Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers.
- Author:
Doohee YOU
1
;
Allan H SMITH
;
David REMPEL
Author Information
1. Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA. doohee.y@berkeley.edu
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
carpal tunnel syndrome;
meta-analysis;
systematic review
- MeSH:
Carpal Tunnel Syndrome*;
Case-Control Studies;
Hand;
Hand Strength;
Peripheral Nervous System Diseases;
Posture*;
Risk Factors;
Wrist*
- From:Safety and Health at Work
2014;5(1):27-31
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Carpal tunnel syndrome (CTS) is a common work-related peripheral neuropathy. In addition to grip force and repetitive hand exertions, wrist posture (hyperextension and hyperflexion) may be a risk factor for CTS among workers. However, findings of studies evaluating the relationship between wrist posture and CTS are inconsistent. The purpose of this paper was to conduct a meta-analysis of existing studies to evaluate the evidence of the relationship between wrist posture at work and risk of CTS. METHODS: PubMed and Google Scholar were searched to identify relevant studies published between 1980 and 2012. The following search terms were used: "work related", "carpal tunnel syndrome", "wrist posture", and "epidemiology". The studies defined wrist posture as the deviation of the wrist in extension or flexion from a neutral wrist posture. Relative risk (RR) of individual studies for postural risk was pooled to evaluate the overall risk of wrist posture on CTS. RESULTS: Nine studies met the inclusion criteria. All were cross-sectional or case-control designs and relied on self-report or observer's estimates for wrist posture assessment. The pooled RR of work-related CTS increased with increasing hours of exposure to wrist deviation or extension/flexion [RR = 2.01; 95% confidence interval (CI): 1.646-2.43; p < 0.01: Shore-adjusted 95% CI: 1.32-2.97]. CONCLUSION: We found evidence that prolonged exposure to non-neutral wrist postures is associated with a twofold increased risk for CTS compared with low hours of exposure to non-neutral wrist postures. Workplace interventions to prevent CTS should incorporate training and engineering interventions that reduce sustained non-neutral wrist postures.
