RESUMEN
AIM: We conducted a prospective randomized parallel clinical trial comparing the efficacy of local steroid injection and nocturnal wrist splinting in patients with carpal tunnel syndrome (CTS). METHODS: The well-validated and disease-specific Boston Carpal Tunnel Questionnaire (BCTQ) was employed and its score at 4 weeks after treatment was used as the primary outcome measure. Important secondary outcomes included patient satisfaction, the change of an objective finger dexterity test and the side effects. RESULTS: Twenty-five patients in the local steroid group and 25 patients in the wrist splinting group completed the study procedures. At 4 weeks after treatment, there was significant improvement of the BTCQ scores in both the steroid group and splinting group. There was improvement of the finger dexterity test only in the steroid group but not in the splinting group. However, there was no statistically significant difference in the changes of BTCQ scores between the two groups after treatment. Patient satisfaction score was higher in the steroid group. Patients in the steroid group took fewer painkillers after treatment. Four patients developed side effects after splinting and three after local steroid injection, which was not statistically significant. CONCLUSION: Although local steroid injection and nocturnal wrist splinting were equally effective in the treatment of patients with CTS, only the former improved objective hand function. Local steroid injection also resulted in better patient satisfaction and less painkiller use without causing more side effects.
Asunto(s)
Síndrome del Túnel Carpiano/terapia , Procedimientos Ortopédicos/instrumentación , Férulas (Fijadores) , Esteroides/administración & dosificación , Anciano , Analgésicos/uso terapéutico , Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Carpiano/fisiopatología , Femenino , Hong Kong , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Procedimientos Ortopédicos/efectos adversos , Satisfacción del Paciente , Estudios Prospectivos , Recuperación de la Función , Esteroides/efectos adversos , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del TratamientoRESUMEN
We have previously shown that when traveling on a circular path, observers use the rotation in the retinal velocity field for path curvature estimation and recover their path of forward travel relative to their perceived instantaneous heading (L. Li, & J. C. K. Cheng, 2011). Here, we examined the contribution of reference objects and extra-retinal information about pursuit eye movements to curvilinear path perception. In Experiment 1, the display simulated an observer traveling on a circular path over a textured ground with and without tall posts while looking at a fixed target on the future path, along heading, or along a fixed axis in the world. We found that reference objects did not help path perception. In Experiment 2, extra-retinal signals about pursuit eye movements were introduced in two viewing conditions: one that corresponded to the natural case of traveling on a circular path when the body orientation is aligned with the instantaneous heading and one that corresponded to the unnatural case of traveling when the body orientation is fixed relative to the world. We found that extra-retinal signals support accurate path perception only for the natural case of self-motion when the body orientation is aligned with heading such that pursuit compensation helps stabilize the heading in the body-centric coordinate system.
Asunto(s)
Percepción de Movimiento/fisiología , Flujo Optico/fisiología , Orientación/fisiología , Seguimiento Ocular Uniforme/fisiología , Adulto , Señales (Psicología) , Femenino , Fijación Ocular/fisiología , Humanos , Masculino , Estimulación Luminosa/métodos , Retina/fisiología , Rotación , Adulto JovenRESUMEN
The visual strategies for the control of steering toward a goal include aligning one's instantaneous direction of travel (i.e., heading; J. J. Gibson, 1950) or the future path (J. P. Wann & D. K. Swapp, 2000) specified by optic flow with the target, equating the time to closure of the target-heading angle with the time to passage of the target (tau equalization, B. Fajen, 2001), or using the target egocentric direction and steering to center the target in the straight ahead or cancel the target optical drift (S. K. Rushton, J. M. Harris, M. Lloyd, & J. P. Wann, 1998). Supporting evidences for the use of these strategies in guiding steering or walking toward a goal were reported, but no consensus has been reached. In this study, by presenting participants with displays in which target egocentric direction was fixed and thus unavailable for steering to force participants to rely on information from optic flow for the control of self-motion, we systematically examined the use of the optic flow-based strategies in the visual control of steering toward a goal. We found that participants steered to align their heading with the target, supporting the use of the heading strategy. We found no evidence to support the use of the path or the tau-equalization strategy in the visual control of steering toward a goal.
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Percepción de Movimiento/fisiología , Orientación/fisiología , Desempeño Psicomotor/fisiología , Caminata , Adulto , Femenino , Humanos , Masculino , Estimulación Luminosa/métodos , Adulto JovenRESUMEN
We examined how people perceive their path of traveling from optic flow. Observers viewed displays simulating their traveling on a circular path over a textured ground, a random-dot ground, or a dynamic random-dot ground display in which dots were periodically redrawn to remove extended dot motion trajectories (flow lines) in the flow field. Five viewing conditions were tested in which the simulated observer gaze direction was pointed to (1) a target on the path at 30° away from the initial heading, (2) a target at 15° outside of the path, (3) a target at 15° inside of the path, (4) along the instantaneous heading, or (5) along the Z-axis of the simulated environment. Path performance was similar for all three display conditions, indicating that observers did not rely on flow lines to perceive path from optic flow. Furthermore, contrary to the idea that looking where you want to go provides accurate path perception, path perception was accurate only when the simulated observer gaze direction pointed in the instantaneous heading direction. In contrast, heading perception was accurate and not affected by path curvature regardless of the simulated gaze direction. The results suggest that heading perception is more robust than path perception.
Asunto(s)
Movimientos Oculares/fisiología , Percepción de Movimiento/fisiología , Orientación/fisiología , Estimulación Luminosa/métodos , Adulto , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
We examined what role motion-streak-like form information plays in heading perception. We presented observers with an integrated form and motion display in which random-dot pairs in a 3D cloud were oriented toward one direction on the screen (the form FOE) to form a radial Glass pattern while moving in a different direction in depth (the motion FOE). Observers' heading judgments were strongly biased toward the form FOE direction (weight: 0.78), and this bias decreased with the reduction of the salience of the global form structure in the Glass pattern. At the local level, the orientation of dot pairs in the Glass pattern can affect their perceived motion direction, leading to a shift of the perceived motion FOE direction in optic flow. However, this shift accounted for about half of the total bias. Using the measurements of the shifted motion FOE and the perceived form FOE directions, we found that at the global level, an optimal combination of these two cues could accurately predict the heading bias observed for the integrated display. Our findings support the claim that motion streaks are effective cues for self-motion perception, and humans make optimal use of both form and motion cues for heading perception.