Objective
To compare transverse and longitudinal safe zones using ultrasonography between healthy individuals and patients with carpal tunnel syndrome (CTS).
Methods
This was a prospective observational case-control study. Forty wrists from 20 healthy individuals and 40 wrists from 24 patients with CTS were examined. Patients with CTS were classified into three groups (mild, moderate, and severe CTS) based on electrodiagnostic findings. Using ultrasonography, we measured the distance between the median nerve and ulnar vessels to identify the transverse safe zone, and between the distal flexor retinaculum and superficial palmar artery arch to identify the longitudinal safe zone.
Results
The transverse and longitudinal safe zones were significantly different between participants with CTS and those without CTS. The transverse safe zone significantly differed between the mild and severe CTS groups, while the longitudinal safe zone was not significantly different between the groups. The cross-sectional area of the median nerve negatively correlated with the transverse and longitudinal safe zones.
Conclusion
Transverse and longitudinal safe zones were narrower in patients with CTS than in the healthy group. A significant difference was observed between patients with mild CTS and those with severe CTS. Furthermore, the cross-sectional area of the median nerve was directly proportional to the degree of narrowing of the transverse and longitudinal safe zones.

Citations

• Ultrasound-guided anterograde Carpal Tunnel release: Anatomical landmarks of the distal boundary – A cadaveric study
  Marion Mutschler, Bérénice Moutinot, Olivier Marès
  Hand Surgery and Rehabilitation.2026; 45(1): 102562.     CrossRef
• The CLEAR procedure: A five-step safety framework for ultrasound-guided carpal tunnel release
  JeanMichel Cognet, Jasper De Geyter
  Hand Surgery and Rehabilitation.2026; 45(1): 102584.     CrossRef
• Die ultraschallgesteuerte Karpaltunnelspaltung
  Esther Vögelin
  Die Orthopädie.2026;[Epub]     CrossRef
• Ultrasound-Guided Partial Release of Transverse Carpal Ligament in Severe Carpal Tunnel Syndrome Using a Curved Needle
  Nishith Kumar, Upinderjeet Singh, Dharmendra Kumar Singh, Alfa Shamim Saifi
  Indian Journal of Radiology and Imaging.2025; 35(03): 490.     CrossRef
• Ultrasound-guided release of carpal tunnel syndrome — Anterograde technique
  Carla Ricardo Nunes, Olivier Marès, Vincent Martinel
  Hand Surgery and Rehabilitation.2025; 44: 102091.     CrossRef
• Ultrasonographic Assessment of Median Nerve and Carpal Tunnel Variations
  Eric J. Super, Marin S. Smith, Matthew E. Miller, Jay Smith, Xiaoning Yuan
  Journal of Ultrasound in Medicine.2025; 44(10): 1819.     CrossRef
• Ultrasound-guided release of the fibro-osseous tunnels around the wrist and hand: a technical review
  Nishith Kumar, Alfa Shamim Saifi, Upinderjeet Singh, Divesh Jalan, Skand Sinha, Dharmendra Kumar Singh
  British Journal of Radiology.2025; 98(1176): 2011.     CrossRef
• Body composition analysis as a comprehensive method for assessing the effectiveness of medical rehabilitation for lymphedema associated with radical breast cancer treatment
  Valeriia A. Vasileva, Tatiana V. Konchugova, Tatiana V. Apkhanova, Olga M. Musaeva, Valentina A. Morunova, Tatiana V. Marfina, Vladislav I. Koptev, Larisa A. Marchenkova
  Bulletin of Rehabilitation Medicine.2025; 24(6): 42.     CrossRef
• USG-Guided Percutaneous Thread Carpal Tunnel Release
  Nishith Kumar, Alfa Shamim Saifi, Upinderjeet Singh, Dharmendra Kumar Singh
  Indian Journal of Radiology and Imaging.2024; 34(04): 745.     CrossRef
• Clinical-applied anatomy of the carpal tunnel regarding mini-invasive carpal tunnel release
  Peter Kaiser, Gernot Schmidle, Simone Bode, Ulrike Seeher, Hanne-Rose Honis, Bernhard Moriggl, Elisabeth Pechriggl, Hannes Stofferin, Marko Konschake
  Archives of Orthopaedic and Trauma Surgery.2024; 144(11): 4753.     CrossRef
• Ultrasound-guided interventions in primary carpal tunnel syndrome: perineural injection to thread carpal tunnel release
  Nishith Kumar, Shishir Kumar Chandan, Divesh Jalan, Skand Sinha, Binita Jaiswal, Dharmendra Kumar Singh
  The British Journal of Radiology.2023;[Epub]     CrossRef

Objective
To evaluate the efficacy and safety of Daewoong botulinum toxin type A (NABOTA) after its launch in South Korea.
Methods
This prospective, multicenter, open-label phase IV clinical trial included 222 patients with stroke. All patients visited the clinic at baseline and at weeks 4, 8, and 12 after injection of upto 360 units of NABOTA into the wrist, elbow, and finger flexor muscles at the first visit. The primary outcome was the change in Modified Ashworth Scale (MAS) score for the wrist flexor muscles between baseline and week 4. The secondary outcomes were the changes in MAS, Disability Assessment Scale (DAS), and Caregiver Burden Scale (CBS) scores between baseline and each visit, and the Global Assessment Scale (GAS) score at week 12.
Results
There was a statistically significant decrease in the MAS score for the wrist flexors between baseline and week 4 (-0.97±0.66, p<0.001). Compared with baseline, the MAS, DAS and CBS scores improved significantly during the study period. The GAS was rated as very good or good by 86.8% of physicians and by 60.0% of patients (or caregivers). The incidence of adverse events was 14.4%, which is smaller than that in a previous trial.
Conclusion
NABOTA showed considerable efficacy and safety in the management of upper limb spasticity in stroke patients.

