Factores de riesgo del síndrome de túnel del carpo en usuarios de sillas de ruedas
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Introducción: El síndrome de túnel de carpo es una neuropatía del nervio mediano muy frecuente en la población. Para los usuarios de sillas de ruedas hay mayor riesgo biomecánico por utilizar reiteradamente la muñeca en la propulsión de este vehículo.
Objetivo: Analizar los factores biomecánicos de la silla de ruedas que inciden en el desarrollo del síndrome de túnel del carpo.
Métodos: Se realizó una revisión sistemática con términos Mesh en bases de datos como Embase, Pubmed, Google Acedemics, Scielo desde 1988 hasta 2021. Se revisaron más de 200 artículos y por su impacto clínico, se seleccionaron 52 para la revisión.
Resultados: El 43 % de los usuarios de silla de ruedas presentan dolor en la muñeca y prevalece como diagnóstico el síndrome de túnel del carpo. La posición de la muñeca en la propulsión genera un aumento de presión en el túnel carpiano lo que condiciona la lesión del nervio mediano. Existen factores de riesgo como el género femenino, las pendientes, el terreno irregular, la vibración, la altura del asiento y el peso del paciente. Entender correctamente las fases de la autopropulsión con sus cuatro patrones, más una prescripción adecuada y los aditamentos necesarios para la silla de ruedas pueden disminuir el riesgo de padecer el síndrome de túnel del carpo.
Conclusión: Es importante involucrar de manera activa a los profesionales de la salud en la implementación de estrategias para el entrenamiento, prescripción y uso correcto de la silla de ruedas y con ello prevenir el padecimiento de el síndrome de túnel carpiano.
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Referencias
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-84. DOI: https://doi.org/10.1016/S1474-4422(16)30231-9
Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153-8. DOI: https://doi.org/10.1001/jama.282.2.153
Mondelli M, Giannini F, Giacchi M. Carpal tunnel syndrome incidence in a general population. Neurology. 2002;58(2):289-94. DOI: https://doi.org/10.1212/wnl.58.2.289
Lee H-J, Lim HS, Kim HS. Validation of known risk factors associated with carpal tunnel syndrome: a retrospective nationwide 11-year population-based cohort study in South Korea. BioRxiv. 2018. DOI: https://doi.org/10.1101/253666
Koytcheva V, Zhekov A, Lazarou G, Riza E. Musculoskeletal disorders BT - promoting health for working women. En: Linos A, Kirch W, editors., New York, NY: Springer New York; 2008. 137-60. DOI: https://doi.org/10.1007/978-0-387-73038-7_5
Sie IH, Waters RL, Adkins RH, Gellman H. Upper extremity pain in the postrehabilitation spinal cord injured patient. Arch Phys Med Rehabil. 1992 [acceso 01/11/2020];73:44-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/1729973/
Middleton JW, Dayton A, Walsh J, Rutkowski SB, Leong G, Duong S. Life expectancy after spinal cord injury: a 50-year study. Spinal Cord. 2012;50:803-11. DOI: https://doi.org/10.1038/sc.2012.55
Kentar Y, Zastrow R, Bradley H, Brunner M, Pepke W, Bruckner T, et al. Prevalence of upper extremity pain in a population of people with paraplegia. Spinal Cord. 2018;56:695-703. DOI: https://doi.org/10.1038/s41393-018-0062-6
Aljure J, Eltorai I, Bradley WE, Lin JE, Johnson B. Carpal tunnel syndrome in paraplegic patients. Paraplegia. 1985;23:182-6. DOI: https://doi.org/10.1038/sc.1985.31
