Impact of Walking Aids on the Occurrence of Carpal Tunnel Syndrome in Rehabilitation

The current evidence indicates that the short-term use of walking aids elicits pressure-induced anatomical changes of the median nerve and that long-term use of walking aids leads to a significant percentage of stroke patients developing clinical symptoms of carpal tunnel syndrome. We will investigate the consequences of using technical walking aids for gait in a broader population of rehabilitation patients. The rehabilitation setting per se may be considered a useful clinical 'human pathological model' for peripheral nerve entrapment. Recruited patients will be naïve to previous use of walking aids and de novo will start using them for gait rehabilitation, regardless of the underlying disease. This intervention model will allow us to identify clinical, electrophysiological, and anatomical changes of the median nerve due to the daily direct pressure elicited by walking aids. We consider that a one-month duration of use of walking aids is needed to observe detectable changes in electrophysiological and ultrasonographical assessment to elicit entrapment neuropathies in patients prone to developing them.

Inclusion criteria

• admitted into an in-patient rehabilitation unit
• Functional Ambulation Category ≥ 1
• de novo need for a walking aid
• at least one functional upper limb
• expected duration of need for walking aid at least one month

Exclusion criteria

• less than 18 years old
• current use of walking aid or use of a walking aid less than 6 months ago)
• difficulty filling out questionnaires or understanding instructions in French
• medical contraindications to the use of walking aids
• refusal to sign the consent form.