Interaction Effects of Wrist and Forearm Posture on the Prediction of Carpal Tunnel Syndrome Cases Within a Fish-Processing Facility

Deviated wrist posture has been implicated as a risk factor for carpal tunnel syndrome (CTS), although alone it has not been found to have a causal relationship with CTS. Studies investigating deviated wrist posture have quantified posture in a single plane of motion and not interactions of wrist postures in multiple planes. The objective of this cross-sectional study was to investigate the ability of wrist and forearm posture interaction effects to predict CTS among a population of fish processing operators. A total of 53 participants performing five job tasks were evaluated using electrogoniometers. Due to task asymmetry, each hand was evaluated separately and treated independently, providing 106 hands as data observations. Using logistic regression analysis it was found that a model including flexed (F); extended (E), the interaction of length of employment (LE) by FE, and the interaction of LE by FE by pronation/supination (PS) accurately classified 78% of all hands as cases or non-cases. The sensitivity of the final model was approximately 48%. The developed model was found to have superior predictive ability when compared to models not considering interaction terms, indicating that posture interactions may in fact have a significant effect on CTS alone.