Akbar M, Penzkofer S, Weber MA, Bruckner T, Winterstein M, Jung M. Prevalence of carpal tunnel syndrome and wrist osteoarthritis in long-term paraplegic patients compared with controls. J Hand Surg Eur. 2014;39(2):132-8. DOI: https://doi.org/10.1177/1753193413478550
Asheghan M, Hollisaz MT, Taheri T, Kazemi H, Aghda AK. The prevalence of carpal tunnel syndrome among long-term manual wheelchair users with spinal cord injury: A cross-sectional study. J Spinal Cord Med. 2016;39(3):265-71. DOI: https://doi.org/10.1179/2045772315Y.0000000033
MacDermid JC, Doherty T. Clinical and electrodiagnostic testing of carpal tunnel syndrome: a narrative review. J Orthop Sports Phys Ther. 2004;34(10):565-88. DOI: https://doi.org/10.2519/jospt.2004.34.10.565
Millesi H, Zöch G, Rath T. Interés clínico del plano de deslizamiento de los nervios periféricos. Ann Chir La Main Du Memb Super. 1990;9(2):87-97. DOI: https://doi.org/10.1016/s0753-9053(05)80485-5
Lundborg G. Intraneural microcirculation. Orthop Clin North Am. 1988 [acceso 01/11/2020];19(1):1-12. Disponible en: https://pubmed.ncbi.nlm.nih.gov/3275919/ 15.Goodman CM, Steadman AK, Meade RA, Bodenheimer C, Thornby J, Netscher DT. Comparison of carpal canal pressure in paraplegic and nonparaplegic subjects: clinical implications. Plast Reconstr Surg. 2001;107(6):1464-71. DOI: https://doi.org/10.1097/00006534-200105000-00024
Impink BG, Boninger ML, Walker H, Collinger JL, Niyonkuru C. Ultrasonographic median nerve changes after a wheelchair sporting event. Arch Phys Med Rehabil. 2009;90(9):1489-94. DOI: https://doi.org/10.1016/j.apmr.2009.02.019
Keir PJ, Bach JM, Hudes M, Rempel DM. Guidelines for wrist posture based on carpal tunnel pressure thresholds. Hum Factors. 2007;49(1):88-99. DOI: https://doi.org/10.1518/001872007779598127
Hatchett PE, Requejo PS, Mulroy SJ, Haubert LL, Eberly VJ, Conners SG. Impact of Gender on Shoulder Torque and Manual Wheelchair Usage for Individuals with Paraplegia: A Preliminary Report. Top Spinal Cord Inj Rehabil. 2009;15(2):79-89. DOI: https://doi.org/10.1310/sci1502-79
Veeger HE, Meershoek LS, van der Woude LH, Langenhoff JM. Wrist motion in handrim wheelchair propulsion. J Rehabil Res Dev. 1998 [acceso 01/11/2020];35(3):305-13. Disponible en: https://europepmc.org/article/med/9704314
Sabick MB, Kotajarvi BR, An K-N. A new method to quantify demand on the upper extremity during manual wheelchair propulsion. Arch Phys Med Rehabil. 2004;85(7):1151-9. DOI: https://doi.org/10.1016/j.apmr.2003.10.024
VanSickle DP, Cooper RA, Boninger ML, DiGiovine CP. Analysis of vibrations induced during wheelchair propulsion. J Rehabil Res Dev. 2001 [acceso 01/11/2020];38:409-21. Disponible en: https://www.semanticscholar.org/paper/Analysis-of-vibrations-induced-during-wheelchair-Vansickle-Cooper/f5ce5aef7702f005747afbe6816333b819e56b4e
Collinger JL, Boninger ML, Koontz AM, Price R, Sisto SA, Tolerico ML, et al. Shoulder biomechanics during the push phase of wheelchair propulsion: a multisite study of persons with paraplegia. Arch Phys Med Rehabil. 2008;89(4):667-76. DOI: https://doi.org/10.1016/j.apmr.2007.09.052
Van Drongelen S, Van der Woude LH, Janssen TW, Angenot EL, Chadwick EK, Veeger DH. Mechanical load on the upper extremity during wheelchair activities. Arch Phys Med Rehabil. 2005;86(6):1214-20. DOI: https://doi.org/10.1016/j.apmr.2004.09.023
