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June 9, 1999

Yoga for Carpal Tunnel Syndrome

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(22):2087-2089. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-22-jbk0609

To the Editor: As occupational medicine specialists, we read with interest the suggestion of Dr Garfinkel and colleagues1 that yoga may benefit patients with CTS. Unfortunately, methodological flaws substantially limit inferences drawn from this article. Among them is the authors' failure to control for potential confounding of intervention efficacy by a number of important variables. For example, 40% of the control and 23% of the comparison populations were men. The groups also differed in baseline grip strength (controls, 183.9 mm Hg; intervention group, 161.6 mm Hg). The sex differential may account for the difference in grip strength, or the results may be independent; either scenario might affect treatment response and bias the results. Other uncontrolled potential confounders include current treatment and CTS severity. Without controlling for the effects of these potential confounders, estimates of intervention efficacy may be biased.

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