ArticleClinical biomechanics (Bristol, Avon)2017
Delineation of the mechanisms of tendon gliding resistance within the carpal tunnel.
Article in Clinical biomechanics (Bristol, Avon), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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Who cites it
5 citing papers in PubMed.
- Article
- A Surface-to-Surface Finite Element Algorithm for Large Deformation Frictional Contact in febio.Journal of biomechanical engineering · 2018Article
- The biomechanics of subsynovial connective tissue in health and its role in carpal tunnel syndrome.Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology · 2018Review
- Ultrasound-guided hydrodissection decreases gliding resistance of the median nerve within the carpal tunnel.Muscle & nerve · 2018Article
- PDGFR Signaling Mediates Hyperproliferation and Fibrotic Responses of Subsynovial Connective Tissue Cells in Idiopathic Carpal Tunnel Syndrome.Scientific reports · 2017Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundForceful, high-velocity, and repetitive manual hand tasks contribute to the onset of carpal tunnel syndrome. This study aimed to isolate and identify mechanisms that contribute to tendon gliding resistance in the carpal tunnel.
methodsEight human cadaver hands (four pairs) were used. Tendon gliding resistance (force, energy, and stiffness) was measured under different conditions: with intact and with divided subsynovial connective tissue, at 2mm/s and 60mm/s tendon excursion velocity, and with and without relaxation time before tendon excursion.
resultsSubsynovial connective tissue stretching substantially contributed to increased gliding resistance force and energy during higher tendon excursion velocities, and subsynovial connective tissue stiffening was observed. Poroelastic properties of the tendon (and possibly the subsynovial connective tissue) also appear to be involved because relaxation time significantly increased gliding resistance force and energy (P<0.01), and the difference in energy and force between high- and low-velocity tendon excursions increased with relaxation time (P=0.01 and P<0.01). Lastly, without relaxation time, no difference in force and energy was observed (P=0.06 and P=0.60), suggesting contact friction.
interpretationThese findings are consistent with the hypothesis that the mechanics of tendon motion within the carpal tunnel are affected by the integrity of the subsynovial connective tissue. While not tested here, in carpal tunnel syndrome this tissue is known to be the fibrotic, thickened, and less-fluid-permeable. An extrapolation of our findings suggests that these changes in the subsynovial connective tissue of carpal tunnel syndrome patients could increase contact friction and carpal tunnel pressure.
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