Carpal tunnel syndrome (CTS) is a neuropathic condition commonly caused by the entrapment of the median nerve. The most common complaint presented by the CTS patients is pricking sensation, numbness, pins and needles, burning sensation as well as in the hand and sometimes the arm/s distribution of the affected side. The patients with CTS usually complain of nocturnal periodic sleep disruption caused by the pain discomfort. In my dissertation, I explore the extent to which the CTS pain influences sleep architecture using neurophysiological measurements like an overnight electroencephalogram (EEG), conduction tests as well as subjective questionnaires. I initially conducted a pilot research study on 33 patients with CTS using subjective questionnaires. The CTS patients reported sleep disturbance. I also demonstrated that they (patients) had a minimal mood and psychological disturbance. I was prompted therefore to investigate the influence of the CTS pain on the sleep architecture using more objective empirical instruments like the polysomnogram as well as subjective measurements such as Beck Depression Inventory, Profile of mood states, Visual analogue scales as well as the McGill pain questionnaire to further investigate changes. The patients were required to spend four nights in the sleep laboratory divided into two nights before surgery and two nights at least two to six weeks following the CTS surgery. The CTS surgery is commonly used to release the compression of the median nerve at the wrist. The changes in subjective and objective variables were compared before and after CTS surgery. The age and gender-matched control group was introduced into the research study. The control group was required to spend the same number of nights in the sleep laboratory as the CTS group. The control group was also going to have a non-painful procedure of the same magnitude as the experimental subjects. The conclusion I reached on this study was that the CTS patients reported poor sleep quality. I also demonstrated that there were not many changes in the polysomnogram and that there were minimum changes shown on the nerve conduction studies variables as might have been expected based on the severity of the carpal tunnel syndrome. Another important finding was that there was a relationship between pain and depressive mood in CTS patients. The removal of pain in CTS patients showed that there was a subsequent subjective improvement in mood and psychological status and no significant improvement in subjective measurements. There were no significant changes noted on the control subjects who were pain-free.

Thesis (M.Sc.)--York University, 2004. Graduate Programme in Kinesiology and Health Science. / Typescript. Includes bibliographical references (leaves 68-74). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL:http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss&rft%5Fval%5Ffmt=info:ofi/fmt:kev:mtx:dissertation&rft%5Fdat=xri:pqdiss:MQ99282

Thesis (M.F.A.)--Ohio State University, 2006. / Includes bibliographical references (leaves 112-114). Available online via OhioLINK's ETD Center

The purpose of this study was to determine the utility of decomposition-based quantitative electromyography (DQEMG) in detecting signs of motor unit loss and collateral sprouting in compression neuropathy. In order to accomplish this, needle- and surface-detected motor unit potential (MUP) morphological features, determined by DQEMG, were used to determine evidence of collateral sprouting. Evidence of motor unit loss was measured using motor unit number estimates (MUNEs). Six subjects with severe carpal tunnel syndrome (CTS), eight subjects with mild CTS and nine healthy individuals with no known neuropathy participated in this cross sectional study. All subjects completed two phases of data collection: 1) an examination consisting of physical and electrophysiological tests to assess the presence and/or severity of CTS and 2) quantitative electromyography techniques to record MUNEs and MUP morphological characteristics. The needle-detected MUP parameters included peak-to-peak amplitude, duration and number of phases. The presence of satellite potentials was also investigated in the needle-detected MUPs. The surface-detected MUP parameters examined included peak-to-peak amplitude, duration and negative peak area. Kruskall-Wallace tests were used to determine group differences for all outcome measures. The MUNEs were lower (p<0.017) in the severe CTS group as compared to those with mild or no CTS. This result suggests that individuals with severe CTS experience a decrease in the number of functioning motor units. Despite statistically similar surface-detected MUP morphology, there were significantly larger needle-detected MUP amplitudes (p<0.017) and satellite potentials (p<0.05) were present in the severe CTS group as compared to the mild CTS group and healthy control group. These findings suggest there is collateral reinnervation in individuals with severe CTS. The results of this study support the use of DQEMG in future studies of compression neuropathies as an effective means to document the progression of motor deficits. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2008-09-16 12:08:13.587

Thesis (PhDPhysiotherapy)--University of South Australia, 2001

Thesis (MAppSc in Physiotherapy)--University of South Australia, 1996

Thesis (PhDPhysiotherapy)--University of South Australia, 2001

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed Apr. 29, 2008). PDF text: ix, 121 p. : ill. ; 1 Mb. UMI publication number: AAT 3278295. Includes bibliographical references. Also available in microfilm and microfiche formats.

Carpal tunnel syndrome (CTS) is a common peripheral compression neuropathy which is often idiopathic in etiology. There is evidence that the development of CTS may result from circulatory disturbances. The purpose of this thesis was to improve our understanding of the vascular component to the development and progression of CTS. Ultrasound allowed for non-invasive investigation of median nerve intraneural blood flow and morphology, tissue stiffness, and mechanics of the flexor digitorum superficialis (FDS) tendon and its adjacent subsynovial connective tissue (SSCT). Nerve conduction study (NCS) allowed for investigation of median nerve function. Three studies were completed, two with patients and one involving healthy participants, to investigate the relationship between local blood flow and carpal tunnel tissue function, morphology, and mechanics. Nerve function, intraneural blood flow, individual FDS and SSCT displacements, and measures of shear strain (relative FDS-SSCT displacement and shear strain index (SSI)) were quantified in CTS patients (Chapter 2). These patients were followed-up six months later and the measures were repeated (Chapter 3), allowing me to determine the prognostic value of ultrasound measures. Results from these two studies suggested a high interdependency among intraneural blood flow velocity, nerve function, and FDS-SSCT relative displacement and SSI. Intraneural blood flow velocity, peak FDS-SSCT relative displacement, and SSI were also significant predictors of median nerve function at 6-months follow-up. To directly investigate the effects of circulatory disturbances, temporary partial ischemia of the carpal tunnel was induced in healthy participants through a 30-minute occlusion protocol (Chapter 4). Partial ischemia immediately decreased intraneural blood flow velocity. Nerve dysfunction, and increased SSI and relative displacement were observed soon after. This thesis clearly demonstrates the interrelationship among median nerve vascular dynamics, tendon-SSCT kinematics, and nerve function. Altered nerve blood flow may be a driver in the development of CTS. / Thesis / Doctor of Philosophy (PhD) / Carpal tunnel syndrome (CTS) is due to compression of the median nerve as it passes through the carpal tunnel which is located at the base of the palm. Nerve compression leads to nerve dysfunction, resulting in symptoms of tingling, numbness and weakness of the hand. The purpose of this thesis was to improve our understanding of the effects of altered blood flow on the development of CTS. I conducted three unique studies to investigate the relationship among nerve blood flow, nerve function, and motion of the tendons and connective tissue within the carpal tunnel. The use of ultrasound allowed for real-time, non-invasive investigation of function in these tissues. Results from these three studies clearly demonstrate the interrelationship between nerve function, tendon-connective tissue motion and adequate nerve blood flow. These findings have implications for individuals with cardiovascular conditions and for people working under conditions that may compromise normal blood flow.

Thesis (M. Med. Sc.)--University of Hong Kong, 2005.