Associations Between Body Anthropometric Measures and Severity of Carpal Tunnel. Syndrome

作者：Mondelli Mauro; Curti Stefania; Mattioli Stefano; Aretini Alessandro; Ginanneschi Federica; Greco Giuseppe; Farioli Andrea

来源：Archives of Physical Medicine and Rehabilitation, 2016, 97(9): 1456-1464.

DOI：10.1016/j.apmr.2016.03.028

• Carpal tunnel syndrome
• Obesity
• Rehabilitation
• Risk factors

Objective: To assess the associations between carpal tunnel syndrome (CTS) severity and selected anthropometric and obesity indexes.
Design: We performed a case-control study. Clinical and electrophysiological severity of CTS was classified as mild, moderate, or severe based on validated scales. Body and hand anthropometric characteristics were measured at the time of the electrodiagnostic study. We estimated the relative risk ratios (RRRs) of CTS severity by fitting multinomial logistic regression models adjusted by age and sex. In addition, we fitted multivariable models, including age, sex, wrist ratio, hand ratio, body mass index (BMI), and waist/stature ratio.
Setting: Electromyography laboratories.
Participants: Consecutive patients (N=1087), those with CTS (n=340) and those without CTS (n=747), were enrolled.
Interventions: Not applicable.
Main Outcome Measures: Associations between CTS severity and selected anthropometric and obesity indexes.
Results: We observed associations between many anthropometric indexes and CTS severity. Among obesity indexes, the waist/stature ratio, and among hand anthropometric indexes, the wrist/palm ratio, showed the highest RRRs for the clinical and electrophysiological severity scales. The RRRs of severe CTS (adjusted for age and sex) for the wrist/palm ratio were 3.5 for the clinical scale and 2.4 for the electrophysiological scale. The RRRs of severe CTS for the waist/stature ratio were 2.3 for the clinical scale and 2.0 for the electrophysiological scale. In the multivariable models, both BMI and the waist/stature ratio were associated with the outcomes.
Conclusions: Different configurations of the body and, in particular, the hand and wrist system may influence the occurrence and severity of CTS. Multiple obesity indexes, possibly including the waist/stature ratio, should be considered when investigating the association between body composition and CTS. Future studies should determine whether in obese subjects with CTS the weight and waist circumference loss produces an improvement in CTS symptoms and recovery of distal conduction velocity of the median nerve.

• 出版日期2016-9