Carpal tunnel syndrome treatment and the subsequent alterations in tendon and connective tissue dynamics.
Carpal tunnel syndrome treatment and the subsequent alterations in tendon and connective tissue dynamics.
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DOI：
10.1016/j.clinbiomech.2021.105440
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Amadio PC
中科院分区：
文献类型：
--
作者：
Hosseini-Farid M;Schrier VJMM;Starlinger J;Zhao C;Amadio PC
腕管综合征患者表现为正中神经运动减少和腕管内滑膜下结缔组织纤维化改变。目前，有一些预后因素，以帮助预测结果的常用治疗，包括手术腕管松解和皮质类固醇注射。本研究旨在非侵入性评估介入后滑膜下组织相对于肌腱运动的动态反应变化，并将其与疾病严重程度相关联。本研究共纳入145例腕管综合征患者。通过注射或手术，在治疗前后收集临床和人口统计学数据、电生理严重程度和动态超声图像。使用斑点跟踪算法测量滑膜下组织与下方中指指浅屈肌腱的相对运动，并表示为剪切指数（SI）。对基线和随访数据、SI变化与严重程度之间的关系以及治疗方式的作用进行分析和统计学比较。总体而言，治疗后平均剪切指数从79.9%（±15.4% SD）显著增加（更多相对运动）至82.9%（±14.8% SD）（p=0.03）。次要分析显示，这种变化主要存在于接受手术的轻度疾病严重程度患者中（p=0.01）。这项研究表明，相对滑膜下组织的运动增加后，患者的干预。本研究为将来的研究奠定了基础，以非侵入性评估腕管动力学的作用，对治疗的反应。
Carpal tunnel syndrome patients demonstrate diminished motion of the median nerve and fibrotic changes in the subsynovial connective tissue within the carpal tunnel. Currently, there are few prognostic factors to help predict the outcome of commonly performed treatments including surgical carpal tunnel release and corticosteroid injections. This study aimed to non-invasively assess the changes in the dynamic response of the subsynovial tissue relative to tendon motion after the intervention and to correlate this with disease severity. A total of 145 patients with carpal tunnel syndrome were recruited into this study. Clinical and demographic data, electrophysiological severity and dynamic ultrasound images were collected before and after treatment, either by injection or surgery. The relative motion of the subsynovial tissue with the underlying middle finger flexor digitorum superficialis tendon was measured using a speckle tracking algorithm and was expressed as a shear index (SI). Baseline and follow-up data, the association between change in SI and severity, and the role of treatment modality were analyzed and statistically compared. Overall, there was a significant increase (more relative motion) after treatment in the mean shear index from 79.9% (±15.4% SD) to 82.9% (±14.8% SD) (p=0.03). Secondary analyses showed that this change was mostly present in those with mild disease severity undergoing surgery (p=0.01). This study shows that the relative subsynovial tissue movement increases in patients after intervention. The present study lays a foundation for future studies to non-invasively assess the role of carpal tunnel dynamics in response to treatment.
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影响因子：
2.8
作者：
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通讯作者：
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DOI：
10.1016/j.jelekin.2017.10.007
发表时间：
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期刊：
Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology
影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
Hand (New York, N.Y.)
影响因子：
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作者：
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影响因子：
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作者：
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