Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review (original) (raw)
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Systematic review of treatment methods for the carpal tunnel syndrome
Timisoara Physical Education and Rehabilitation Journal
The carpal tunnel syndrome is a common condition, localized at the hand and knuckle level, caused by a compression of the median nerve as it travels the rigid structures of the carpal tunnel. This phenomenon is, essentially, a compressive neuropathy.Aim: The purpose of our research is to comparatively analyze the treatment methods of the carpal tunnel syndrome: treatment by acupuncture, fascial manipulation, low-level laser therapy, cupping treatment, kinesiotaping, surgical treatment, orthosis method, nerve and tendon gliding exercises, and ultrasound therapy, based on the review of specialized articles relevant for the last 10 years.Methods: The research method consisted of 3 steps. First, we analyzed and selected 160 specialized articles, based on titles and key words; in the second step, we analyzed the summaries of the articles, thus, reducing the number to 50 articles. The third step consisted of selecting 7 relevant articles based on an article content review.Results: The res...
Archives of Physical Medicine and Rehabilitation, 2014
To achieve consensus on a multidisciplinary treatment guideline for carpal tunnel syndrome (CTS). Design: Delphi consensus strategy. Setting: Systematic reviews reporting on the effectiveness of surgical and nonsurgical interventions were conducted and used as an evidencebased starting point for a European Delphi consensus strategy. Participants: In total, 35 experts (hand surgeons selected from the Federation of European Societies for Surgery of the Hand, hand therapists selected from the European Federation of Societies for Hand Therapy, physical medicine and rehabilitation physicians) participated in the Delphi consensus strategy. Interventions: Not applicable. Main Outcome Measures: Each Delphi round consisted of a questionnaire, analysis, and feedback report. Results: After 3 Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis of CTS. The experts agreed that patients with CTS should always be instructed, and instructions combined with splinting, corticosteroid injection, corticosteroid injections plus splinting, and surgery are suitable treatments for CTS. Relevant details for the use of instructions, splinting, corticosteroid injections, and surgery were described. Main factors for selecting one of the aforementioned treatment options were identified as follows: severity and duration of the disorder and previous treatments received. A relation between the severity/duration and choice of therapy was found by the experts and reported in the guideline. Conclusions: This multidisciplinary treatment guideline may help physicians and allied health care professionals to provide patients with CTS with the most effective and efficient treatment available.
Comparison of three conservative treatment protocols in carpal tunnel syndrome
International Journal of Clinical Practice, 2006
The aim of this study was to investigate and compare the therapeutic effect of three different combinations in the conservative treatment of carpal tunnel syndrome (CTS) by means of clinical and electrophysiological studies. The combinations included tendon-and nerve-gliding exercises in combination with splinting, ultrasound treatment in combination with splinting and the combination of ultrasound, splinting, tendon-and nerve-gliding exercises. A total 28 female patients (56 wrists) with clinical and electrophysiologic evidence of bilateral CTS were studied. In all patient groups, the treatment combinations were significantly effective immediately and 8 weeks after the treatment. The results of the long-term patient satisfaction questionnaire revealed that symptomatic improvement is more prominent in the group treated with splinting, exercise and ultrasound therapy combination. Our results suggest that a combination of splinting, exercise and ultrasound therapy is a preferable and an efficacious conservative type of treatment in CTS.
A Pilot Study Comparing Two Manual Therapy Interventions for Carpal Tunnel Syndrome
Journal of Manipulative and Physiological Therapeutics, 2007
Objective: The purpose of this study was to determine the clinical efficacy of manual therapy interventions for relieving the signs and symptoms of carpal tunnel syndrome (CTS) by comparing 2 forms of manual therapy techniques: Graston Instrument-assisted soft tissue mobilization (GISTM) and soft tissue mobilization administered with the clinician hands.
Caspian Journal of Internal Medicine, 2020
Background: Manual therapy techniques are part of physiotherapy treatment of carpal tunnel syndrome (CTS) which are classified into two groups including nerve mobilization and mechanical interface mobilization. The aim of the study was to find which manual therapy method-technique directed to mechanical interface and nerve mobilization–has superior beneficial effects on clinical and electrophysiological findings in conservative management of patients with CTS. Methods: Thirty patients with CTS participated into two groups namely: mechanical interface and nerve mobilization in this randomized clinical trial. The intervention was performed three times weekly for 4 weeks. Mechanical interface mobilization was directed to structures around the median nerve at the forearm and wrist. Techniques of median nerve gliding and tension were used in the nerve mobilization group. The outcome measures included visual analogue scale (VAS), symptom severity scale (SSS), hand functional status scale ...
Manual Therapy Interventions For Carpal Tunnel Syndrome: A Review
2019
Carpal Tunnel Syndrome (CTS) is a debilitating condition which affects majority of the middle aged people in the community. This condition is predominant in females than the males. The condition may be affecting the patient‘s single hand (unilateral) or both hands (bilateral). The functional outcomes are very poor and patient may be deteriorating psychologically as well. Signs and symptoms of the CTS can be varied from mild to moderate to severe. This includes numbness or paresthesia along the distribution of the median nerve of hand, pain, atrophy of muscles, reduced hand grip strength etc. The people who are experiencing mild or moderate symptoms usually seek for conservative therapies including elctro therapeuatic modalities and manual therapy techniques. When the condition becomes chronic, the concern is more towards the surgical approaches that involves the carpal tunnel release and thereby releasing the median nerve compression. But majority of the patients with CTS are reluct...
Rheumatology International, 2012
We aimed to bring a more understandable and applicable technique to the literature instead of ''massage therapy'' in CTS. We compared our new technique with the splint wear, of which the efficacy in CTS has been proven with many studies. Eighty-four patients between 31 and 65 years of age were included in the study. The patients were divided into two equal groups. In the first group, splint and ''Madenci'' hand massage technique were applied, and in the second group only splint was applied. A splint was provided for all patients with tendon and nerve gliding exercises, and also when needed analgesic drugs were given. When the pretreatment and posttreatment parameters were compared via repetitive measurement analysis, it was found that PGA and MDPGA were significantly decreased in both groups (P = 0.001), whereas grip strength was significantly increased (P = 0.001). While no statistically significant difference was found between the groups regarding pretreatment values (P [ 0.05), the posttreatment PGA, MDPGA, and grip strength scores were significantly improved in Group I compared to Group II (P \ 0.05). To the best our knowledge, the present study is the first and largest study in the literature conducted on the massage technique that will contribute to the treatment of CTS. As this new massage technique is easy for self-application, cheap, and practical, every patient with CTS can apply the massage to him/ herself easily.