Measurement of Muscle Strength Using a Manual Muscle Tester in Women With Electrophysiologically Confirmed Carpal Tunnel Syndrome

September 28, 2026 updated by: Bezmialem Vakif University

The aim of this cross-sectional study is to evaluate muscle strength in female patients with carpal tunnel syndrome (CTS) who have only sensory involvement detected on electromyography. Muscle strength will be assessed using the "Lafayette Manual Muscle Tester®".

The main questions of the study are:

  1. Is there a difference in muscle strength between healthy individuals and female patients with carpal tunnel syndrome?
  2. Is there a difference in muscle strength between female patients with carpal tunnel syndrome who have only sensory involvement and those who have both sensory and motor involvement?
  3. Are there differences in the strength of thumb palmar abduction and adduction, radial adduction and abduction, thumb flexion, extension and opposition, and flexion of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints of the fingers between these groups?

The investigators will measure the muscle strength associated with these movements using the "Lafayette Manual Muscle Tester®" in order to objectively evaluate motor involvement in female patients with carpal tunnel syndrome and to compare muscle strength between healthy individuals and patients with different degrees of electrophysiological involvement.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and develops as a result of compression of the median nerve within the carpal tunnel at the level of the wrist. It manifests with pain in the wrist and hand, paresthesia and sensory loss in the dermatome of the median nerve in the hand (paresthesias may sometimes extend to the entire hand and even the arm), as well as weakness in thumb abduction, opposition, and flexion, and flexion of the second and third fingers at the metacarpophalangeal joints. The carpal tunnel is a structure located in the proximal palmar region of the wrist, bounded superiorly by connective tissue and the carpal ligament and inferiorly by the carpal bones, through which the median nerve and flexor tendons pass. The motor fibers of the median nerve passing through the carpal tunnel innervate the thenar muscle group (abductor pollicis brevis, flexor pollicis brevis-superficial head, and opponens pollicis), as well as the first and second lumbrical muscles; its sensory fibers provide innervation to the first three digits and the lateral aspect of the fourth digit

Among the risk factors for this common entrapment neuropathy are female sex, obesity, age, occupations and activities involving repetitive rotational and flexion movements of the hand, trauma, and pregnancy . The diagnosis of CTS is primarily clinical. It is established based on typical signs and symptoms, such as hand and wrist pain, symptoms occurring or worsening at night, relief with shaking of the hand, and positive Tinel and Phalen signs. Electrophysiological studies (nerve conduction studies and needle electromyography) are used both to confirm the diagnosis of CTS and to exclude other conditions included in the differential diagnosis, such as polyneuropathy, hereditary neuropathy with liability to pressure palsies, and C6 radiculopathy. Nerve ultrasonography (US) is also valuable for demonstrating compression of the median nerve within the carpal tunnel and can additionally identify other lesions affecting the nerve at this level, such as a ganglion cyst .

Although patients with CTS may not have overt motor involvement, clumsiness and impairment of fine motor functions are frequently observed. It has been suggested that these findings may result from impaired sensory feedback required for motor coordination or from a central sensory-motor integration disorder

Changes in muscle strength in patients with sensory involvement only on electromyography can be measured precisely using hand-held dynamometers . Hand-held dynamometers have long been used for the objective assessment of muscle strength. In recent years, electronic versions of these devices have been developed. In our study, muscle strength will be objectively assessed using the "Lafayette Manual Muscle Tester®" by measuring the force exerted by the relevant muscle group during isometric contraction against the measurement pad of the device. Quantitative parameters, including peak force, mean force, and time-dependent changes in force, will be obtained.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
42

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Sampling Method

Non-Probability Sample

Study Population

Patients who applied to the Bezmialem Vakıf University, Neurology Outpatient Clinic appropriate for eligibility criteria will be enrolled

Description

Inclusion Criteria:

  • Age ≥18 years.
  • Female sex.
  • Unilateral or bilateral carpal tunnel syndrome according to the Boston Carpal Tunnel Syndrome criteria.
  • Sensory or motor involvement on electromyography (EMG).
  • Paresthesia, pain, or numbness in the area of the hand innervated by the median nerve for more than 3 months.
  • Presence of Tinel's and Phalen's signs.

Exclusion Criteria:

  • History of hand surgery.
  • Severe cardiovascular disease.
  • Neuromuscular disease affecting muscle strength.
  • Gout.
  • History of hand trauma.
  • History of rheumatoid arthritis or osteoarthritis of the hand or wrist.
  • Pregnancy.
  • Cervical radiculopathy or any upper extremity neuropathy other than carpal tunnel syndrome.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: CASE_CONTROL
  • Time Perspectives: CROSS_SECTIONAL

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
CTS-affected hand

Participants with unilateral or bilateral carpal tunnel syndrome according to the Boston Carpal Tunnel Syndrome criteria will be admitted to this group.

Median and ulnar sensory and motor nerve conduction studies will be performed in both upper extremities.

The comparison of the peak latency of the median and ulnar sensory responses with fourth-finger stimulation will be performed.

Needle electromyography will be performed when necessary to exclude radiculopathy.

