Wrist Flexion to Identify Carpal Tunnel Syndrome

描述（申请人摘要）：虽然大多数医疗保健从业者 将腕管综合征（CTS）定义为一种压迫，或压缩， 正中神经在手腕的水平（例如腕管），诊断 往往不明确。模糊的一个主要原因是，在其最初的 CTS通常涉及横贯腕关节的肌腱炎症， 控制手指移动和抓握。随着肌腱炎的进展， 一系列炎症事件，包括肿胀、血管淤滞和 伤害感受器敏感化，其解释了许多CTS临床体征。因此，我们认为， 临床体征不能明确区分肌腱炎和CIS， 需要直接测试正中神经功能， 腕部目前，只有手腕上的传导延迟满足这些要求。 的搜索.感官测试的替代方案（例如，两点辨别， 单丝或振动阈值）缺乏特异性;也就是说， 赤字可以归因于其他原因。 最近，一项挑衅性的技术提供了手腕水平的证据， 正中神经卡压症状变得明确之前，更传统的 程序，并已被报告为特定的CTS超过其他形式的 周围神经病变专题测试建议调查的方式， 提高最初报告的挑衅程序的效率， 提高CTS诊断的特异性和敏感性。如果可行 满足标准后，第二阶段将提出一个设备包， 特别是用于改善腕管状况的评估。 拟定商业应用： 腕管综合症的治疗和康复的医疗细分市场 综合症包括手外科手术、手疗法、物理疗法、物理疗法 (PM&R），神经病学和职业医学。潜在的巨大市场 用于筛查腕管损伤的非侵入性仪器，包括人 资源、安全、人体工程学和工业卫生。

DESCRIPTION (Applicant's Abstract): Although most health care practitioners would define carpal tunnel syndrome (CTS) as an entrapment, or compression, of the median nerve at the level of the wrist (e.g. carpal tunnel), the diagnosis is often not clear cut. A major reason for ambiguity is that in its initial stages, CTS often involves inflammation of tendons transversing the wrist that control finger movement and grip. As tendinitis progresses, there is a constellation of inflammatory events including swelling, vascular stasis, and nociceptor sensitization, which account for many of CTS clinical signs. Hence, clinical signs do not clearly differentiate between tendinitis and CIS, which requires direct testing of median nerve function specifically localized to the wrist area. At present, only conduction latency across the wrist fulfills these criteria. The alternative of sensory testing (e.g., two-point discrimination, monofilament or vibratory threshold) lacks specificity; that is, sensory deficits can be attributed to other causes. More recently, a provocative technique has provided evidence of wrist level, median nerve entrapment before symptoms become unequivocal by more traditional procedures, and has been reported to be specific for CTS over other forms of peripheral neuropathy. Topical Testing proposes to investigate ways of improving the efficiency of the initially reported provocative procedure to improve the specificity and sensitivity of CTS diagnosis. If feasibility criteria are satisfied, Phase II will propose an equipment package designed specifically for improved evaluation of carpal tunnel status. PROPOSED COMMERCIAL APPLICATION: Medical market segments for the treatment and rehabilitation of carpal tunnel syndrome include hand surgery, hand therapy, physical therapy, physiatry (PM&R), neurology, and occupational medicine. Potentially large markets for noninvasive instrumentation to screen for carpal tunnel injury include human resources, safety, ergonomics, and industrial hygiene.