Tesis

Korelasi Derajat Keparahan dan Status Fungsional Pasien Sindrom Terowongan Karpal Berdasarkan Kuesioner Boston Carpal Tunnel dengan Pemeriksaan Hantar Saraf Nervus Medianus = The Correlation between the Severity Degree and Functional Status of Carpal Tunnel Syndrome based on the Boston Carpal Tunnel Questionnaire and Median Nerve Conduction Studies.

Latar Belakang: Penegakan diagnosis sindrom terowongan karpal (STK) memerlukan kesesuaian antara gejala klinis, pemeriksaan fisik dan pemeriksaan neurodiagnostik. Penilaian derajat keparahan sedini mungkin dapat memberikan pilihan terapi dan prognosis yang lebih baik pada pasien. Kuesioner Boston Carpal Tunnel Questionnaire (BCTQ) dapat menilai derajat keparahan pasien STK berdasarkan gejala klinis dan status fungsional, namun korelasi kuesioner tersebut dengan pemeriksaan hantar saraf sebagai pemeriksaan standar acuan masih beragam. Penelitian ini bertujuan untuk menilai korelasi derajat keparahan dan status fungsional pasien STK berdasarkan kuesioner BCTQ dengan pemeriksaan hantar saraf nervus medianus. Metode: Studi ini merupakan studi potong lintang yang dilakukan di poliklinik saraf Rumah Sakit Umum Pusat Nasional (RSUPN) Cipto Mangunkusumo pada pasien STK yang terdiagnosis dengan pemeriksaan hantar saraf dan bersedia mengisi kuesioner BCTQ. Karakteristik pasien dan pemeriksaan dijabarkan dalam persentase, lalu dilakukan analisis kekuatan korelasi dengan mengunakan uji Spearman. Hasil: Terdapat 54 subyek penelitian terdiri dari 43 pasien wanita (79,6%) dengan rerata usia 50,94 ± 10,82 dan paling banyak mengalami dejarat keparahan sedang (37%). Nilai rerata total skor BCTQ gejala klinis adalah 2.40±0,87 dan nilai rerata total skor BCTQ skala fungsional adalah 1,63 (1-4,13). Terdapat korelasi lemah antara kuesioner BCTQ gejala klinis seperti nyeri pada siang (r=0,232) dan malam hari (r=0,205), serta frekuensi nyeri yang membangunkan pasien saat malam hari (r=0,207) dan BCTQ status fungsional seperti kesulitan mengancing pakaian (r=0,351), mandi dan berpakaian (r=0,247) serta melakukan pekerjaan rumah tangga (r=0,216). Kesimpulan: Total skor BCTQ status fungsional sebesar 2,13 dapat memprediksi 61,5% kemungkinan pasien mengalami derajat keparahan STK sedang-berat (Klasifikasi 3-6) dengan sensitivitas 38,2% dan spesifisitas 85%. Kuesioner BCTQ dapat dipakai untuk melengkapi dan mendukung penilaian derajat keparahan STK namun tidak dapat menggantikan pemeriksaan elektrofisiologis dalam menentukan diagnosis dan derajat keparahan STK secara obyektif.
Kata Kunci: Sindrom terowongan karpal, gejala klinis, status fungsional, pemeriksaan hantar saraf, BCTQ, derajat keparahan


Background: The diagnosis of carpal tunnel syndrome (CTS) requires concordance between clinical symptoms, physical examination, and electrodiagnostic tests. Early severity assessment can provide better therapeutic options and prognosis for patients. The Boston Carpal Tunnel Questionnaire (BCTQ) assesses the severity of CTS based on clinical symptoms and functional status. However, the correlation between this questionnaire and nerve conduction studies as the standard reference, remains inconsistent. This study aims to evaluate the correlation between severity degree and functional status in CTS patients using the BCTQ and median nerve conduction studies. Methods: This cross-sectional study was conducted at the neurology outpatient clinic of Cipto Mangunkusumo National Central General Hospital on CTS patients diagnosed by nerve conduction studies and agreed to complete the BCTQ. Patient characteristics and examination results were described in percentages, and coefficient correlation was analyzed using Spearman's test. Results: The study included 54 subjects, 43 of whom were women (79.6%), with a mean age of 50.94 ± 10.82 years. The majority had moderate severity (37%). The mean total BCTQ symptom score was 2.40 ± 0.87, and the mean total functional status score was 1.63 (1–4.13). Weak correlations were found between BCTQ clinical symptoms such as daytime pain (r = 0.232), nighttime pain (r = 0.205), frequency of pain waking patients at night (r = 0.207), and functional difficulties such as buttoning clothes (r = 0.351), bathing and dressing (r = 0.247), and performing household chores (r = 0.216). Conclusion: A total BCTQ functional status score of 2.13 predicts a 61.5% likelihood of moderate-to-severe CTS (Grade 3–6) with 38.2% sensitivity and 85% specificity. The BCTQ can complement and support CTS severity assessment but cannot replace electrophysiological examinations for objective determination of diagnosis and severity degree.
Keywords: Carpal tunnel syndrome, clinical symptoms, functional status, nerve conduction studies, BCTQ, severity degree