunnel Syndrome among workers in a condom industry (한 콘돔공장근로자들의 수근관증후군에 관한 연구)

  • Kang, Joong-Koo;Paek, Do-Myung;Lee, Young-Jung;Ma, Hyeo-Il;Son, Mi-A;Lee, Hong-Ki;Choi, Jung-Keun
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.507-519
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    • 1996
  • 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.

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Effects of Catgut -Embedding Therapy in Patients with Carpal Tunnel Syndrome: a Retrospective Pilot Study

  • You, Kyung-Gon;Kwon, Young-Dal
    • The Journal of Korean Medicine
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    • v.36 no.2
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    • pp.43-49
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    • 2015
  • Objectives: We evaluated the effect of the traditional Korean medical therapy of catgut-embedding therapy in patients with carpal tunnel syndrome (CTS). Methods: Thirteen patients(20 hands) with CTS underwent catgut-embedding therapy once per week for a total of 1-4 sessions. We measured the time to tingling in the fingers on performing Phalen's test. We also had patients use a visual analog scale (VAS) to indicate the severity of tingling. We also asked about the awakening time at night due to pain and tingling. We controlled the treatment as being limited to four sessions. Even if a patient had not been treated for four sessions, we ended the patient's treatment if symptoms resolved. Results: Patients who received catgut-embedding therapy showed significant improvements in the clinical symptoms of CTS. After treatment, in a total of 19 hands, the status of fourteen was changed from positive to negative in Phalen's test and the average of tingling occurrence time in that test was delayed. Among the 20 hands, the VAS in eight hands changed to zero and the average of VAS score decreased. Furthermore, in nine patients, four could sleep well without the use of a splint. Conclusions: Patients undergoing this traditional Korean medical therapy showed alleviation of finger tingling after even a single treatment. We thus concluded that this traditional Korean catgut-embedding therapy, may be effective for treating CTS. However, to confirm the effects of catgut-embedding therapy on CTS, further tests are required, including under the defined, strict conditions of a randomized controlled trial.

Clinical study on the Patients with Carpal tunnel syndrome (수근관 증후군에 대한 임상적 고찰)

  • Kim, Il-du;Oh, Hee-hong;Byun, Jae-young;Moon, Hyung-cheol;Koh, Kang-hoon;Park, So-young;Chang, Byoung-sun
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.61-66
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    • 2002
  • Objective : Carpal tunnel syndrome has gained increasing attention and acceptance as a significant cause of peripheral neuropathy, since it was first reported in 1836. The purpose of this study is to inspect the effect of oriental medical treatment on Carpal tunnel syndrome patients who is not come under surgical decompession. Methods : 20 patients who visited Won-Kwang University Hospital during the period from January 1998 to May 2000 were analysed for clinical manifestations. Results : 1. Among 20 patients, 3 were male and 17 were female. 2. The syndrome occurred on the right side in 5 patients, on the left side in 0 patients, and on both 15 patients 3. The most of causes were overwork. 4. Numbness was the most common symptom followed by night pain, paresthesis, morning stiffness, puffiness and resting pain 5. Among 20 patients, 12 were Tinel's sign positive, 16 were Phalen's test positive Conclusions : When the symptom is mild and duration is short, conservative treatment is effetive, but when neurological deficit is prominent and conservative treatment is not effective, surgical decompession is indicated. We treated 19 among 20 cases of the patients which Carpal Tunnel syndrome. We achieved effective results.

