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K D Meadows

Publications and source records attributed to K D Meadows.

At least 19 recordsLinked to original sources
PubMed2005

A longitudinal study of predictors of research-defined carpal tunnel syndrome in industrial workers: findings at 17 years.

In 1984, we initiated a prospective study of factors associated with research-defined carpal tunnel syndrome (CTS) in 471 industrial workers. Medical history, lifestyle factors and job tasks were assessed by questionnaire and CTS case status was based on both symptoms and electrophysiologic findings. Participants were re-examined in 1989, 1994 to 1995 and 2001 to 2002. This study reports both baseline and aggregated risk factors associated with increased risk of CTS by 2001 to 2002 for 166 participants successfully re-examined after 17 years. In analyses of baseline risk factors, fewer repetitive tasks at work, female gender and greater relative weight were associated with any occurrence of CTS during follow-up. In analyses of aggregate risk factor scores through 1994 to 1995, only greater relative weight and female gender were associated with CTS in 2001 to 2002. Although obesity and gender are consistent predictors of CTS, workplace demands appear to bear an uncertain relationship to CTS. These findings are also discussed in relation to the possible differences between research-defined CTS and medically referred CTS.

Carpal Tunnel Syndrome↗
PubMed2005

Intermediate and long-term outcomes following simple decompression of the ulnar nerve at the elbow.

INTRODUCTION: There is currently little consensus regarding the appropriate surgical approach to treatment of cubital tunnel syndrome (CubTS), and few studies have reported long-term follow-up of patients who have received surgical treatment for ulnar nerve compression at the elbow. METHOD: Seventy-four patients with a total of 102 cases of CubTS treated with simple decompression of the ulnar nerve were examined 1.0-12.4 years postoperatively. Ulnar nerve conduction studies (slowest conducting 5 cm segment of ulnar nerve motor fibers measured at the elbow) were performed both pre- and postoperatively. The primary clinical outcome was percentage relief of symptoms, divided into "excellent" outcome group or less (> or = 90% improvement or < 90% improvement). RESULTS: Ulnar nerve conduction improved pre- to postoperatively, but clinical improvement was not related to changes in velocity. Women reported greater clinical improvement than men, and weight gain in men (but not women) predicted less improvement. Relief of cubital tunnel symptoms was greatest for those arms receiving carpal tunnel release surgery simultaneous or subsequent to cubital tunnel release. DISCUSSION: Simple decompression may offer excellent intermediate and long-term relief of symptoms associated with CubTS. Although improvement in ulnar motor nerve conduction velocity occurs following treatment of CubTS, it may not be a consistent marker of perceived symptom relief. Finally, these findings suggest that less complete relief of symptoms following ulnar nerve decompression may be related to unrecognized carpal tunnel syndrome or weight gain.

Adult↗
PubMed2001

Effects of an aerobic exercise program on median nerve conduction and symptoms associated with carpal tunnel syndrome.

Carpal tunnel syndrome is associated with greater body mass index and less physical activity. To determine the effect of aerobic exercise on median nerve conduction and symptoms suggestive of carpal tunnel syndrome, 30 symptomatic volunteers (30 to 64 years old) with abnormal median nerve conduction studies participated in a 10-month program of supervised aerobic exercise. Changes in percentage of body fat, body mass index, peak oxygen consumption, 14-cm median sensory latency, and hand/wrist symptoms were assessed. A decrease in 14-cm sensory median latency correlated with a decrease in percentage of body fat (R = 0.52, P = 0.004) and was predicted by an increase in peak oxygen utilization (partial R = 0.52, P = 0.005) and a decrease in body mass index (partial R = 0.47, P = 0.014). There was also a tendency for a set of symptoms sometimes associated with carpal tunnel syndrome (pain, tightness, and clumsiness) to be relieved by the exercise program. These results suggest that an aerobic exercise program can be beneficial to median nerve function and may be associated with a reduction in hand symptoms.

Adult↗
PubMed1998

Natural history of median nerve sensory conduction in industry: relationship to symptoms and carpal tunnel syndrome in 558 hands over 11 years.

