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      Aspectos clínicos y rehabilitadores en pacientes con síndrome del túnel carpiano tratados con láser Translated title: Clinical and rehabilitation aspects in patients with carpal tunnel syndrome treated with laser

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          Abstract

          Se realizó una intervención terapéutica en 21 pacientes con síndrome del túnel carpiano, atendidos en los servicios de rehabilitación integral de los policlínicos "30 de Noviembre" y "Josué País García" de Santiago de Cuba, desde junio de 2009 hasta igual mes de 2010, con vistas a describir aspectos clínicos de interés y la respuesta al tratamiento con láser blando semiconductor a 6 J/cm². Las principales variables analizadas fueron: edad, sexo, demanda funcional, mano afectada, síntomas y signos e intensidad del dolor. Se aplicó la prueba de Ji al cuadrado (p<0,05) y se utilizó el porcentaje como medida de resumen. En la serie predominaron el sexo femenino y el grupo etario de 50-59 años. Luego de la terapia aplicada disminuyó el dolor y se logró la analgesia en 66,7 % de los afectados; asimismo, la mejoría se obtuvo principalmente entre las 16 y 20 sesiones. Se concluyó que la fisioterapia es capaz de modificar evolutivamente parámetros clínicos en quienes presentan esta afección.

          Translated abstract

          A therapeutical intervention in 21 patients with carpal tunnel syndrome, assisted in the services of comprehensive rehabilitation of the polyclinics "30 de Noviembre" and "José País García" in Santiago de Cuba was carried out from June, 2009 to the same month of 2010, aimed at describing clinical aspects of interest and the response to the treatment with semiconductor soft laser at 6 J/cm2. The main variables were analyzed: age, sex, functional demands, affected hand, symptoms and signs and intensity of pain. The chi-square test was applied (p <0.05) and the percentage was used as summary measure. In the series the female sex and the age group 50-59 years prevailed. After the applied therapy, the pain decreased and the analgesia was achieved in 66.7% of those affected; likewise, the improvement was mainly obtained between the 16 and 20 sessions. It was concluded that the physiotherapy can progressively modify clinical parameters in those who present this disorder.

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          When exactly can carpal tunnel syndrome be considered work-related?

          Carpal tunnel syndrome (CTS), compression of the median nerve at the wrist, is the most frequently encountered peripheral entrapment neuropathy. Whilst rates of all other work-related conditions have declined, the number of work-related musculoskeletal disorders (which include CTS) has not changed for the past 9 years in the USA. Median days off work are also highest for CTS: 27 compared to 20 for fractures and 18 for amputations. This results in enormous Workers Compensation and other costs to the community. Awareness of CTS as a disorder associated with repeated trauma at work is now so widespread amongst workers that many have diagnosed themselves before being medically assessed, often by means of the Internet. Surprisingly, however, a definite causal relationship has not yet been established for most occupations. Although the quality of research in this area is generally poor, CTS research studies are being used as the basis for acceptance of Workers Compensation claims, substantial expensive ergonomic workplace change and even workplace closures. The fact that the incidence of work-related musculoskeletal disorders has not changed despite these latter measures would suggest that a causal relationship is not proven and that some resources are being misdirected in CTS prevention and treatment. A literature review of 64 articles on CTS was conducted. This included those articles most frequently cited as demonstrating the relationship between CTS and work. Primary risk factors in the development of CTS are: being a woman of menopausal age, obesity or lack of fitness, diabetes or having a family history of diabetes, osteoarthritis of the carpometacarpal joint of the thumb, smoking, and lifetime alcohol intake. In most cases, work acts as the 'last straw' in CTS causation. Except in the case of work that involves very cold temperatures (possibly in conjunction with load and repetition) such as butchery, work is less likely than demographic and disease-related variables to cause CTS. To label other types of work as having caused CTS, therefore, would result in inappropriate allocation of resources. It would also relieve individuals of the responsibility of addressing correctable lifestyle factors and treatable illnesses such as obesity, diabetes, smoking and increased alcohol intake which may have contributed to their CTS more that their work. This results in both avoidable long-term health effects and ongoing costs to the community.
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            Síntomas Músculo Esqueléticos en trabajadores de una empresa de construcción Civil

            Con el propósito de determinar la prevalencia de síntomas músculo esqueléticos y su relación con las características sociodemográficas y ocupacionales en trabajadores de una empresa de construcción civil, se llevó a cabo un estudio descriptivo, transversal en 89 trabajadores masculinos. A cada trabajador se le realizó una historia laboral y fue aplicado el Cuestionario Nórdico Estandarizado. El 67,4% de los participantes reportó síntomas musculoesqueléticos, la mayor prevalencia de síntomas se observó en el grupo de 36 a 40 años, siendo más afectados los ayudantes de albañil (23,3%) y obreros (13,33%). La prevalencia más elevada de síntomas fue reportada para la espalda baja (50,6%), seguida por los hombros (13,25%). No se encontró relación significativa entre las variables edad (X2 = 7,19) e IMC (X2 = 0,33) con la presencia de síntomas. Existe una elevada prevalencia de síntomas musculoesqueléticos en los trabajadores de la empresa estudiada lo que orienta hacia la necesidad de realizar la evaluación ergonómica de los puestos de trabajo y desarrollar estrategias de reducción y prevención de riesgos a fin de minimizar el desarrollo de lesiones musculoesqueléticas incapacitantes en este grupo de trabajadores, así como, ampliar el estudio a los fines de conocer la problemática en esta actividad económica.
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              Practice parameter for carpal tunnel syndrome

              (1993)
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                san
                MEDISAN
                MEDISAN
                Centro Provincial de Ciencias Médicas, Santiago de Cuba (Santiago de Cuba )
                1029-3019
                December 2012
                : 16
                : 12
                : 1883-1890
                Affiliations
                [1 ] Policlínico Docente Josué País García Cuba
                [2 ] Hospital General Dr. Juan Bruno Zayas Alfonso Cuba
                [3 ] Policlínico Docente Julián Grimau García Cuba
                Article
                S1029-30192012001200010
                0f693ab5-d277-4e62-9061-a73418305224

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=1029-3019&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL

                Internal medicine
                carpal tunnel syndrome,rehabilitation,laser,therapeutic intervention,primary health care,síndrome del túnel carpiano,rehabilitación,láser,intervención terapéutica,atención primaria de salud

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