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| 14. |
- Thomsen, Niels, et al.
(author)
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Health-related quality of life 5 years after carpal tunnel release among patients with diabetes: a prospective study with matched controls.
- 2014
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In: BMC Endocrine Disorders. - : Springer Science and Business Media LLC. - 1472-6823. ; 14:1
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Journal article (peer-reviewed)abstract
- Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy encountered in diabetes. The short-term improvement after carpal tunnel release has previously been demonstrated not to differ between patients with and without diabetes, despite a marked impairment in health-related quality of life (HRQL) among the former. In this study, we compare HRQL 5 years after carpal tunnel release between these two groups of patients.
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| 15. |
- Thomsen, Niels, et al.
(author)
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Health-related quality of life in diabetic patients with carpal tunnel syndrome
- 2010
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In: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 27:4, s. 466-472
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Journal article (peer-reviewed)abstract
- P>Aims To determine health-related quality of life (HRQL) in diabetic and non-diabetic patients with carpal tunnel syndrome (CTS) before and after surgical treatment. Methods In a prospective study, 35 consecutive diabetic patients with CTS were age and gender matched with 31 non-diabetic patients with idiopathic CTS. At baseline (preoperatively), 6, 12 and 52 weeks after surgical carpal tunnel release, patients completed the generic Short-Form 36 (SF-36) and the disease-specific Boston Carpal Tunnel Questionnaire (BCTQ). Results The SF-36 physical component scores at baseline were significantly reduced for diabetic (39 +/- 7.4) compared with non-diabetic patients (48 +/- 9.0) (P < 0.05). Mixed model analysis demonstrated no differences in post-surgical improvement over time between diabetic and non-diabetic patients. The largest clinical effect was found for bodily pain (effect size 0.8). However, population norms were not reached for the diabetic patients. At baseline, no difference was found in mental component score, which deteriorated over time for diabetic patients. At baseline, BCTQ demonstrated that diabetic patients experienced more pronounced 'numbness in the hand' than non-diabetic patients. Large clinical improvements were found in both symptom severity (effect size 1.98-2.14) and functional status score (effect size 0.89-0.94) for both diabetic and non-diabetic patients, with no difference between the two patient groups. Conclusions HRQL is impaired in diabetic patients with CTS compared with non-diabetic patients with CTS and population norms. However, diabetic patients experience similar symptomatic and functional benefits from carpal tunnel release as do non-diabetic patients.
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| 16. |
- Thomsen, Niels, et al.
(author)
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Neurophysiologic recovery after carpal tunnel release in diabetic patients.
- 2010
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In: Clinical Neurophysiology. - : Elsevier BV. - 1872-8952 .- 1388-2457. ; May 4, s. 1569-1573
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare nerve conduction study results, before and after surgical carpal tunnel release, in diabetic and non-diabetic patients. METHODS: In a prospective study (2004-2007), we included 35 consecutive diabetic patients with carpal tunnel syndrome (CTS), who were age and gender matched with 31 non-diabetic patients having idiopathic CTS. Preoperatively, and at the 1year follow-up, nerve conduction studies were performed of the median and ulnar nerve. Presence of neuropathy was based on abnormal preoperative neurophysiologic values in both the sural and the peroneal nerve. RESULTS: Diabetic patients demonstrated significantly impaired nerve conduction parameters, before as well as after surgical carpal tunnel release, compared to non-diabetic patients. However, neurophysiologic recovery after carpal tunnel release was not different between the two patient groups or between diabetic patients with or without peripheral neuropathy. In general, the largest neurophysiologic recovery was demonstrated for parameters with the greatest impairment, but normal values were seldom reached. CONCLUSIONS: Marked neurophysiologic impairment of the median nerve, or signs of peripheral neuropathy, does not preclude significant recovery after carpal tunnel release in diabetic patients. SIGNIFICANCE: Diabetic patients with CTS should be offered the same opportunities for surgical carpal tunnel release as non-diabetic patients.
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| 17. |
- Thomsen, Niels, et al.
(author)
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Vibrotactile sense in patients with diabetes and carpal tunnel syndrome.
- 2011
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In: Diabetic Medicine: A journal of the British Diabetic Association. - : Wiley. - 1464-5491. ; 28, s. 1401-1406
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Journal article (peer-reviewed)abstract
- Aim: To evaluate vibration perception thresholds of patients with and without diabetes, before and after surgical carpal tunnel release. of patients with and without diabetes. Methods: In a prospective study, 35 consecutive patients with diabetes and carpal tunnel syndrome were age and gender matched with 31 patients without diabetes having idiopathic carpal tunnel syndrome. Preoperatively, 6, 12 and 52 weeks after surgery, the vibration perception threshold of the index and little finger (median and ulnar nerve, respectively) was measured at seven different frequencies (8, 16, 32, 64, 125, 250 and 500 Hz). Results: At several frequencies, patients with diabetes and carpal tunnel syndrome demonstrated significantly impaired vibration perception thresholds of both the index and the little finger, before as well as after carpal tunnel release, compared with patients without diabetes with idiopathic carpal tunnel syndrome. After surgery, the overall sensibility index improved for the index finger [patients with diabetes and carpal tunnel syndrome (0.79-0.91, P < 0.001), patients without diabetes with idiopathic carpal tunnel syndrome (0.91-0.96, P > 0.05)] as well as for the little finger [patients with diabetes and carpal tunnel syndrome (0.82-0.90, P < 0.008), patients without diabetes with idiopathic carpal tunnel syndrome (0.95-0.99, P < 0.05)]. For the index finger, the sensibility index improved to a significantly higher degree for patients with diabetes and carpal tunnel syndrome not having signs of peripheral neuropathy (0.83-0.95, P < 0.001) compared with those with neuropathy (0.74-0.84, P < 0.02). Vibration perception threshold correlates with age of both patients with diabetes and carpal tunnel syndrome and patients without diabetes with idiopathic carpal tunnel syndrome, while no relationship was found based on duration of diabetes. Conclusions: Vibrotactile sense is significantly impaired in patients with diabetes before and after carpal tunnel release compared with patients without diabetes. However, patients with diabetes obtained significant recovery of vibration perception threshold, particularly those without peripheral neuropathy.
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