We evaluated the natural history of median nerve sensory conduction, hand/wrist symptoms, and carpal tunnel syndrome (CTS) in an 11-year longitudinal study of 289 workers from four industries. Twenty hands which had carpal tunnel release surgery were excluded, leaving 558 hands for the primary study group. Overall, the trend was for mean sensory latencies and prevalence of slowing to increase, the prevalence of symptoms to decrease, and the prevalence of CTS to remain unchanged. Among individual hands, nerve conduction abnormalities tended to persist (82% 11-year persistence), while symptoms fluctuated widely (13% 11-year persistence). There was a strong, direct linear correlation between initial severity of slowing and subsequent development of CTS; however, most workers who developed de novo slowing did not develop symptoms or CTS. We conclude that changes in conduction status of the median nerve occur naturally with increasing age and do not necessarily lead to symptoms and CTS.

Adult↗
PubMed1996

Tobacco, caffeine, alcohol, and carpal tunnel syndrome in American industry. A cross-sectional study of 1464 workers.

We investigated the effects of three legal drugs (tobacco, caffeine, and alcohol) on the prevalence of carpal tunnel syndrome (CTS) confirmed by nerve conduction studies (definite CTS) in two groups of American industrial workers: 656 nonclaimant workers and 808 working patients referred for upper extremity symptoms. Comparing workers with definite CTS to workers without definite CTS revealed 26% greater current use of tobacco, 19% greater lifetime use of tobacco, 5% greater current use of caffeine, 14% lesser current use of alcohol, and 75% greater history of alcohol abuse in the workers with definite CTS. All these differences were statistically significant. Those who currently used alcohol but not tobacco or caffeine were at the lowest risk for slowing, symptoms, and definite CTS. Those who currently used caffeine alone or in combination with tobacco were at the highest risk. In female workers, current smoking, current caffeine use, and current coffee consumption independently predicted 5.0% of the explainable risk for definite CTS. In male workers, history of alcohol abuse and current beer consumption independently predicted 3.0% of the explainable risk for definite CTS. Prevalence of slowing, symptoms, and definite CTS in 12 specific job categories correlated directly with current tobacco use. We conclude that the use of legal drugs affects the prevalence of median nerve slowing, symptoms, and carpal tunnel syndrome, but the effects of the drugs independently explain only a small portion of the total risk. Nevertheless, legal drug use or abuse may serve as a marker for increased CTS risk.

Adult↗
PubMed1995

Outcome study of ulnar nerve compression at the elbow treated with simple decompression and an early programme of physical therapy.

Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper limb. This paper presents the experience of treating cubital tunnel syndrome with simple decompression in 131 patients (164 ulnar nerves) over the past 12 years. 85% of these patients had mild or moderate ulnar nerve disease. In 146/164 ulnar nerves (89%), simple decompression resulted in good or excellent immediate post-operative relief of symptoms. After an average follow-up of 4.3 years (range, 0.8-12.0 years), 130/164 (79%) still reported good or excellent relief. The independent predictors of a better long-term outcome were absence of post-operative subluxation, greater body weight, normal pre-operative two-point discrimination (2-PD), and a more recent date of operation. A physical therapy rehabilitation program generally began on the day after surgery. Active participation in this predicted a rapid return to work or activities of daily living. The average time to return to work with simple decompression was 20 workdays.

Adult↗
PubMed1994

Slowing of sensory conduction of the median nerve and carpal tunnel syndrome in Japanese and American industrial workers.

As part of a continuing study of the causes of carpal tunnel syndrome (CTS) in industry, we measured sensory conduction of the median nerve in 101 Japanese furniture factory workers. We used the maximum latency difference (MLD) with a critical value of > or = 0.40 msec to indicate abnormal slowing of nerve conduction. The prevalence of slowing in the Japanese workers was 17.8%, while the prevalence of probable CTS (based on symptoms only) was 2.5%, and the prevalence of definite CTS (probable CTS confirmed by slowing) was 2.0%. The most important factor predicting the MLD was the body mass index. The MLD was the most important factor predicting probable CTS. The prevalence of slowing in the Japanese workers was not significantly different from the prevalence of slowing in 316 American workers from four industries (22.0%), but the prevalences of probable CTS and definite CTS were much lower in the Japanese. The meaning of these findings is discussed.

Adolescent↗