Musculoskeletal Health of the Upper Extremity in Emerging Health Professionals

Completed

Interventions: Other: Academic Coursework
Other: Work-Related Hand Activities

Brief Summary: Carpal tunnel syndrome is the most expensive upper extremity work-related musculoskeletal disorder, impacting 10 million people annually and costing employers up to $113,695 per incident. There is currently no established method to detect this disorder prior to the onset of symptoms and nerve damage. Preliminary research suggests that sonography-a relatively inexpensive, widely available, increasingly portable technology-can provide a non-invasive and pain-free method of early detection that could reduce incidence, improve targeted interventions and ultimately reduce costs. The primary aims of this study are to establish predictive validity of a novel method for early detection using sonographic imaging and to identify task components of intensive functional hand activity associated with morphologic changes.

Detailed Description: This longitudinal study will follow dental hygiene students-a high-risk population with minimal retrospective and controlled prospective task exposure-for two years and compare them to a non-exposed cohort of occupational therapy students to investigate the primary aims. This research is directed at the National Occupational Research Agenda's (NORA) Healthcare and Social Assistance sector with a focus on the National Institute of Occupational Safety and Health's (NIOSH) Exposure Assessment and Musculoskeletal Disorders cross-sectors. Intermediate outcomes of this research will establish sonographic imaging as an early detection tool for workplace-screening and inform methods for combining measures of nerve morphology, neurophysiology, and subjective symptoms for predicting the development of work-related carpal tunnel syndrome. This work will also inform the development of targeted preventive interventions for task components of intensive hand activities that are related to changes in tissue morphology. Identifying morphologic changes in early-stages of pathology and the specific task components linked to these changes are the first steps toward early detection and prevention of work-related carpal tunnel syndrome.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

<18 years of age
Prior carpal tunnel release surgery
Prior diagnosis of median nerve pathology or other poly-neuropathy that includes the median nerve

Arm && Interventions

Group	Intervention	Description
Dental Hygiene Students	Academic Coursework	Students enrolled in the 2-year dental hygiene academic coursework programs at the University of Southern California and Loma Linda University who are exposed to high-intensity work-related hand activities as part of their training program.
Dental Hygiene Students	Work-Related Hand Activities	Students enrolled in the 2-year dental hygiene academic coursework programs at the University of Southern California and Loma Linda University who are exposed to high-intensity work-related hand activities as part of their training program.
Occupational Therapy Students	Academic Coursework	Students enrolled in the 2-year occupational therapy academic coursework program at the University of Southern California.

Primary Outcome Measures

Name	Time	Method
Change from Baseline in Symptom & Function Reports on the Boston Carpal Tunnel Questionnaire at 2 years	Baseline and 2 years

Secondary Outcome Measures

Name	Time	Method
Change from Baseline in Cross-Sectional Area of Median Nerve in the Carpal Tunnel Measured with Sonography at 1 year	Baseline and 1 year
Change from Baseline in Vascularity within the Median Nerve Measured with Doppler Sonography at 2 years	Baseline and 2 years
Change from Baseline in Cross-Sectional Area of Median Nerve in the Carpal Tunnel Measured with Sonography at 2 years	Baseline and 2 years
Change from Baseline in Nerve Conduction Velocity of the Median Nerve at 1 year	Baseline and 1 year	Nerve conduction velocity testing of the median nerve includes physiological measurement of the ability of the nerve to conduct electrical signals using nerve conduction testing equipment (Sierra Wave) with a surface stimulator at the wrist and surface electrodes on the second and fifth digits.
Change from Baseline in Vascularity within the Median Nerve Measured with Doppler Sonography at 1 year	Baseline and 1 year
Change from Baseline in Nerve Conduction Velocity of the Median Nerve at 2 years	Baseline and 2 years	Nerve conduction velocity testing of the median nerve includes physiological measurement of the ability of the nerve to conduct electrical signals using nerve conduction testing equipment (Sierra Wave) with a surface stimulator at the wrist and surface electrodes on the second and fifth digits.

Locations (3): Loma Linda Univeristy Dental Hygiene Program
🇺🇸
Loma Linda, California, United States
USC Musculsokeletal Sonography & Occupational Performance Laboratory
🇺🇸
Los Angeles, California, United States
USC Dental Hygiene
🇺🇸
Los Angeles, California, United States