The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-Analysis
Background/Objectives: Mechanical compression of the median nerve is believed to be responsible for idiopathic carpal tunnel syndrome (CTS) due to fibrosis of the subsynovial connective tissue (SSCT). Vascular consequences have also been observed in structures of the carpal tunnel, raising speculati...
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MDPI AG
2025-03-01
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| Series: | Biomechanics |
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| Online Access: | https://www.mdpi.com/2673-7078/5/1/15 |
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| author | Andrew Y. W. Wong Aaron M. Kociolek Peter J. Keir |
| author_facet | Andrew Y. W. Wong Aaron M. Kociolek Peter J. Keir |
| author_sort | Andrew Y. W. Wong |
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| description | Background/Objectives: Mechanical compression of the median nerve is believed to be responsible for idiopathic carpal tunnel syndrome (CTS) due to fibrosis of the subsynovial connective tissue (SSCT). Vascular consequences have also been observed in structures of the carpal tunnel, raising speculation regarding the role of factors such as ischemia and edema in CTS pathology. Methods: We performed a mega-analysis from our database of over 10 years of studies. Mixed-effects models were used to address the disconnect between mechanical and vascular influences on CTS; the effects of biomechanical factors and CTS status were evaluated on carpal tunnel tissue mechanics and blood flow. Altered blood flow was also induced during tissue motion to draw inferences regarding the cyclical relationship between tissue mechanics and fluid flow changes on CTS pathology. Results: Greater movement speed and flexed wrist postures were found to contribute to greater shear strain. Flexed wrist postures and greater fingertip force were found to increase median nerve blood flow. Greater CTS severity was associated with lower median nerve blood flow. Finally, brachial blood flow restriction as a surrogate for elevated carpal tunnel pressure was found to alter tissue motion and increase carpal tunnel tissue shear strain. Conclusions: Finger movement speed, force application, wrist posture, and altered fluid flow in the carpal tunnel contribute to changes in outcomes associated with the development of CTS. The mechanistic findings from this paper should be incorporated into future research to update the damage model for CTS pathology. |
| format | Article |
| id | doaj-art-8a0b4bd61ba340c2a44382208da528a6 |
| institution | DOAJ |
| issn | 2673-7078 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomechanics |
| spelling | doaj-art-8a0b4bd61ba340c2a44382208da528a62025-08-20T02:42:45ZengMDPI AGBiomechanics2673-70782025-03-01511510.3390/biomechanics5010015The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-AnalysisAndrew Y. W. Wong0Aaron M. Kociolek1Peter J. Keir2Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, CanadaSchool of Physical and Health Education, Nipissing University, North Bay, ON P1B 8L7, CanadaOccupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, CanadaBackground/Objectives: Mechanical compression of the median nerve is believed to be responsible for idiopathic carpal tunnel syndrome (CTS) due to fibrosis of the subsynovial connective tissue (SSCT). Vascular consequences have also been observed in structures of the carpal tunnel, raising speculation regarding the role of factors such as ischemia and edema in CTS pathology. Methods: We performed a mega-analysis from our database of over 10 years of studies. Mixed-effects models were used to address the disconnect between mechanical and vascular influences on CTS; the effects of biomechanical factors and CTS status were evaluated on carpal tunnel tissue mechanics and blood flow. Altered blood flow was also induced during tissue motion to draw inferences regarding the cyclical relationship between tissue mechanics and fluid flow changes on CTS pathology. Results: Greater movement speed and flexed wrist postures were found to contribute to greater shear strain. Flexed wrist postures and greater fingertip force were found to increase median nerve blood flow. Greater CTS severity was associated with lower median nerve blood flow. Finally, brachial blood flow restriction as a surrogate for elevated carpal tunnel pressure was found to alter tissue motion and increase carpal tunnel tissue shear strain. Conclusions: Finger movement speed, force application, wrist posture, and altered fluid flow in the carpal tunnel contribute to changes in outcomes associated with the development of CTS. The mechanistic findings from this paper should be incorporated into future research to update the damage model for CTS pathology.https://www.mdpi.com/2673-7078/5/1/15carpal tunnel syndromecarpal tunnelwrist posturefinger movement speedfinger forcetissue motion |
| spellingShingle | Andrew Y. W. Wong Aaron M. Kociolek Peter J. Keir The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-Analysis Biomechanics carpal tunnel syndrome carpal tunnel wrist posture finger movement speed finger force tissue motion |
| title | The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-Analysis |
| title_full | The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-Analysis |
| title_fullStr | The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-Analysis |
| title_full_unstemmed | The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-Analysis |
| title_short | The Effects of Altered Blood Flow, Force, Wrist Posture, Finger Movement Speed, and Population on Motion and Blood Flow in the Carpal Tunnel: A Mega-Analysis |
| title_sort | effects of altered blood flow force wrist posture finger movement speed and population on motion and blood flow in the carpal tunnel a mega analysis |
| topic | carpal tunnel syndrome carpal tunnel wrist posture finger movement speed finger force tissue motion |
| url | https://www.mdpi.com/2673-7078/5/1/15 |
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