Objective
To evaluate the efficiency of powered wheelchair and scooter and to investigate the factors affecting the accidents and injuries. Method We investigated 90 subjects with mobility disability who had used powered wheelchair or scooter more than a year. The subjects responded to a questionnaire of the 34 items. Results Seventy (77.7%) of respondents used powered wheelchair or scooter more than 3 days a week. More than 50% of them regarded the obstacles such as curbs or thresholds as the most common hindering factor to outside mobility. The causes of breakdown were due to battery, wheel, gear box and motor. About a third of 58 respondents were dissatisfied with the result of repair. The high cost of the repair was regarded as the leading cause of dissatisfaction. Contusions were the most common, with abrasion and sprain accounting for most of the remainder. Of the 18 users who were affected by injuries, only 11.1% wore a safety seatbelt. Only 25 of 89 respondents had a safety education. Conclusion Our study showed that the efficiency of power wheelchair and scooter was relatively high. But the obstacles such as curbs, recurrent breakdown, and concerns about the accident were regarded as the hindering factors to the outside mobility. The degree of satisfaction to the safety education is relatively low, so more systemic and practical programs need to be devised.

Objective
To investigate the actual driving status and driving related safety issues of older drivers aged 65 years or older. Method: We conducted a survey on 56 elderly drivers about driving status, driving habits, safe driver self check list, and medical conditions that may affect safe driving. For comparison, 50 younger drivers aged between third and fifth decades were also surveyed. Results: The mean age of total 56 elderly drivers was 69.96 years old. Their mean driving time in life was 23.6 years and the purposes of driving were shopping (23.2%), religion activity (21.4%) and leisure (16.1%). Most vehicles were equipped with automatic transmission (83.9%) and power steering (91.1%) and the most common type of vehicle was a sedan (82.1%). The incidence of their motor vehicle accidents in recent 2 years was 21.4%, which was higher than that of control group (18.0%) without statistical significance. The driving habits questionnaire revealed elderly drivers tend to avoid rush-hour traffic, driving at night, and high-traffic roads in 75.0%, 69.6%, 51.8% of subjects respectively. The result of safe driver self check list showed that mean demerit score of elderly drivers was 4.3, which was higher than that of younger drivers (3.2). Elderly drivers had hypertension (33.9%), diabetes mellitus (17.9%), eye disorders (8.9%), heart disease (8.9%), arthritis (8.9%), stroke (7.1%), and respiratory disease (5.4%). Conclusion: Compared to younger drivers, elderly drivers tend to avoid unsafe driving situations and reported more safety problems in the safe driver self check list. Elderly drivers also had more medical conditions that may affect safe driving, such as eye disorders, cardiovascular, and metabolic diseases. (J Korean Acad Rehab Med 2010; 34: 570-576)

Objective
To investigate the safety of early symptom limited exercise stress test (GXT) performed within 10 days after coronary intervention in acute coronary syndrome patients. Method: Forty-six patients with acute coronary syndrome including unstable angina (UA) and acute myocardial infarction (AMI) were recruited. All of them performed GXT within 10 days after coronary intervention and received cardiac rehabilitation for 6 weeks. Results: Mean age of the patients was 57.6±9.8 years (unstable angina 26 patients, acute myocardial infarction 23 patients). The number of the patients complained of cardiac events during GXT was 8 (16%); chest pain (3), ischemic changes on electrocardiogram (2) and hemodynamic instability (3). However, none of them showed any major adverse cardiac events such as acute myocardial infarction (AMI). Major cause of termination of GXT was patient's request such as dyspnea, fatigue, and musculoskeletal pain. After early GXT, there was no significant difference between two groups in all variables (p＞0.05). Conclusion: Early GXT was safe in acute coronary syndrome patients and did not show any significant difference between UA patients and AMI patients. (J Korean Acad Rehab Med 2010; 34: 336-341)

Objective: To identify the effect of the 'disability prevention program' for elementary school students.

Method: Our disability prevention program was a 60 minutes program composed of watching an education video for disability prevention and having a conversation with disabled speakers in wheelchairs. A questionnaire to measure the effect of the education was administered among 5,315 students in the 4th to 6th grades. The questionnaire was administered at 7 days before and after education. The questionnaire was to measure the changes in self-efficacy and in confidence to follow safety regulation. Also the questions on satisfaction about program were asked.

Results: The result showed that only 9.7% of bicycle owners, 18.9% of inline skate owners wore helmets, 9.3% of quick board (or skateboard) owners wore helmets, and only 47.6% of students fastened seat-belts in a car. After the program was conducted, there were significant improvements in self-efficacy and practice-confidence to wear protective device and to fasten seat belt in a car (p＜0.01). The most impressive part of the program for students was 'conversation with disabled speaker' and the next was 'watching the video'. After program was conducted, 51.5% of students answered "I will keep safety regulations in mind and practice it" and 10.1% of students answered "I could learn a better understanding of the disabled and I also want to help them".

Conclusion: The 'disability prevention program with disabled speakers in wheelchair' was effective in improving the self-efficacy and practice-confidence for safety regulation. (J Korean Acad Rehab Med 2008; 32: 160-168)