Sleep Problems and Disabilities of the Arm, Shoulder, and Hand in Persons with Thoracic Outlet Syndrome—A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
- Confirmation of a TOS diagnosis based on the presence of at least three of the following symptoms: Pain in the neck region, numbness along the arms, hand numbness, impaired gross motor strength of the arm muscles, loss of sensation in the hands, cold arms and hands, poor circulation in the hands, pain in the hands, chest pain, throbbing sensation, palpitations, shoulder pain, headache, dizziness, tinnitus, and loss of consciousness.
- Positive hand oscillography findings [23].
- Evidence of hyperplasia of the transverse extension of the seventh cervical vertebra or cervical rib on a standard radiological image of the cervical spine [24].
3. Results
3.1. Descriptive Statistics and Differences between Groups
3.2. Correlation between Sleep Problems and Disabilities of the Arm, Shoulder, and Hand
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
- Clinical (physical and neurological) examination: examination of the patient’s posture (observation of the neck, shoulder and the arm muscles for trophism, tone, consistency, mobility and contractility), observation of skin changes (with special emphasis on skin discoloration, trophic changes in skin and nails, and hand skin temperature), testing the reflexes in the triceps brachii, biceps brachii and brachioradialis, and sensitivity testing in the regions of innervation of the corresponding spinal roots (C4, C5, C6, C7 and C8);
- Nutritional status evaluation: body height and body mass measurement, and the body mass index (BMI) calculation;
- Analysis of the available oscillography findings for the upper extremities in the physiological position, as well as in provocative positions;
- Neutral arm position (upper arm next to the body)
- Upper arm abduction position (at 90° relative to the body)
- Complete elevation of the upper arm (at 180° relative to the body)
Appendix B
Items | Group | N | Mean | SD | t | p |
---|---|---|---|---|---|---|
1 Open a tight or new jar. | TOS-free | 81 | 1.51 | 0.78 | −5.66 | <0.001 |
TOS | 82 | 2.38 | 1.15 | |||
2 Write. | TOS-free | 81 | 1.04 | 0.19 | −5.20 | <0.001 |
TOS | 82 | 1.49 | 0.76 | |||
3 Turn a key. | TOS-free | 81 | 1.03 | 0.16 | −5.03 | <0.001 |
TOS | 82 | 1.43 | 0.70 | |||
4 Prepare a meal. | TOS-free | 81 | 1.09 | 0.32 | −6.81 | <0.001 |
TOS | 82 | 1.87 | 0.98 | |||
5 Push open a heavy door. | TOS-free | 81 | 1.51 | 0.69 | −8.04 | <0.001 |
TOS | 82 | 2.67 | 1.03 | |||
6 Place an object on a shelf above your head. | TOS-free | 81 | 1.30 | 0.58 | −11.07 | <0.001 |
TOS | 82 | 2.81 | 1.08 | |||
7 Do heavy household chores (e.g., wash walls, wash floors). | TOS-free | 81 | 1.61 | 0.70 | −10.42 | <0.001 |
TOS | 82 | 3.10 | 1.08 | |||
8 Garden or do yard work. | TOS-free | 81 | 1.77 | 0.94 | −9.26 | <0.001 |
TOS | 82 | 3.26 | 1.11 | |||
9 Make a bed. | TOS-free | 81 | 1.11 | 0.35 | −7.58 | <0.001 |
TOS | 82 | 2.13 | 1.16 | |||
