Imperial College London
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Prof Caroline Alexander

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice (Musculoskeletal Physiotherapy)
 
 
 
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Contact

 

caroline.alexander

 
 
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Location

 

Department of PhysiotherapyCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kennedy:2021:10.1186/s12891-021-04832-2,
author = {Kennedy, DL and Ridout, D and Lysakova, L and Vollert, J and Alexander, CM and Rice, ASC},
doi = {10.1186/s12891-021-04832-2},
journal = {BMC Musculoskeletal Disorders},
pages = {1--19},
title = {The association of sensory phenotype and concomitant mood, sleep and functional impairment with the outcome of carpal tunnel surgery},
url = {http://dx.doi.org/10.1186/s12891-021-04832-2},
volume = {22},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundUp to 25% of people who have had carpal tunnel release surgery (CTR) fail to report improvement; however, evidence for prognostic indicators in this surgical cohort is limited. To identify candidate prognostic factors, this study investigated the association of quantitative sensory testing (QST) derived sensory phenotype and attendant impairment with patient-reported surgical outcome.MethodsWith ethical approval and informed consent, this prospective observational longitudinal study recruited patients from two London hospitals. Multimodal phenotyping measures including quantitative sensory testing (QST), pain parameters, insomnia, pain-related worry, mood and function, were evaluated prior to; and at 3- and 6-months post-surgery. Pain in median nerve distribution with electrophysiologically confirmed conduction delay and DN4 score ≥ 4 was defined as neuropathic. Primary outcome was patient-rated change at 6 months, dichotomised as poor outcome; “worse” or “no change” and good outcome; “slightly better”, “much better” or “completely cured”.ResultsSeventy-six patients participated. Prior to surgery, substantial heterogeneity in established categories of somatosensory function was observed with 21% of participants categorised as having a healthy sensory phenotype; 29% with thermal hyperalgesia; 32% mechanical hyperalgesia and 18% sensory loss. Seventy six percent of participants were classified as having neuropathic pain, 33% with high levels of pain related worry and 64% with clinical insomnia. Observed differences in pain, sleep impairment, psychological factors and function, between sensory phenotypic groups, was not significant. At 3- and 6-months post-surgery there was significant improvement in all phenotyping measures with a moderate to large effect size. Thermal and mechanical measures of somatosensation improved (p < 0.001), as did functional ability
AU  - Kennedy,DL
AU  - Ridout,D
AU  - Lysakova,L
AU  - Vollert,J
AU  - Alexander,CM
AU  - Rice,ASC
DO  - 10.1186/s12891-021-04832-2
EP  - 19
PY  - 2021///
SN  - 1471-2474
SP  - 1
TI  - The association of sensory phenotype and concomitant mood, sleep and functional impairment with the outcome of carpal tunnel surgery
T2  - BMC Musculoskeletal Disorders
UR  - http://dx.doi.org/10.1186/s12891-021-04832-2
UR  - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04832-2
UR  - http://hdl.handle.net/10044/1/92773
VL  - 22
ER  -
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