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AĞIR KARPAL TÜNEL SENDROMU İÇİN RİSK FAKTÖRLERİNİN İNCELENMESİ - EV HANIMLIĞI BİR RİSK Mİ?

Yıl 2023, Cilt: 8 Sayı: 1, 71 - 79, 17.01.2023
https://doi.org/10.35232/estudamhsd.1143949

Öz

Karpal tünel sendromu (KTS) en sık görülen tuzak nöropatidir. Bu çalışmada ağır KTS için risk faktörleri incelenmiştir. Bu çalışma EMG
Laboratuvarına başvuran ve Karpal Tünel Sendromu tanısı alan 227 hasta üstünde yapılmıştır. KTS tanı kriterleri olarak American
Academy of Electrodiagnostic Medicine baz alınmıştır. Bütün hastalar bilateral median ve ulnar duyusal pik latans, amplitud ve ileti
hızları açısından değerlendirilmiştir. Motor ileti çalışmasında ise bilateral median ve ulnar sinir motor latans, amplitud ve ileti hızları
değerlendirildi. Hastalar elektrofizyolojik olarak 4 grupta sınıflandırılmıştır; Normal, Hafif, Orta, Ağır. Elektrofizyolojik sınıflandırma
belirlenen risk faktörleri ile karşılaştırılmıştır. Hastaların yaş ortalaması 51.04±13.37’dir (min=18-max=83). Her iki elde de ağır KTS
vakaları ev hanımlarında yüksektir. Ev hanımlığı sağ ve sol el ağır KTS riskini sırasıyla 2.74 ve 2.23 kat artırmıştır. Ayrıca ağır KTS riski
obez olanlarda 5.10- 4.40 kat, lateral epikondilit varlığında 2.73-4.19 kat, medial epikondilit varlığında 4.39-4.93 kat arttığı bulunmuştur.
Dominant elde ağır KTS gelişme riskinin de sol el için 6.88, sağ el için 1.15 kat arttığı bulunmuştur. Çoklu değişkenli analizlerde ise sol
el için ağır KTS riskini obez olmanın 3.34 kat, kronik hastalık varlığının 2.62 kat, sol elin dominant olmasının 7.83 kat artırdığı, sağ el
için ise ev hanımı olmanın 2.14 kat, obez olmanın 4.68 kat, medial epikondilit varlığının 6.40 kat artırdığı bulunmuştur. Ev hanımlığı,
obezite, dominat elde KTS, medial ve lateral epikondilit varlığı ağır KTS için risk faktörü olarak bulunmuştur. KTS tanısı alan kişilerde
belirtilen risk faktörlerine sahip olmaları durumunda ağır KTS açısından koruyucu yaklaşım önerilmektedir.

