WORKER MONITORING TESTS FOR CARPAL TUNNEL SYNDROME

说明(改编自《调查员摘要》)：本提案 使用一组精神运动和感觉测试进行调查 定期监测产业工人的细微功能缺陷 与腕管综合征(CTS)相关。尽管这些测试不是 用于诊断，它们应该足够敏感，以检测到 早期CTS缺陷，但CTS比其他监测更具体 工具，如自我报告或结构化症状调查。自.以来 这些测试是自动化和非侵入性的，它们可能适合于 常规监测工人的早期CTS，类似于如何测听 测试用于监测暴露在巨大声学噪声中的工人。 需要监测工具才能进行主动监测，以便及早 在这些病例进展到昂贵和致残之前检测CTS 用于职业病，并触发人体工学干预。 首席研究员已经开发了生物医学 这项提议的工具。这些测试被证明是 对精神运动和感觉缺陷的检测可靠和敏感 与CTS关联。这些测试与正中神经相关。 门诊患者电生理参数的病例对照研究 有电生理证实的CTS，以及没有 症状和电诊断参数与CTS一致。这项建议 通过提出一项前瞻性研究来推进这项工作 在工人中可以观察到这些测试参数的时间变化 出现CTS症状。工业人口中有250名工人受到 来自多个相关行业的CTS相关风险因素 对于CTS发病率较高的患者，将定期检测其变化情况 四年期间的精神运动和感觉功能测试参数。 工人将每年接受CTS检查，包括 电生理测试。结果具有积极/消极的功能 将确定变化和阳性/阴性自我报告的症状，并 比较敏感度、特异度和预测值。此外 对于这些实地调查，这些仪器的新参数将是 使用门诊受试者和对照进行调查。

DESCRIPTION (Adapted From the Investigator's Abstract): This proposal investigates using a battery of psychomotor and sensory tests for periodically monitoring industrial workers for subtle functional deficits associated with carpal tunnel syndrome (CTS). Although these tests are not intended for diagnosis, they should be sufficiently sensitive to detect early CTS deficits, yet be more specific for CTS than other monitoring instruments, such as self-reported or structured symptom surveys. Since these tests are automated and non-invasive, they may be suitable for routinely monitoring workers for early CTS, analogous to how audiometric tests are used for monitoring workers exposed to loud acoustic noise. Monitoring instruments are needed for active surveillance, for early detection of CTS before these cases progress into costly and disabling occupational illnesses, and for triggering ergonomics interventions. The Principal Investigator has already developed the biomedical instrumentation for this proposal. The tests were demonstrated to be reliable and sensitive for detection of psychomotor and sensory deficits associated with CTS. These tests were correlated with median nerve electrophysiologic parameters in a case-control study involving outpatients with electrophysiologically confirmed CTS, and a control group free of symptoms and electrodiagnostic parameters consistent with CTS. The proposal advances that work by proposing a prospective study for investigating if temporal changes in these test parameters can be observed among workers developing CTS symptoms. An industrial population of 250 workers exposed to risk factors associated with CTS from a variety of industries associated with high CTS incidence rates will be periodically tested for changes in psychomotor and sensory functional test parameters over a four year period. Workers will annually undergo examination for CTS, including electrophysiologic testing. Outcomes having positive/negative functional changes and positive/negative self reported symptoms will be ascertained and sensitivity, specificity and predictive value will be compared. In addition to these field investigations, new parameters for these instruments will be investigated using outpatient subjects and controls.