| Summary: | 碩士 === 國立成功大學 === 醫學工程研究所碩博士班 === 97 === Carpal tunnel syndrome is caused by increased pressure on median nerve entering the hand through the confined space of the carpal tunnel at wrist. The most common symptoms are tingling, numbness, weakness, or pain felt in the radial three and one-second fingers. With long-lasting carpal tunnel syndrome (CTS), the thenar muscles can get atrophy and loss some hand strength. The purpose of this study was to investigate the coordination of applied force and the contribution ratio of twisting torque of the right digits in jar opening and closing in female patient with carpal tunnel syndrome. In addition, the difference between patients and normal subjects was analyzed.
There were two female groups, one was CTS group and another was normal group. Each group had thirty-six subjects. Right hand was divided to three parts, thumb & thenar, index finger and others three finger for analysis. Using the simulated jar apparatus (diameter 8.0 cm, equipped with three six-axis load cells and one torque cell) to measure the maximal strength of the thumb at lateral pinch, tip pinch and power grip. All subjects were recruited to measure the total twisting torque. The force amount, coordination and contribution were respectively analyzed.
CTS group was small than normal group in the items of lateral pinch, tip pinch, power grip. The maximal torque generated by CTS group was smaller than normal group in jar opening and closing. But the amount of decrease between CTS and normal group, closing jar was larger than opening jar. The angle between the point of combined force application of the three parts of hand were different between opening jar and closing jar no matter CTS or normal group. But comparing CTS and normal group, only the angle between thumb and index finger had difference no matter opening jar or closing jar. Comparing total force between opening jar and closing jar, only the three fingers part hadn’t difference no matter CTS or normal group. Dividing the total force of thumb to normal, tangential and axial force, only tangential force had difference between opening jar and closing jar. Analyzing the contribution at CTS group, thumb plays the most important role no matter opening jar or closing jar. Comparing with normal group, the contribution of normal force decreased at the three parts of CTS hand. But the contribution of tangential and axial force, only index finger had difference.
CTS patient is difficult to tighten jar than normal subject. From the analysis of the contribution of normal, tangential and axial force, it seems to prove median nerve compressed affects jar opening and closing. Thumb plays the most important role no matter opening jar or closing jar. Index finger plays the important role in finger coordination. The other three fingers part plays the steady role when opening jar or closing jar.
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