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KMID : 0860920050070020079
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2005 Volume.7 No. 2 p.79 ~ p.89
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Comparison of Various Clinical Scales with Electrophysiological Scales for Carpal Tunnel Syndrome
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Jung Se-Hee
Paik Nam-Jong
Bang Moon-Suk
Han Tai-Ryoon
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Abstract
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Objectives: To evaluate various carpal tunnel syndrome (CTS) clinical scales through a comparison with
electrophysiological severity scales and to select the most reliable clinical scale.
Methods: One hundred eighty hands (mean age 56.43 years) with suggestive symptoms and signs of CTS
were prospectively assessed by three clinical scales and three electrophysiological scales. The clinical
scales adopted were the Boston carpal tunnel syndrome questionnaire (BCTQ), quantitative clinical scale
by Simovic (Simovic clinical scale) and Historical-Objective (Hi-Ob) scale. The scales for electrophysiological
assessment were the Bland classification, Padua scale and Mondelli scale.
Results: All the clinical scales showed highly significant, positive correlation with the electrophysiological
scales (p<0.001). The physician-measured clinical scales showed higher correlation coefficients with
the electrophysiological assessment than the patient-oriented one. Among the electrophysiological scales,
the Bland and Padua scales showed very similar distribution patterns, but the Mondelli scale, especially
the motor subscale, showed left-skewed distribution of data leading to the misdiagnosis of CTS patients
as normal.
Conclusion: The BCTQ, Hi-Ob and Simovic clinical scale are all reliable but the physician-measured
scales showed stronger correlation with the electrophysiological scales. Knowledge of the characteristics
of the scales and the precise cut-offs are important in the electrophysiological assessments.
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KEYWORD
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Carpal Tunnel Syndrome, Clinical Scales, Electrophysiological Scales, Nerve conduction studies
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