Kotajarvi BR, Sabick MB, An K-N, Zhao KD, Kaufman KR, Basford JR. The effect of seat position on wheelchair propulsion biomechanics. J Rehabil Res Dev. 2004;41(3B):403-14. DOI: https://doi.org/10.1682/jrrd.2003.01.0008
Boninger ML, Cooper RA, Baldwin MA, Shimada SD, Koontz A. Wheelchair pushrim kinetics: body weight and median nerve function. Arch Phys Med Rehabil. 1999;80(8):910-5. DOI: https://doi.org/10.1016/s0003-9993(99)90082-5
Cowan RE, Nash MS, Collinger JL, Koontz AM, Boninger ML. Impact of surface type, wheelchair weight, and axle position on wheelchair propulsion by novice older adults. Arch Phys Med Rehabil. 2009;90(7):1076-83. DOI: https://doi.org/10.1016/j.apmr.2008.10.034
Lin Y-N, Chiu C-C, Huang S-W, Hsu W-Y, Liou T-H, Chen Y-W, et al. Association between manual loading and newly developed carpal tunnel syndrome in subjects with physical disabilities: a follow-up study. Arch Phys Med Rehabil. 2017;98(10):2002-8. DOI: https://doi.org/10.1016/j.apmr.2017.02.008
Shimada SD, Robertson RN, Bonninger ML, Cooper RA. Kinematic characterization of wheelchair propulsion. J Rehabil Res Dev. 1998 [acceso 01/11/2020];35(2):210-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/9651893/
Sullivan KJ, Kantak SS, Burtner PA. Motor learning in children: feedback effects on skill acquisition. Phys Ther. 2008;88(6):720-32. DOI: https://doi.org/10.2522/ptj.20070196
Medola FO, Carril VM, da Silva C, Fortulan CA. Aspects of manual wheelchair configuration affecting mobility: a review. J Phys Ther Sci. 2014;26(2):313-8. DOI: https://doi.org/10.1589/jpts.26.313
Brubaker CE. Wheelchair prescription : an analysis of factors that affect mobility and performance. J of Reh Research and D. 1986 [acceso 01/11/2020];23:19-26. Disponible en: https://www.scirp.org/%28S%28lz5mqp453edsnp55rrgjct55%29%29/reference/referencespapers.aspx?referenceid=1763236
Subbarao JV, Klopfstein J, Turpin R. Prevalence and impact of wrist and shoulder pain in patients with spinal cord injury. J Spinal Cord Med. 1995;18(1):9-13. DOI: https://doi.org/10.1080/10790268.1995.11719374
Ebrahimi A, Kazemi A, Ebrahimi A. Review paper: wheelchair design and its influence on physical activity and quality of life among disabled individuals. Iran Rehabil J. 2016;14(2):85-92. DOI: https://doi.org/10.18869/nrip.irj.14.2.85
Cherubini M, Melchiorri G. Descriptive study about congruence in wheelchair prescription. Eur J Phys Rehabil Med. 2012 [acceso 01/11/2020];48(2):217-22. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21654593/
Giner-Pascual M, Alcanyis-Alberola M, Millan L, Aguilar-Rodríguez M, Querol F. Shoulder pain in cases of spinal injury : influence of the position of the wheelchair seat. Int J of Reh Res. 2011;34(4):282-9. DOI: https://doi.org/10.1097/MRR.0b013e32834a8fd9
Desroches G, Aissaoui R, Bourbonnais D. Effect of system tilt and seat-to-backrest angles on load sustained by shoulder during wheelchair propulsion. J Rehabil Res Dev. 2006;43(7):871-82. DOI: https://doi.org/10.1682/jrrd.2005.12.0178
Boninger ML, Koontz AM, Sisto SA, Trevor A, Chang M, Price R, et al. Pushrim biomechanics and injury prevention in spinal cord injury: Recommendations based on CULP-SCI investigations. 2005;42(3 supl1):9-19. DOI: https://doi.org/10.1682/jrrd.2004.08.0103