Kaynakça

  • 1. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999;282(2): 153-8. Doi: 10.1001/jama.282.2.153. 2. Keskin Y, Kilic G, Taspinar O, Posul SO, Halac G, Eren F, Erol E, Urkmez B, Aydin T. Effectiveness of home exercise in pregnant women with carpal tunnel syndrome: Randomized Control Trial. J Pak Med Assoc. 2020 Feb;70(2):202-7. DOI: 10.5455/JPMA.1846. 3. Jerosch-Herold C, Shepstone L, Wilson EC, Dyer T, Blake J. Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: the PALMS study protocol. BMC Musculoskelet Disord. 2014 Feb 7;15:35. DOI: 10.1186/1471-2474-15-35.
  • 4. DeKrom MC, Kester AD, Knipschild PG, Spaans F. Risk factors for carpal tunnel syndrome. Am J Epidemiol. 1990;132(6): 1102-10. DOI: 10.1093/oxfordjournals. aje.a115753.
  • 5. Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve. 1993;16(12): 1392-414. DOI: 10.1002/mus.880161220.
  • 6. Stevens JC. The electrodiagnosis of carpal tunnel syndrome. Muscle Nevre 1997; 20:1477-86. DOI:10.1002/(sici) 1097-4598(199712)20:12<1477:aid-mus 1>3.0.co;2-5
  • 7. American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nevre 2002;25: 918-922. DOI: 10.1002/ mus.10185.
  • 8. Thomsen NO, Björk J, Cederlund RI. Health-related quality of life 5 years after carpal tunnel release among patients with diabetes: a prospective study with matched controls. BMC Endocr Disord. 2014 Oct 17;14: 85. DOI: 10.1186/ 1472-6823-14-85.
  • 9. Palmer KT, Harris EC, Coggon D. Carpal tunnel syndrome and its relation to occupation: a systematic literature review. Occup Med (Lond) 2007;57: 57–66. DOI: 10.1093/occmed/kql125. Epub 2006 Nov 2.
  • 10. Mattioli S, Baldasseroni A, Curti S, Cooke RM, Mandes A, Zanardi F, et all. Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy. Occup Environ Med. 2009 May;66(5):299-304. DOI: 10.1136/oem.2008.040212.
  • 11. Abbas MA, Afifi AA, Zhang ZW, Kraus JF. Meta-analysis of published studies of work-related carpal tunnel syndrome. Int J Occup Environ Health. 1998 Jul-Sep;4(3):160-7. DOI: 10.1179/oeh. 1998.4.3.160.
  • 12. Bahou YG. Carpal tunnel syndrome: a series observed at Jordan University Hospital (JUH) on June 1999-December 2000. Clin Neurol Neurosurg. 2002; 104(1): 49-53. DOI: 10.1016/s0303- 8467(01)00181-0.
  • 13. Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Pract Res Clin Rheumatol. 2015 Jun;29(3):440-53. DOI: 10.1016/j.berh.2 015.04.026.
  • 14. Şahin BE, Yetiş A, Duran S, Özdemir ÖE. Comparing the Neurophysiological Findings of 200 Cases with Boston Carpal Tunnel Syndrome Questionnaire Scores and Job Exposure. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2021; 23(1): 25-33.
  • 15. Moghtaderi A, Izadi S, Sharafadinzadeh N. An evaluation of gender, body mass index, waist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome. Acta Neurol Scand. 2005: 112: 375–9. DOI: 10.1111/j.1600-0404.2005.00528.x.
  • 16. Kurt S, Kisacik B, Kaplan Y, Yildirim B, Etikan I, Karaer H. Obesity and Carpal Tunnel Syndrome: Is There a Causal Relationship? Eur Neurol. 2008;59: 253–7. DOI: 10.1159/000115639.
  • 17. Zhang D, Collins JE. Earp BE, Blazar P. Surgical Demographics of Carpal Tunnel Syndrome and Cubital Tunnel Syndrome Over 5 Years at a Single Institution. J Hand Surg Am. 2017; 42(11): 929.e1-929.e8. DOI: 10.1016/j.jhsa. 2017.07.009.
  • 18. Murray-Leslie CF, Wright V. Carpal tunnel syndrome, humeral epicondylitis, and the cervical spine: a study of clinical and dimensional relations. Br Med J. 1976 Jun 12;1(6023):1439-42. DOI: 10.1136/ bmj.1.6023.1439.
  • 19. Kim YH, Han EY, Kim J, Seo KB, Jeon YT, Im SH. Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome. Sci Rep. 2020 Nov 6;10(1):19278. DOI: 10.1038/ s41598-020-74795-2.
  • 20. Nazari G, Shah N, MacDermid JC, Woodhouse L. The Impact of Sensory, Motor and Pain Impairments on Patient- Reported and Performance Based Function in Carpal Tunnel Syndrome. Open Orthop J. 2017 Nov 10;11: 1258-67. DOIS: 10.2174/18743250017 11011258.
  • 21. Titchener AG, Fakis A, Tambe AA, Smith C, Hubbard RB, Clark DI. Risk factors in lateral epicondylitis (tennis elbow): a case-control study. J Hand Surg Eur Vol. 2013;38: 159-64. DOI: 10.1177/17 53193412442464.
  • 22. Bahar-Moni AS, Abdullah S, Fauzi H, Chee-Yuen SY, Abdul-Razak FZ, Sapuan J. Demographics of Patients Undergoing Carpal Tunnel Release in an Urban Tertiary Hospital in Malaysia. Malays Orthop J. 2019 Nov;13(3): 53-9. DOI: 10.5704/MOJ.1911.009.
  • 23. Rossignol M, Stock S, Patry L, et al. Carpal tunnel syndrome: what is attributable to work? The Montreal study. Occup Environ Med 1997;54: 519–23. DOI: 10.1136/oem.54.7.519.
  • 24. Baldasseroni A, Tartaglia R, Carnevale F. Rischio di sindrome del tunnel carpale in alcune attività lavorative. Med Lav. 1995 Jul-Aug;86(4): 341-51.

