Kinematic Consultants of New Jersey

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Carpal Tunnel - Post Release
History

The patient is was 32 year old male. His work as a road crew laborer involved repetitive stress on both hands and wrists. The patient developed carpal tunnel syndrome of the right wrist. The diagnosis was verified with EMG and NCV. Surgical release was performed 16 months prior to this analysis. The patient was back to work without restriction. He claimed to have continued disability from the carpal tunnel and the subsequent surgery. The question of current functional disability was addressed with kinematic, functional EMG, and work capacity analysis.

Test Protocol

A test was designed to analyze the kinematics, and functional electromyography of the patient's right vs. left wrist and finger capability. Video computerized motion analysis and multi-channel dynamic electromyography procedures were implemented to gather the necessary data.

Illustration 1
Right vs. Left Index Finger Kinematic Analysis

Functional Motion Analysis Results

EMG analysis [see Graph 1] revealed symmetrical and appropriate EMG response to multiple dynamic wrist and finger flexion/extension exercises.

Graph I
EMG Left vs. Right Wrist Flexor Group

Kinematic analysis revealed the patient to have an active range of motion of 83.9 deg. for the right wrist, compared to 80.9 deg. for the left wrist. [see Graph 2]

Graph 2
Right Wrist vs. Left Wrist AROM Kinematics

Analysis of wrist and finger velocity and acceleration, indicated the patient was capable of flexing and extending the wrist and fingers with a higher velocity for the right wrist and hand than the left. [see Graph 3]

Graph 3
Left vs. Right Wrist Flexion/Extension

Outcome

Kinematic and EMG results verified the patient is fully rehabilitated. His movement capability for active range of motion, velocity and acceleration of the right wrist and fingers, is equal to or greater than the left wrist and fingers. The conclusion was a current rating of 0% disability.

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