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Saf Health Work. 2014 Mar;5(1):27-31. doi: 10.1016/j.shaw.2014.01.003. Epub 2014 Jan 31.

Meta-analysis: association between wrist posture and carpal tunnel syndrome among workers.

Author information

1
Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA.
2
Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA ; Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, USA.

Abstract

BACKGROUND:

Carpal tunnel syndrome (CTS) is a common work-related peripheral neuropathy. In addition to grip force and repetitive hand exertions, wrist posture (hyperextension and hyperflexion) may be a risk factor for CTS among workers. However, findings of studies evaluating the relationship between wrist posture and CTS are inconsistent. The purpose of this paper was to conduct a meta-analysis of existing studies to evaluate the evidence of the relationship between wrist posture at work and risk of CTS.

METHODS:

PubMed and Google Scholar were searched to identify relevant studies published between 1980 and 2012. The following search terms were used: "work related", "carpal tunnel syndrome", "wrist posture", and "epidemiology". The studies defined wrist posture as the deviation of the wrist in extension or flexion from a neutral wrist posture. Relative risk (RR) of individual studies for postural risk was pooled to evaluate the overall risk of wrist posture on CTS.

RESULTS:

Nine studies met the inclusion criteria. All were cross-sectional or case-control designs and relied on self-report or observer's estimates for wrist posture assessment. The pooled RR of work-related CTS increased with increasing hours of exposure to wrist deviation or extension/flexion [RR = 2.01; 95% confidence interval (CI): 1.646-2.43; p < 0.01: Shore-adjusted 95% CI: 1.32-2.97].

CONCLUSION:

We found evidence that prolonged exposure to non-neutral wrist postures is associated with a twofold increased risk for CTS compared with low hours of exposure to non-neutral wrist postures. Workplace interventions to prevent CTS should incorporate training and engineering interventions that reduce sustained non-neutral wrist postures.

KEYWORDS:

carpal tunnel syndrome; meta-analysis; systematic review

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