10 Carry a shopping bag or briefcase. | TOS-free | 81 | 1.27 | 0.55 | −8.17 | <0.001 |
TOS | 82 | 2.48 | 1.21 | |||
11 Carry a heavy object (over 10 lbs). | TOS-free | 81 | 1.69 | 0.86 | −8.94 | <0.001 |
TOS | 82 | 3.13 | 1.17 | |||
12 Change a lightbulb overhead. | TOS-free | 81 | 1.32 | 0.63 | −10.85 | <0.001 |
TOS | 82 | 3.02 | 1.27 | |||
13 Wash or blow dry your hair. | TOS-free | 81 | 1.16 | 0.51 | −10.09 | <0.001 |
TOS | 82 | 2.63 | 1.21 | |||
14 Wash your back. | TOS-free | 81 | 1.32 | 0.59 | −9.26 | <0.001 |
TOS | 82 | 2.81 | 1.32 | |||
15 Put on a pullover sweater. | TOS-free | 81 | 1.04 | 0.19 | −7.41 | <0.001 |
TOS | 82 | 1.99 | 1.14 | |||
16 Use a knife to cut food. | TOS-free | 81 | 1.11 | 0.52 | −5.33 | <0.001 |
TOS | 82 | 1.79 | 1.03 | |||
17 Recreational activities which require little effort (e.g., cardplaying, knitting, etc.). | TOS-free | 81 | 1.12 | 0.46 | −6.88 | <0.001 |
TOS | 82 | 2.11 | 1.21 | |||
18 Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.). | TOS-free | 81 | 1.75 | 1.08 | −8.20 | <0.001 |
TOS | 82 | 3.21 | 1.18 | |||
19 Recreational activities in which you move your arm freely (e.g., playing frisbee, badminton, etc.). | TOS-free | 81 | 1.43 | 0.82 | −9.12 | <0.001 |
TOS | 82 | 3.01 | 1.33 | |||
20 Manage transportation needs (getting from one place to another). | TOS-free | 81 | 1.11 | 0.32 | −6.68 | <0.001 |
TOS | 82 | 1.96 | 1.11 | |||
21 Sexual activities. | TOS-free | 81 | 1.24 | 0.73 | −5.18 | <0.001 |
TOS | 82 | 2.07 | 1.27 | |||
22 During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups? | TOS-free | 81 | 1.28 | 0.60 | −8.85 | <0.001 |
TOS | 82 | 2.52 | 1.11 | |||
23 During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem? | TOS-free | 81 | 1.30 | 0.56 | −9.56 | <0.001 |
TOS | 82 | 2.74 | 1.25 | |||
24 Arm, shoulder or hand pain. | TOS-free | 81 | 1.35 | 0.57 | −10.99 | <0.001 |
TOS | 82 | 2.98 | 1.21 | |||
25 Arm, shoulder or hand pain when you performed any specific activity. | TOS-free | 81 | 1.40 | 0.63 | −11.80 | <0.001 |
TOS | 82 | 3.10 | 1.14 | |||
26 Tingling (pins and needles) in your arm, shoulder or hand. | TOS-free | 81 | 1.31 | 0.56 | −12.09 | <0.001 |
TOS | 82 | 2.92 | 1.06 | |||
27 Weakness in your arm, shoulder or hand. | TOS-free | 81 | 1.40 | 0.61 | −12.02 | <0.001 |
TOS | 82 | 3.09 | 1.11 | |||
28 Stiffness in your arm, shoulder or hand. | TOS-free | 81 | 1.25 | 0.49 | −12.76 | <0.001 |
TOS | 82 | 3.05 | 1.18 | |||
29 During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand? | TOS-free | 81 | 1.28 | 0.55 | −11.09 | <0.001 |
TOS | 82 | 2.84 | 1.14 | |||
30 I feel less capable, less confident or less useful because of my arm, shoulder or hand problem. | TOS-free | 81 | 1.33 | 0.63 | −10.61 | <0.001 |
TOS | 82 | 3.00 | 1.27 | |||
DASH DISABILITY/SYMPTOM SCORE | TOS-free | 81 | 7.83 | 9.10 | −13.21 | <0.001 |
TOS | 82 | 39.59 | 19.76 |
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Gender | TOS-Free | TOS | Total |
---|---|---|---|
Male, n, (%) | 23 (28.4%) | 17 (20.7%) | 40 |
Female, n, (%) | 58 (71.6%) | 65 (79.3%) | 123 |