RESEARCHING OF RISK FACTORS FOR SEVERE CARPAL TUNNEL SYNDROME - IS HOUSEWIFERY A RISK?

Yıl 2023, Cilt: 8 Sayı: 1, 71 - 79, 17.01.2023
https://doi.org/10.35232/estudamhsd.1143949

Öz

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. In this study, risk factors of severe CTS were examined.
This study was conducted on 227 patients diagnosed with CTS in EMG laboratuary. The criteria of American Academy of
Electrodiagnostic Medicine was used as the diagnosis for CTS. All patients were examined for bilateral median and ulnar motor and
sensory peak latency, amplitude and conduction velocities. The patients were classified into 4 groups electrophysiologically; Normal,
Light, Medium, Severe. Electrophysiological classification was compared with the identified risk factors. The mean age of the patients
was 51.04±13.37 (min=18-max=83). Severe CTS cases in both hands were higher in housewives. Housewifery increased the risk of
severe CTS in the right and left hand by 2.74 and 2.23 times, respectively. In addition, obesity increased the risk of severe CTS in the
right and left hand by 5.10-4.40, presence of lateral epicondylitis was 2.73-4.19 and medial epicondylitis was 4.39-4.93, respectively.
Hand dominancy was increased the risk of severe CTS by 6.88 times for the left hand and 1.15 times for the right hand. Otherwise in
multivariate analyse of left hand results, obesity increase the risk of severe CTS by 3.34, left hand dominancy 7.83 times, chronic
disease 2.62 times, and for the right hand being a housewife increases the risk by 2.14, obesity 4.68 times and medial epicondylitis
6.40 times. This study put forth that being a housewife, obesity, dominant hand, presence of lateral or medial epicondylitis are the risk
factors of severe CTS.