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Clinical Study on Treatment of the Carpal Tunnel Syndrome with CF Herbal Acupuncture (홍화약침을 이용한 수근관증후군치료)

  • Shin, Min-Seop;Park, Min-Ho;Lim, Sung-Taek;Shin, Jin-Cheol;Lee, Bu-Young;Lee, Si-Seop;Yook, Tae-Han;Choi, Seok-Woo
    • Journal of Pharmacopuncture
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    • v.8 no.2
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    • pp.39-45
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    • 2005
  • Objective : The purpose of the study was to evaluate if CF herbal acupuncture is more effective than simple acupuncture in the carpal tunnel syndrome. Methods : We classified two groups: CF group(patients treated by CF herbal acupuncture and then treated by acupuncture) and N-CF group(patients treated entirely by acupuncture without other treatment). We evaluated subjective symptoms and Phalen's test of patients after executing, and then analyzed those. Results : 1. Both CF group and N-CF group were statistically significant(p<0.05) in improvement of symptoms and Phalen's test since third times of treatment. 2. It appears that CF group was more effective than N-CF group for treatment of carpal tunnel syndrome. That was statistically significant(p<0.05) since third times of treatment.

Carthami Semen Pharmacopuncture Combined with Electroacupuncture on Carpal Tunnel Syndrome: A Retrospective Case Series Study

  • Kim, Pyung-Wha;Choe, Seon;Han, Kyungsun;Yang, Changsop;Lee, Jinbok;Kim, Sungha;Shin, Minseop
    • Journal of Pharmacopuncture
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    • v.24 no.2
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    • pp.76-83
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    • 2021
  • While carpal tunnel syndrome (CTS) is the most common entrapment neuropathy affecting the wrist, resulting in substantial physical, psychological, and economic effects, there is no gold standard therapy for CTS. In this case series study, we aimed to report CTS patients treated with Carthami Semen Pharmacopuncture (CSP) and electroacupuncture (EA) showing improvements in their symptoms, and the combinatorial effects of CSP and EA. We collected medical records of CTS outpatients who received CSP and EA at Chuku Acupuncture & Moxibustion Korean Medicine Clinic from August 2017 to September 2018. The outcome measures were the visual analog scale (VAS) for pain, paresthesia, the Korean version of the Boston carpal tunnel questionnaire (K-BCTQ) score, and changes in nocturnal pain, Tinel sign, and Phalen's test. We included patient satisfaction at the completion of all treatments. 17 patients were included for this case series study. After treatment, VAS for pain decreased significantly from 50.41 ± 16.19 to 9.59 ± 9.46, VAS for paresthesia also decreased significantly from 63.50 ± 11.49 to 14.75 ± 12.97, and K-BCTQ symptom severity scale decreased from 2.48 ± 0.68 to 1.89 ± 0.70 (all p < 0.001). Nocturnal pain, Tinel signs, and Phalen's test showed improvements after all the treatments. All the patients reported favorable overall satisfaction with the treatments, and 69.23% wanted future pharmacopuncture treatments if CTS recurred. No complications were detected. The combination of CSP and EA could be an effective and safe option in treating CTS.

Korean Medicine for Carpal Tunnel Syndrome: a Systematic Review of Literature Published in Korea (수근관 증후군의 한의학적 치료에 대한 논문 고찰 -국내 학술지를 중심으로-)

  • Lee, Jong Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.1
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    • pp.79-84
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    • 2015
  • The aim of this review is to investigate studies of Korean medical treatment of carpal tunnel syndrome published in Korea and the evidence of it's effects in order to suggest a better research method in the future. Four Korean web databases were searched by using key words such as 'carpal', and checked relevant Korean journals. The papers were classified into the field of study, publish date, diagnostic methods, evaluation methods and analysed the study tendency. There are 9 case studies, 4 controlled studies. The paper was published almost every year more than once. Acupucture, pharmacopuncture, acupotomy, warm needle acupuncture, taping, etc. were used as treatment tools. The two most commonly used diagnostic method for carpal tunnel syndrome are Phalen's test and Tinel's sign. The two most commonly used evaluation method are VAS(Visual Analog Scale) and subjective symptoms. Korean medical treatment of carpal tunnel syndrome was effective in all studies. Korean medical treatment of carpal tunnel syndrome was effective in all studies. So it is possible that Korean medical treatment of carpal tunnel syndrome is useful as therapeutic medicine, but there are not sufficient evidence based papers, so there should be further studies.