Carpal tunnel syndrome (CTS) is a commonly diagnosed upper extremity neuropathy with a prevalence of 3.7% in the general population. The need to identify effective and economical conservative management strategies for the treatment of CTS is critical. The purpose of this randomized controlled clinical trial was to evaluate the effectiveness of a non-traditional wrist splint combined with tendon and nerve gliding exercises for the treatment of CTS. Sixty-one subjects diagnosed with mild to moderate CTS enrolled in the study. Fifty-one subjects completed the study. After completing the CTS history and demographic questionnaire, the CTS Symptom Severity and Functional Status Scale, the Disabilities of the Arm Shoulder and Hand (DASH) questionnaire, and a physical examination subjects were randomly assigned to a group. The FAB-EX (n=13) and the FAB-NOEX (n=14) received the fabricated wrist splint, which supported the wrist and metacarpophalangeal (MCP) joints. The FAB-EX also received exercises. The OTS-EX (n=13) and the OTS-NOEX group (n=11) received an off the shelf wrist cock-up splint. The OTS-EX also received exercises. Subjects were instructed to wear either splint all night, for 4 weeks and if applicable, perform exercises 3 times a day. At 4 weeks subjects completed the same measures given at baseline. At 8 weeks, subjects were mailed the CTS Symptom Severity and Functional Status Scale, the DASH, and an exit survey. 2 x 2 x 3 mixed analysis of variances (ANOVA) were performed on the subjective measures and 2 x 2 x 2 mixed ANOVAs were performed on the objective measures. All groups, over time, demonstrated a significant improvement on the CTS Symptom Severity (p < .001) and Functional Status Scale (p < .001), DASH (p < .001), tip pinch (p < .008), and palmar pinch (p < .034). Subjects randomized to the non-traditional fabricated wrist/MCP splint demonstrated significant improvement on the CTS Symptom Severity (p < .014) and Functional Status Scale (p < .029). There were no significant findings between the groups who received exercises and the groups who did not receive exercises. The results of this study support the use of a fabricated wrist/MCP splint for the treatment of CTS.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12012005-141442 |
| Date | 01 December 2005 |
| Creators | Brininger, Teresa Lucente |
| Contributors | Joan C. Rogers, PhD, OTR/L, Robert J. Goitz, MD, Zong-Ming Li, PhD, Margo B. Holm, PhD, OTR/L, Nancy A. Baker, ScD, OTR/L |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12012005-141442/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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