Scientific/Clinical Article| Volume 33, ISSUE 4, P493-506, October 2020

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Using Carpal Tunnel Questionnaire in clinical practice: A systematic review of its measurement properties

Published:March 07, 2020DOI:


      • Carpal Tunnel Questionnaire (CTQ), also known as Boston Carpal Tunnel Questionnaire, is a reliable, valid, and responsive measure for assessing impairments in individuals with carpal tunnel syndrome.
      • Given its condition-specific assessment, the CTQ showed superior reliability and responsiveness compared to regional measures such as Disability of Arm, Shoulder, and Hand or generic health status measures such as Short-Form 36.
      • Clinicians using CTQ can consider 0.72 as minimal detectable change at 90% confidence interval (MDC90) for Symptom Severity Scale and 0.79 as MDC90 for Function Status Scale.
      • Similarly, clinicians using CTQ can consider 1.05 as minimal clinically important difference for Symptom Severity Scale and 1.13 as minimal clinically important difference for Function Status Scale.



      Carpal Tunnel Questionnaire (CTQ) is widely used for assessing condition-specific impairments in individuals with carpal tunnel syndrome (CTS) or for assessing outcomes after carpal tunnel surgery (carpal tunnel release [CTR]). A systematic review of its measurement properties can greatly facilitate its evidence-based use in clinical practice. The purpose of this study was to systematically locate, appraise, and synthesize the evidence concerning the reliability, responsiveness, validity, minimal detectable change (MDC), and minimal clinically important difference (MCID) for the CTQ and its scales.

      Study Design

      This is a systematic review of measurement properties.


      Using predefined keywords, PubMed, CINAHL, PsychInfo, and ProQuest were searched to locate primary studies that assessed measurement properties of the CTQ. The methodological quality of the included studies was assessed using a standardized tool. Data concerning the measurement properties were extracted and synthesized. The pooled estimates for the indices of test-retest reliability, standard error of measurement, responsiveness, MDC, and MCID were calculated from the included studies.


      A total of 34 articles were deemed eligible and included in this review. The methodological quality of these 34 studies was generally good. Most studies suggested that the CTQ and its scales had good test-retest reliability and internal consistency. However, few studies found that the Symptom Severity Scale had more than one factor. The responsiveness of the CTQ and its scales was excellent across the studies. The pooled estimates for the MDC90 and MCID for Symptom Severity Scale/Functional Status Scale were 0.72/0.79 and 1.05/1.13, respectively.


      The results of this review support the use of CTQ and its scales in assessing conditions-specific impairments in individuals with CTS or after CTR. However, an effort should be made to review and modify the content of the symptom severity scale due to multiple reports challenging its unidimensional structure.


      The totality of evidence emerging from this systematic review suggests that the CTQ and its scales provide reliable and valid estimate of impairments resulting from CTS or after CTR.


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      JHT Read for Credit

      Quiz: # 713

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        The study design is
        • a.
        • b.
          a systematic review
        • c.
        • d.
          a case series
      • # 2.
        The authors sought to appraise the __________________ of the CTQ
        • a.
          MCID and MDC
        • b.
          validity and reliability
        • c.
        • d.
          all of the above
      • # 3.
        The CTQ is typically used to assess
        • a.
          outcomes after carpal tunnel release
        • b.
          impairments from carpal tunnel syndrome
        • c.
          a and b above
        • d.
          none of the above
      • # 4.
        Almost ________ articles were found
        • a.
        • b.
        • c.
        • d.
      • # 5.
        The authors endorse the clinical use of the CTQ
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.