Abstract

OBJECTIVE
To compare the effectiveness of an intensive lumbrical splint/stretch combination with 3 less intensive lumbrical splint/stretch combinations on carpal tunnel symptoms and function.
DESIGN
Randomized Clinical Trial.
SETTING
Outpatient hand therapy clinics.
PARTICIPANTS
Volunteers (N=124) with mild to moderate carpal tunnel syndrome.
INTERVENTIONS
A 4-week home regimen of nocturnal splints (lumbrical splints or cock-up splints) combined with stretches (lumbrical intensive or general) performed 6 times daily.
MAIN OUTCOME MEASURES
The effect of the intervention on carpal tunnel symptoms and function was examined with the Carpal Tunnel Symptom Severity and Function Questionnaire (CTQ) and Disabilities of the Arm, Shoulder, and Hand (DASH). We also evaluated whether subjects obtained surgery at 24 weeks.
RESULTS
There were significant main effects over time for all outcome measures at 4, 12, and 24 weeks. There was a significant interaction effect for the CTQ-Function and DASH at 12 weeks. Post hoc analyses indicated significant differences between the lumbrical splint/general stretch and general splint/lumbrical stretch groups and the other 2 groups. At 24 weeks, a significantly greater percentage of subjects in the general splint/lumbrical stretch group achieved a clinically important improvement on the CTQ-Function. By 24 weeks, only 25.5% of subjects had elected to undergo surgery.
CONCLUSIONS
A combination of a cock-up splint with lumbrical intensive stretches was the most effective combination for improvements in functional gains at 24 weeks postbaseline. Our findings support further evaluation of this combination as a method of conservative carpal tunnel syndrome treatment.

Links

Publisher Full Text

Authors

Baker NA, Moehling KK, Rubinstein EN, Wollstein R, Gustafson NP, Baratz M

Institution

Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA 15260, USA. nab36@pitt.edu

Source

Archives of physical medicine and rehabilitation 93:1 2012 Jan pg 1-10

MeSH

Adult
Aged
Ambulatory Care
Analysis of Variance
Carpal Tunnel Syndrome
Chi-Square Distribution
Combined Modality Therapy
Education, Medical, Continuing
Electromyography
Female
Follow-Up Studies
Hand Strength
Humans
Male
Middle Aged
Muscle Stretching Exercises
Pain Measurement
Range of Motion, Articular
Reference Values
Risk Assessment
Severity of Illness Index
Splints
Time Factors
Treatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22200381