Woude LHV Van Der, Veeger D, Rozendal PRN. Seat height in handrim wheelchair propulsion. J Rehabil Res Dev. 1989 [acceso 01/11/2020];26(4):31-50. Disponible en: https://pubmed.ncbi.nlm.nih.gov/2600867/
Boninger ML, Baldwin M, Cooper RA, Koontz A, Chan L. Manual wheelchair pushrim biomechanics and axle position. Arch Phys Med and Reh. 2000;81(5):608-13 DOI: https://doi.org/10.1016/S0003-9993(00)90043-1
van der Woude LH, Bouw A, van Wegen J, van As H, Veeger D, de Groot S. Seat height: effects on submaximal hand rim wheelchair performance during spinal cord injury rehabilitation. J Rehabil Med. 2009;41(3):143-9. DOI: https://doi.org/10.2340/16501977-0296
Perdios A, Sawatzky BJ, Sheel AW. Effects of camber on wheeling efficiency in the experienced and inexperienced wheelchair user. J Rehabil Res Dev. 2007;44(3):459-66. DOI: https://doi.org/10.1682/jrrd.2006.08.0097
Liu H, Pearlman J, Cooper R, Hong E, Wang H, Salatin B, et al. Evaluation of aluminum ultralight rigid wheelchairs versus other ultralight wheelchairs using ANSI/RESNA standards. J Rehabil Res Dev. 2010;47(5):441-55. DOI: https://doi.org/10.1682/jrrd.2009.08.0137
Chénier F, Aissaoui R. Effect of wheelchair frame material on users’ mechanical work and transmitted vibration. Biomed Res Int. 2014;2014:609369. DOI: https://doi.org/10.1155/2014/609369.
Hughes B, Sawatzky BJ, Hol AT. A comparison of spinergy versus standard steel-spoke wheelchair wheels. Arch Phys Med Rehabil. 2005;86(3):596-601. DOI: https://doi.org/10.1016/j.apmr.2004.10.006
Gordon J, Kaualarich JJ, Thacker JG. Tests of two new polyurethane foam wheelchair tires. J Rehabil Res Dev. 1989 [acceso 01/11/2020];26(1):33-46. Disponible en: https://pubmed.ncbi.nlm.nih.gov/2918486/
Cooper RA, Wolf E, Fitzgerald SG, Boninger ML, Ulerich R, Ammer WA. Seat and footrest shocks and vibrations in manual wheelchairs with and without suspension. Arch Phys Med Rehabil. 2003;84(1):96-102. DOI: https://doi.org/10.1053/apmr.2003.50069
van der Woude LH, Formanoy M, de Groot S. Hand rim configuration: effects on physical strain and technique in unimpaired subjects? Med Eng Phys. 2003;25(9):765-74. DOI: https://doi.org/10.1016/s1350-4533(03)00102-4
van der Linden ML, Valent L, Veeger HE, van der Woude LH. The effect of wheelchair handrim tube diameter on propulsion efficiency and force application (tube diameter and efficiency in wheelchairs). IEEE Trans Rehabil Eng. 1996;4(3):123-32. DOI: https://doi.org/10.1109/86.536767
Dieruf K, Ewer L, Boninger D. The natural-fit handrim : factors related to improvement in symptoms and function in wheelchair. J Spinal Cord Med. 2008;31(5):578-85. DOI: https://doi.org/10.1080/10790268.2008.11754605
Richter WM, Rodriguez R, Woods KR, Karpinski AP, Axelson PW. Reduced finger and wrist flexor activity during propulsion with a new flexible handrim. Arch Phys Med Rehabil. 2006;87(12):1643-7. DOI: https://doi.org/10.1016/j.apmr.2006.09.009
Medola FO, Fortulan CA, de Moraes B, Carril VM. A new design for an old concept of wheelchair pushrim. Disabil Rehabil Assist Technol. 2012;7(3):234-41. DOI: https://doi.org/10.3109/17483107.2011.629327
Zukowski LA, Roper JA, Shechtman O, Otzel DM, Hovis PW, Tillman MD. Wheelchair ergonomic hand drive mechanism use improves wrist mechanics associated with carpal tunnel syndrome. J Rehabil Res Dev. 2014;51(10):1515-24. DOI: https://doi.org/10.1682/JRRD.2013.09.0211
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