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Selected Case Studies
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Lumbar Degenerative Disc Disease
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Low Back Pathology
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Dancer S/P Multiple Trauma
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Carpal Tunnel, Post Release
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Cervical Pathology
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Charo-Marie Tooth Disease
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Degenerative Medial Meniscus
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Femur Fracture - IM Rod
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Hip Pathology
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Knee Pathology
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Systemic Lupus Erythematosus
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Pitcher's Shoulder
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Rotator Cuff Pathology
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Shoulder Tendonitis
Functional Capacity Evaluations

CASE STUDIES - Carpal Tunnel, Post Release

History: The patient is a 32 year old male. His work as a road crew laborer involved repetitive stress on both hands and wrists. He developed a right carpal tunnel syndrome. The diagnosis was verified with EMG/NCS. 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 residual disability requiring additional compensation was raised.

Study: To evaluate and compare the right wrist and hand functional capacity to the left sides. 3D video, computerized motion analysis [Illustration I] and multi-channel dynamic surface electromyography devices were utilized.


Illustration 1
Index Finger Stick-Figure Diagrams


Electromyography Analysis revealed symmetrical and appropriate response to multiple dynamic wrist and finger flexion/extension exercises [Graph I].



Graph I
Comparative EMG of Wrist Flexors


Kinematic Analysis revealed an active range of motion (AROM) of 83.9 deg. for the right wrist, compared to 80.9 deg. for the left wrist [Graph II].


Graph II
Comparative AROM of the Wrist Joint


Analysis of wrist velocity indicated that the patient was capable of flexing and extending the wrist with a higher velocity on the injured right side [Graph III].


Graph III
Comparative Wrist Flexion/Extension Velocity


Outcome: Kinematic and EMG results verified that the patient was fully rehabilitated. His movement capability for active range of motion, velocity and acceleration of the right wrist, was equal to or greater than the left wrist. The conclusion was no increase in impairment rating.



© 2008 Kinematic Consultants, Inc.