Muscle strength of thumb palmar abduction, radial abduction, thumb flexion, extension and opposition, and proximal and distal interphalangeal joint flexion of the fingers will be evaluated using a hand-held dynamometer (Lafayette Manual Muscle Tester®).
Healthy Control Group

Participants without carpal tunnel syndrome will be included in this group. Muscle strength of thumb palmar abduction, radial abduction, thumb flexion, extension and opposition, and proximal and distal interphalangeal joint flexion of the fingers will be evaluated using a hand-held dynamometer (Lafayette Manual Muscle Tester®).

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ)
Time Frame: 1 day

A questionnaire consisting of 11 questions assessing symptom severity and 8 questions assessing functional status. Higher scores indicate greater disease severity. The Turkish version of the questionnaire has demonstrated validity and reliability. Numerical Rating Scale (NRS), A scale in which patients rate their pain on a numerical scale from 0 to 10. Higher scores indicate greater pain intensity.
1 day
Phalen Test
Time Frame: 1 day

The patient is asked to flex both wrists and hold the dorsal surfaces of the hands together for 60 seconds. The test is considered positive if pain or paresthesia occurs in the areas innervated by the median nerve, including the thumb, second and third fingers, the radial half of the fourth finger, or the forearm.
1 day
Durkan Test
Time Frame: 1 day

The patient's forearm is placed in supination, and pressure is applied over the median nerve between the thenar and hypothenar eminences for 30 seconds. The test is considered positive if paresthesia or pain is experienced.
1 day
Tinel Test
Time Frame: 1 day

In the symptomatic hand, the distal portion of the palmaris longus tendon near the palmar aspect of the wrist is gently percussed with a neurological reflex hammer. The test is considered positive if paresthesia or pain is experienced.
1 day
Electrophysiological Tests
Time Frame: 1 day

Median and ulnar sensory and motor nerve conduction studies will be performed in both upper extremities. The peak latency of the median and ulnar sensory responses with fourth-finger stimulation will be compared. Needle electromyography will be performed when necessary to exclude radiculopathy.1
1 day
Thumb Palmar Abduction
Time Frame: 1 day

The hand will be stabilized with the dorsal surface facing the table. The thumb will be positioned in maximum palmar abduction, perpendicular to the plane of the palm. The measurement pad of the device will be placed on the radial aspect of the proximal phalanx of the thumb. The patient will be instructed to push against the measurement pad with maximum force.Thumb Palmar Abduction Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Thumb Radial Abduction Muscle Strength
Time Frame: 1 day

The forearm will be positioned in supination with the palm facing upward. The patient will be instructed to move the thumb away from the palm in the radial direction. The measurement pad will be placed against the radial aspect of the proximal phalanx of the thumb, and the patient will be instructed to perform maximal radial abduction against the pad. Radial Abduction Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Thumb Extension Muscle Strength
Time Frame: 1 day

The hand will be stabilized with the dorsal surface facing the table, and the patient will be asked to lift the thumb upward in the sagittal plane. The measurement pad will be positioned against the radial aspect of the distal phalanx of the thumb, and the patient will be instructed to push against the pad with maximum force. Thumb Extension Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Thumb Opposition Muscle Strength
Time Frame: 1 day

The measurement device will be placed in the palm, with the measurement pad positioned at the level of the fifth finger. The patient will be instructed to perform thumb opposition and push against the measurement pad with maximum force. Thumb Opposition Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Thumb IP Flexion Muscle Strength
Time Frame: 1 day

The measurement device will be stabilized on a flat surface while the patient performs flexion of the thumb interphalangeal (IP) joint. The patient will be instructed to press the fingertip against the measurement pad with maximum force. Thumb IP Flexion Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Thumb MCP Flexion Muscle Strength
Time Frame: 1 day

The measurement device will be placed in the palm, with the measurement pad positioned over the third metacarpophalangeal (MCP) joint. The patient will be instructed to perform thumb MCP flexion and push against the measurement pad with maximum force.Thumb MCP Flexion Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Second Finger PIP Flexion
Time Frame: 1 day

The measurement device will be placed on a flat surface. The patient will be instructed to perform flexion of the proximal interphalangeal (PIP) joint of the second finger and press the fingertip against the measurement pad with maximum force. Second finger pıp flexion Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Second Finger DIP Flexion Muscle Strength
Time Frame: 1 day

The measurement device will be placed on a flat surface. The patient will be instructed to perform flexion of the distal interphalangeal (DIP) joint of the second finger while the metacarpophalangeal (MCP) and distal interphalangeal (DIP) joints are stabilized and press the fingertip against the measurement pad with maximum force. Second Finger DIP Flexion Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Third Finger PIP Flexion Muscle Strength
Time Frame: 1 day

The measurement device will be placed on a flat surface. The patient will be instructed to perform flexion of the proximal interphalangeal (PIP) joint of the third finger and press the fingertip against the measurement pad with maximum force. Third Finger PIP Flexion Muscle Strength will be calculated with hand-held dynamometer(Lafayette Manual Muscle Tester ) and reported as kilograms.
1 day
Third Finger DIP Flexion muscle strength
Time Frame: 1 day

The third finger will be positioned with the MCP and PIP joints stabilized. The measurement pad will be positioned against the palmar aspect of the distal phalanx. The patient will be instructed to perform maximal flexion of the DIP joint against the pad.
1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Bezmialem Vakif University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

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Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 9, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 28, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 29, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 29, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 28, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2026/130

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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