Total, N, (%) | 81 (100%) | 82 (100%) | 163 |
Group | Min | Max | Mean | SD | t | p | |
---|---|---|---|---|---|---|---|
Age (years) | TOS-free | 20.00 | 65.00 | 44.70 | 10.70 | −4.48 | 0.000 |
TOS | 19.00 | 66.00 | 51.74 | 9.35 | |||
Body height (cm) | TOS-free | 156.00 | 195.00 | 172.22 | 9.02 | 2.29 | 0.023 |
TOS | 146.00 | 194.00 | 168.83 | 9.89 | |||
Body weight (kg) | TOS-free | 50.00 | 117.00 | 73.28 | 17.412 | −1.02 | 0.306 |
TOS | 47.00 | 125.00 | 76.02 | 16.67 | |||
BMI | TOS-free | 17.76 | 36.33 | 24.50 | 4.42 | −2.79 | 0.006 |
TOS | 17.51 | 47.05 | 26.65 | 5.35 |
Group | Instrument | Min | Max | Mean | SD | Skewness | Kurtosis |
---|---|---|---|---|---|---|---|
TOS-free | DASH | 0.00 | 41.67 | 7.83 | 9.10 | 1.58 | 2.26 |
PSQI | 1.00 | 11.00 | 4.59 | 2.24 | 0.80 | 0.15 | |
TOS | DASH | 0.00 | 81.67 | 39.59 | 19.76 | 0.19 | −0.75 |
PSQI | 2.00 | 16.00 | 7.98 | 3.55 | 0.36 | −0.92 |
Components of PSQI | Group | N | Mean | SD | t | p |
---|---|---|---|---|---|---|
C1 Subjective sleep quality | TOS-free | 81 | 0.22 | 0.69 | −3.59 | <0.001 |
TOS | 82 | 0.74 | 1.12 | |||
C2 Sleep latency | TOS-free | 81 | 0.86 | 0.85 | −6.52 | <0.001 |
TOS | 82 | 1.77 | 0.92 | |||
C3 Sleep duration | TOS-free | 81 | 1.01 | 0.66 | −2.32 | 0.021 |
TOS | 82 | 1.28 | 0.81 | |||
C4 Habitual sleep efficiency | TOS-free | 81 | 0.22 | 0.57 | −3.22 | 0.002 |
TOS | 82 | 0.59 | 0.84 | |||
C5 Sleep disturbances | TOS-free | 81 | 1.09 | 0.45 | −7.79 | <0.001 |
TOS | 82 | 1.83 | 0.73 | |||
C6 Use of sleep medication | TOS-free | 81 | 0.17 | 0.52 | −2.04 | 0.044 |
TOS | 82 | 0.39 | 0.81 | |||
C7 Daytime dysfunction | TOS-free | 81 | 1.01 | 0.37 | −4.93 | <0.001 |
TOS | 82 | 1.38 | 0.56 | |||
Global PSQI Score | TOS-free | 81 | 4.59 | 2.24 | −7.27 | <0.001 |
TOS | 82 | 7.98 | 3.56 |
Group | Age | BMI | DASH | |
---|---|---|---|---|
BMI | TOS-free | −0.01 | ||
TOS | 0.11 | |||
DASH | TOS-free | 0.15 | 0.12 | |
TOS | 0.31 ** | −0.01 | ||
PSQI | TOS-free | 0.07 | 0.03 | 0.40 ** |
TOS | 0.21 | 0.04 | 0.58 ** |
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Milenovic, N.; Klasnja, A.; Skrbic, R.; Popovic Petrovic, S.; Lukac, S.; Devecerski, G. Sleep Problems and Disabilities of the Arm, Shoulder, and Hand in Persons with Thoracic Outlet Syndrome—A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 12486. https://doi.org/10.3390/ijerph191912486
Milenovic N, Klasnja A, Skrbic R, Popovic Petrovic S, Lukac S, Devecerski G. Sleep Problems and Disabilities of the Arm, Shoulder, and Hand in Persons with Thoracic Outlet Syndrome—A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2022; 19(19):12486. https://doi.org/10.3390/ijerph191912486
Chicago/Turabian StyleMilenovic, Natasa, Aleksandar Klasnja, Renata Skrbic, Svetlana Popovic Petrovic, Sonja Lukac, and Gordana Devecerski. 2022. "Sleep Problems and Disabilities of the Arm, Shoulder, and Hand in Persons with Thoracic Outlet Syndrome—A Cross-Sectional Study" International Journal of Environmental Research and Public Health 19, no. 19: 12486. https://doi.org/10.3390/ijerph191912486