Kaynakça

  • 1. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999;282(2): 153-8. Doi: 10.1001/jama.282.2.153. 2. Keskin Y, Kilic G, Taspinar O, Posul SO, Halac G, Eren F, Erol E, Urkmez B, Aydin T. Effectiveness of home exercise in pregnant women with carpal tunnel syndrome: Randomized Control Trial. J Pak Med Assoc. 2020 Feb;70(2):202-7. DOI: 10.5455/JPMA.1846. 3. Jerosch-Herold C, Shepstone L, Wilson EC, Dyer T, Blake J. Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: the PALMS study protocol. BMC Musculoskelet Disord. 2014 Feb 7;15:35. DOI: 10.1186/1471-2474-15-35.
  • 4. DeKrom MC, Kester AD, Knipschild PG, Spaans F. Risk factors for carpal tunnel syndrome. Am J Epidemiol. 1990;132(6): 1102-10. DOI: 10.1093/oxfordjournals. aje.a115753.
  • 5. Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve. 1993;16(12): 1392-414. DOI: 10.1002/mus.880161220.
  • 6. Stevens JC. The electrodiagnosis of carpal tunnel syndrome. Muscle Nevre 1997; 20:1477-86. DOI:10.1002/(sici) 1097-4598(199712)20:12<1477:aid-mus 1>3.0.co;2-5
  • 7. American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nevre 2002;25: 918-922. DOI: 10.1002/ mus.10185.
  • 8. Thomsen NO, Björk J, Cederlund RI. Health-related quality of life 5 years after carpal tunnel release among patients with diabetes: a prospective study with matched controls. BMC Endocr Disord. 2014 Oct 17;14: 85. DOI: 10.1186/ 1472-6823-14-85.
  • 9. Palmer KT, Harris EC, Coggon D. Carpal tunnel syndrome and its relation to occupation: a systematic literature review. Occup Med (Lond) 2007;57: 57–66. DOI: 10.1093/occmed/kql125. Epub 2006 Nov 2.
  • 10. Mattioli S, Baldasseroni A, Curti S, Cooke RM, Mandes A, Zanardi F, et all. Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy. Occup Environ Med. 2009 May;66(5):299-304. DOI: 10.1136/oem.2008.040212.
  • 11. Abbas MA, Afifi AA, Zhang ZW, Kraus JF. Meta-analysis of published studies of work-related carpal tunnel syndrome. Int J Occup Environ Health. 1998 Jul-Sep;4(3):160-7. DOI: 10.1179/oeh. 1998.4.3.160.
  • 12. Bahou YG. Carpal tunnel syndrome: a series observed at Jordan University Hospital (JUH) on June 1999-December 2000. Clin Neurol Neurosurg. 2002; 104(1): 49-53. DOI: 10.1016/s0303- 8467(01)00181-0.
  • 13. Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Pract Res Clin Rheumatol. 2015 Jun;29(3):440-53. DOI: 10.1016/j.berh.2 015.04.026.
  • 14. Şahin BE, Yetiş A, Duran S, Özdemir ÖE. Comparing the Neurophysiological Findings of 200 Cases with Boston Carpal Tunnel Syndrome Questionnaire Scores and Job Exposure. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2021; 23(1): 25-33.
  • 15. Moghtaderi A, Izadi S, Sharafadinzadeh N. An evaluation of gender, body mass index, waist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome. Acta Neurol Scand. 2005: 112: 375–9. DOI: 10.1111/j.1600-0404.2005.00528.x.
  • 16. Kurt S, Kisacik B, Kaplan Y, Yildirim B, Etikan I, Karaer H. Obesity and Carpal Tunnel Syndrome: Is There a Causal Relationship? Eur Neurol. 2008;59: 253–7. DOI: 10.1159/000115639.
  • 17. Zhang D, Collins JE. Earp BE, Blazar P. Surgical Demographics of Carpal Tunnel Syndrome and Cubital Tunnel Syndrome Over 5 Years at a Single Institution. J Hand Surg Am. 2017; 42(11): 929.e1-929.e8. DOI: 10.1016/j.jhsa. 2017.07.009.
  • 18. Murray-Leslie CF, Wright V. Carpal tunnel syndrome, humeral epicondylitis, and the cervical spine: a study of clinical and dimensional relations. Br Med J. 1976 Jun 12;1(6023):1439-42. DOI: 10.1136/ bmj.1.6023.1439.
  • 19. Kim YH, Han EY, Kim J, Seo KB, Jeon YT, Im SH. Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome. Sci Rep. 2020 Nov 6;10(1):19278. DOI: 10.1038/ s41598-020-74795-2.
  • 20. Nazari G, Shah N, MacDermid JC, Woodhouse L. The Impact of Sensory, Motor and Pain Impairments on Patient- Reported and Performance Based Function in Carpal Tunnel Syndrome. Open Orthop J. 2017 Nov 10;11: 1258-67. DOIS: 10.2174/18743250017 11011258.
  • 21. Titchener AG, Fakis A, Tambe AA, Smith C, Hubbard RB, Clark DI. Risk factors in lateral epicondylitis (tennis elbow): a case-control study. J Hand Surg Eur Vol. 2013;38: 159-64. DOI: 10.1177/17 53193412442464.
  • 22. Bahar-Moni AS, Abdullah S, Fauzi H, Chee-Yuen SY, Abdul-Razak FZ, Sapuan J. Demographics of Patients Undergoing Carpal Tunnel Release in an Urban Tertiary Hospital in Malaysia. Malays Orthop J. 2019 Nov;13(3): 53-9. DOI: 10.5704/MOJ.1911.009.
  • 23. Rossignol M, Stock S, Patry L, et al. Carpal tunnel syndrome: what is attributable to work? The Montreal study. Occup Environ Med 1997;54: 519–23. DOI: 10.1136/oem.54.7.519.
  • 24. Baldasseroni A, Tartaglia R, Carnevale F. Rischio di sindrome del tunnel carpale in alcune attività lavorative. Med Lav. 1995 Jul-Aug;86(4): 341-51.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Halk Sağlığı, Çevre Sağlığı
Bölüm Araştırma Makalesi
Yazarlar

Metin Balduz 0000-0002-1542-8005

Ersin Nazlıcan 0000-0002-1460-1996

Burak Mete 0000-0002-0780-6176

Bahar Balduz 0000-0001-5437-4321

Muhsin Akbaba 0000-0003-3028-6698

Yayımlanma Tarihi 17 Ocak 2023
Gönderilme Tarihi 15 Temmuz 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 8 Sayı: 1

Kaynak Göster

Vancouver Balduz M, Nazlıcan E, Mete B, Balduz B, Akbaba M. RESEARCHING OF RISK FACTORS FOR SEVERE CARPAL TUNNEL SYNDROME - IS HOUSEWIFERY A RISK?. ESTÜDAM Halk Sağlığı Dergisi. 2023;8(1):71-9.

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