Application Of Pinch And Grip Strength In The Diagnosis And Postoperative Evaluation Of Carpal Tunnel Syndrome

Objective:To study the measured values of pinch and grip strength of the patients with carpal tunnel syndrome and healthy volunteers,and to explore the application of hand pinch and grip strength in the diagnosis and postoperative evaluation of carpal tunnel syndrome.Method:16 patients with carpal tunnel syndrome admitted to the Hand and Foot Surgery Department of China Japan Friendship Hospital of Jilin University from December 2021 to September 2022 were selected as the experimental group.According to their results of electromyography,the experimental group was divided into the mild-moderate group and the severe group.According to preoperative or postoperative time,the above groups were further divided into the mild-moderate preoperative group,the severe preoperative group,the mild-moderate postoperative group and the severe postoperative group.A total of 15 healthy volunteers matching gender and age were selected as the control group.All subjects took the same position during the measurement,applied their maximum strengths according to the passwords said by the same inspector,and held their maximum strengths for 2-5 seconds.The measured values were measured five times on each item,with 30 seconds between each measurement.Grip strength,tip pinch strength,lateral pinch strength and palmar pinch strength were recorded in healthy volunteers and twice for the patients with carpal tunnel syndrome,before and 3 to 12 months after surgery.General and clinical information was also collected for all subjects.Results:1.Hand grip strength,tip pinch strength,lateral pinch strength and palmar pinch strength of the mild-moderate preoperative group were14.71±6.706 kg,5.58±2.348 kg,12.54±4.537 kg and 10.08±3.758 kg,respectively.The above measurements of the severe preoperative group were 13.26±4.501 kg,3.38±1.339 kg,8.79±1.694 kg and 7.87±1.965 kg,respectively.The above measurements of the control group were23.41±7.148 kg,9.02±3.593 kg,15.93±4.218 kg and 12.67±3.747 kg,respectively.Grip strength,tip pinch strength,lateral pinch strength and palmar pinch strength of the mild-moderate preoperative group and the severe preoperative group were lower than those of the control group,with statistically significant significance(P<0.05).There were significant differences in grip strength and tip pinch strength between the mild-moderate preoperative group and the control group(P<0.05).And there was no statistical significance in lateral pinch strength and palmar pinch strength between the mild-moderate preoperative group and the control group(P > 0.05).There were significant differences in grip strength,tip pinch strength,lateral pinch strength and palmar pinch strength between the severe preoperative group and the control group(P<0.05).Grip strength,tip pinch strength,lateral pinch strength and palmar pinch strength in the severe preoperative group were lower than those in the mild-moderate preoperative group,with no significant difference(P > 0.05).2.Hand grip strength,tip pinch strength,lateral pinch strength and palmar pinch strength of the mild-moderate postoperative group were22.4±3.6kg,7.75±1.707 kg,15.88±2.883 kg and 12.79±3.054 kg,respectively.The above measurements of the severe preoperative group were 17.99±4.88 kg,5.28±1.097 kg,11.07±2.9kg and 9.47±1.725 kg,respectively.In the experimental group,grip strength,tip pinch strength,lateral pinch strength and palmar pinch strength between the preoperative group and the postoperative group were statistically significant(P<0.05).3.There were significant differences in tip pinch strength and lateral pinch strength between the mild-moderate postoperative group,the severe postoperative group and the control group(P<0.05).Tip pinch strength and lateral pinch strength in the severe postoperative group were lower than those in the control group,and the difference was statistically significant(P< 0.05).Grip strength and palmar pinch strength were lower than those in the control group,the difference was not significant,and there was no statistical significance(P>0.05).With the exception of palmar pinch strength,grip strength,tip pinch strength and lateral pinch strength of the mild-moderate postoperative group were lower than those of the control group,and there was no significant difference between the above two groups(P<0.05).Lateral pinch strength of the mild-moderate postoperative group was statistically significant compared with that of the severe postoperative group(P<0.05).Conclusion:1.For patients with carpal tunnel syndrome,hand grip and pinch strength are weakened due to the compression of median nerve.When the function of median nerve recovers after surgery,pinch and grip strength in the mild-moderate patients with carpal tunnel syndrome return to normal values,while pinch and grip strength in severe patients with carpal tunnel syndrome are significantly higher compared with their preoperative values,but still lower than the normal values of healthy volunteers.2.The measurement of hand grip and pinch strength is a non-invasive,economical and reproducible examination method,which can provide objective measurement values and have crucial clinical meanings for the diagnosis and postoperative evaluation of carpal tunnel syndrome.