The impact of symptoms, proprioception, and electrodiagnostic findings on activity and participation in idiopathic carpal tunnel syndrome: an ICF framework approach.

Background: The role of carpal tunnel syndrome (CTS) in activity and participation is critical for improving rehabilitation outcomes, but there is a gap in the literature on this subject. This study presents an innovative application of Structural Equation Modelling (SEM) within the framework of the International Classification of Functioning, Disability and Health (ICF) for CTS patients.

Purpose: The aim of this study was to examine the effects of symptoms, proprioception, electrodiagnostic findings, and activity/participation in idiopathic CTS.

Methods: This cross-sectional study included 81 patients with mild to moderate idiopathic CTS. For the assessment of body structure/function, symptoms were measured by Visual Analogue Scale, Leeds Assessment of Neuropathic Symptoms and Signs, and Boston Carpal Tunnel Questionnaire - Symptom Severity Scale; proprioception by the force reproduction tests; and electrodiagnostic findings. Activity/participation were assessed using the Boston Carpal Tunnel Questionnaire - Functional Status Scale and the Quick Disability of the Arm, Shoulder, and Hand. SEM was used to examine the effect of body structure/function on activity/participation.

Results: This study revealed that symptoms (standardized coefficient = 0.858, p < .001) and proprioception (0.207, p = .032) had a significant effect on activity/participation. Conversely, the model results indicated no significant effect of sensory nerve conduction findings (-0.031, p = .673) and motor nerve conduction findings (0.195, p = .170) on activity/participation.

Conclusion: Relying solely on electrodiagnostic findings may contribute to the underestimation or misinterpretation of activity/participation limitations in patients with CTS. The findings of this study suggest that reducing symptoms may enhance activity/participation. Incorporating proprioception into the management of CTS patients may offer promising benefits.