Article

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.
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.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS