{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:55:23Z","timestamp":1785437723944,"version":"3.56.0"},"reference-count":13,"publisher":"Michigan State University College of Osteopathic Medicine Statewide Campus System","issue":"2","license":[{"start":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T00:00:00Z","timestamp":1630281600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"introduction\">\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>The diagnosis of carpal tunnel syndrome (CTS) with nerve conduction studies traditionally involves warming the hand to avoid misleading prolongation of distal latency (DL). Comparing the median nerve DL to the ulnar and radial nerves using the combined sensory index (CSI) has been reported to improve the accuracy of CTS diagnosis. During this study, the authors examined the effect of hand temperature on the CSI and diagnosis of CTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors conducted a prospective, controlled, cohort study with 20 asymptomatic control patients and 21 symptomatic patients with confirmed CTS. Symptomatic patients underwent nerve conduction studies with the CSI calculated under both cold and warm conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Control subjects with warm hands had an average CSI of 0.0 milliseconds (ms), and -0.3ms with cold hands. CTS subjects with warm hands had an average CSI of 3.2ms, and 3.7ms with cold hands. Although hand temperature was shown to slow sample latencies, differences calculated with the CSI did not misclassify any of the 41 sample subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>During this study, cold temperature did not result in misclassification of either control patients or CTS patients when CSI was diagnostically used. Based on these results, peak latency comparisons in cold hands can be considered as diagnostically reliable as under standard hand temperature ranges for the diagnosis of CTS, with caution warranted in borderline cases. This diagnostic technique can save time for the patient, physician, and care team without compromising quality of care. Future larger sample blinded studies at multiple electrodiagnostic sites are indicated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.51894\/001c.25941","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T11:04:15Z","timestamp":1630321455000},"source":"Crossref","is-referenced-by-count":2,"title":["Can Carpal Tunnel Syndrome be Appropriately Diagnosed in a Cold Hand?"],"prefix":"10.51894","volume":"6","author":[{"given":"Michael T.","family":"Andary","sequence":"first","affiliation":[{"name":"Michigan State University College of Osteopathic Medicine, Sparrow Hospital, McLaren Greater Lansing Hospital","department":["Physical Medicine & Rehabilitation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9630-1144","authenticated-orcid":false,"given":"Drew B.","family":"Parkhurst","sequence":"additional","affiliation":[{"name":"Michigan State University College of Osteopathic Medicine, Sparrow Hospital, McLaren Greater Lansing Hospital","department":["Physical Medicine & Rehabilitation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice R.","family":"Bernaiche","sequence":"additional","affiliation":[{"name":"New England Sports, Orthopedics, Spine, and Rehabilitation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose S.","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Des Moines University Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lata","family":"Kumaraswamy","sequence":"additional","affiliation":[{"name":"Southwest Spine and Sports"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M.","family":"Manzi","sequence":"additional","affiliation":[{"name":"Performance Pain & Sports Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan A.","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Michigan State University College of Osteopathic Medicine, Sparrow Hospital, McLaren Greater Lansing Hospital","department":["Physical Medicine & Rehabilitation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid P.","family":"Parrington","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/025cem651","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Reed National Military Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim R.","family":"Sylvain","sequence":"additional","affiliation":[{"name":"Michigan State University College of Osteopathic Medicine, Sparrow Hospital, McLaren Greater Lansing Hospital","department":["Physical Medicine & Rehabilitation"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29343","published-online":{"date-parts":[[2021,8,30]]},"reference":[{"issue":"8","key":"ref1","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1002\/1097-4598(200008)23:8<1261::AID-MUS16>3.0.CO;2-M","article-title":"Test-retest reliability of combined sensory index: Implications for diagnosing carpal tunnel syndrome","volume":"23","author":"H.L. 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