The aim of this prospective study was to test the reproducibility between two observers before surgery and the sensitivity to modifications (responsiveness) 6 months after surgery of a clinical severity scale. The test was applied to a consecutive series of hands with carpal tunnel syndrome (CTS), referred for surgical decompression. The scale includes medical history, symptoms reported by patients and any sensory and/or motor deficit demonstrable by objective examination. It is therefore an objective-anamnestic clinical severity scale. Associations between the scale and age, duration of symptoms, self-administered questionnaire of symptoms and hand function (Italian version of "Boston Questionnaire" BQ), and severity of electrophysiological findings were also evaluated. The series included 254 hands with idiopathic CTS, consecutively undergoing surgical decompression by the mini-incision at palm technique. The hands belonged to 219 subjects (177 women and 42 men) with a mean age of 55.6 years (range 20-90 years). Percentage agreement between the two observers in assigning severity to the same class was 78% and Cohen coefficient k was 0.69. The scale was found to be sensitive in demonstrating clinical improvements after decompression. Direct correlations were also found between the scale and patient age, duration of symptoms, BQ scores and the neurophysiological severity scale. The significance of these associations was maintained between post-surgical severity scale, BQ score and neurophysiological scale 6 months after the operation. In conclusion, the scale is simple, reproducible and sensitive for evaluating severity of CTS in patients undergoing surgery.
|Translated title of the contribution||Sensibility of a clinical severity scale in surgically treated patients with carpal tunnel syndrome|
|Number of pages||10|
|Journal||Rivista di Neurobiologia|
|Publication status||Published - 2001|
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