Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial.

Abstract

OBJECTIVE:

To compare the effects of a neutral wrist and metacarpophalangeal (MCP) splint with a wrist cock-up splint, with and without exercises, for the treatment of carpal tunnel syndrome (CTS).

DESIGN:

A 2x2x3 randomized factorial design with 3 main factors: splint (neutral wrist and MCP and wrist cock-up), exercise (exercises, no exercise), and time (baseline, 4wk, 8wk).

SETTING:

Subjects were evaluated in an outpatient hand therapy clinic.

PARTICIPANTS:

Sixty-one subjects with mild to moderate CTS; 51 subjects completed the study.

INTERVENTIONS:

There were 4 groups: the neutral wrist and MCP group and the neutral wrist and MCP-exercise group received fabricated customized splints that supported the wrist and MCP joints; the wrist cock-up group and the wrist cock-up-exercise group received wrist cock-up splints. The neutral wrist and MCP-exercise and wrist cock-up-exercise groups also received tendon and nerve gliding exercises and were instructed to perform exercises 3 times a day. All subjects were instructed to wear the assigned splint every night for 4 weeks.

MAIN OUTCOME MEASURES:

We used the CTS Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) to assess CTS symptoms and functional status.

RESULTS:

Analysis of variance showed a significant main effect for splint and time on the SSS (P<.001, P=.014) and FSS (P<.001, P=.029), respectively. There were no interaction effects.

CONCLUSIONS:

Our results validate the use of wrist splints for the treatment of CTS, and suggest that a splint that supports the wrist and MCP joints in neutral may be more effective than a wrist cock-up splint.

• Authors: Teresa L Brininger, Joan C Rogers, Margo B Holm, Nancy A Baker, Zong-Ming Li, Robert J Goitz
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 88 Issue 11 Pg. 1429-35 (Nov 2007) ISSN: 1532-821X [Electronic] United States
• PMID: 17964883 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Aged, 80 and over
• Carpal Tunnel Syndrome (diagnosis, physiopathology, rehabilitation)
• Combined Modality Therapy
• Equipment Design
• Exercise Therapy
• Female
• Follow-Up Studies
• Humans
• Male
• Median Nerve (physiopathology)
• Metacarpophalangeal Joint (physiopathology)
• Middle Aged
• Muscle Weakness (diagnosis, physiopathology, rehabilitation)
• Physical Therapy Modalities
• Splints
• Tendons (physiopathology)
• Wrist Joint (physiopathology)