scholarly journals Comparison in Wrist Splints and Wrist-­Metacarpophalangeal Splints Use for Patients with Carpal Tunnel Syndrome Evi

1970 ◽  
Vol 1 (1) ◽  
pp. 63-69
Author(s):  
Evi Yuliani ◽  
Widjajalaksmi Kusumaningsih ◽  
Vitriana ◽  
Hadyana Sukandar

Objectives : To compare the effect of both wrist splint and wrist-­metacarpophalangeal splint at night using Symptom Severity Scale (SSS) and Functional Status Scale (FSS) and to know the validity andreliability of Indonesian version of SSS dan FSS.Methods : This study enrolled 19 subjects in each of the two groups that were given neutral wrist splint and exercise in one group (group A) and neutral wrist-­metacarpophalangeal splint and exercise in theother group (group B).Results : Indonesian version of SSS and FSS have been proven valid with rs lowest = 0.360 and highest 0.810(>0.3) and relable with α SSS=0.762 dan FSS=0.781 (>0.7). There were significant improvement score of SSS and FSS in each group with p value <0.001. There were greater functional improvement in group treated with wrist-­metacarpophalangeal splint (group B) with p value = 0.036 (p<0.05) Conclusions: There was improvement of SSS and FSS in both groups of study with greater improvement of in wrist-­hand splint group.Keywords: Carpal Tunnel Syndrome, wrist splint, wrist-­hand splint,,nerve and tendon gliding, SSS, FSS.

2019 ◽  
Vol 11 (1) ◽  
pp. 24-27
Author(s):  
Nadia Siddiquee ◽  
Farzana Akonjee Mishu ◽  
Monzur Ahmed ◽  
Shaila Sharmin Shahnewaz ◽  
Hashina Bilkish Banu ◽  
...  

This randomized controlled trial was conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhaka during the period from March 2014 to August 2014 to evaluate the effect of ultrasound therapy (UST) on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly divided in two groups by lottery. Group-A was treated with UST, Exercise, Wrist splint, non steroidal anti inflammatory drugs (NSAIDs) and group-B received Exercise, Wrist splint and NSAIDs. Treatment continued for a period of 6 weeks. Group-A were compared to group B by both Visual Analog Scale (VAS) and Levine Symptom severity scale(LSSS) after 3 weeks and 6weeks of treatment. The result showed mean VAS at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3) In Group-A was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W6) after 6 weeks. Mean LSSSat pretreatment (W0),1st follow up after 3 weeks (W 3), 2nd follow up (W 6) after 6 weeksin group-A was 31.64±1.55, 14.32 ± 2.29 and 14.31 ±1.12 respectively,and in group-B was 31.3±0.74,18.51±0.92and 18.31 ± 0.42 respectively.This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 24-27


2020 ◽  
Vol 185 (11-12) ◽  
pp. e2049-e2054
Author(s):  
Michele A Gatheridge ◽  
Elsa A Sholty ◽  
Alexander Inman ◽  
Meghan Pattillo ◽  
Frank Mindrup ◽  
...  

Abstract Introduction The purpose of this study was to evaluate optimal neutral wrist splint duration in treatment-naive mild and mild to moderate carpal tunnel syndrome (CTS). Neutral wrist splinting is a conservative treatment for CTS; however, no clear guidelines exist for how long splinting should be prescribed for optimal outcomes. Materials and Methods In this prospective clinical trial subjects were assigned to wear a neutral wrist splint for 6 (group A) or 12 weeks (group B). Symptom and functional outcomes were assessed by questionnaire at baseline, 6 and 12 weeks. Median nerve sensory and motor latencies were recorded at baseline and 12 weeks. Pretreatment, midtreatment, and posttreatment measures were compared within and between treatment groups where applicable. This study was approved by the United States Air Force Academy institutional review board. Results A total of 30 subjects (37 hands) were randomized to 2 treatment groups. Mean symptom severity and median sensory peak latency significantly improved in both groups at 12 weeks, without a significant difference between groups. Mean functional severity significantly improved only in group A. Conclusion Neutral wrist splint for 6 weeks resulted in better clinical improvements in patients with untreated mild and mild to moderate CTS. There was no additional benefit in extending splinting 6 additional weeks. This is the first study to compare duration of wrist splint use beyond 8 weeks. A larger sample size is needed to identify the reason for lack of functional improvement in group B. Long-term follow-up of this cohort will be helpful to determine the natural history of initial wrist splint use.


2019 ◽  
Vol 9 (1) ◽  
pp. 70-73
Author(s):  
Nadia Siddiquee ◽  
Farzana Akonjee Mishu ◽  
Sohely Rahman ◽  
Abul Khan Ahmed Zaman

Background: Carpal tunnel syndrome is a common condition in medical practice. Ultrasound therapy is a common non-surgical treatment of carpal tunnel syndrome including other modalities like the use of antiinflammatory agents and exercise. This study was designed to evaluate the effect of ultrasound therapy for the relief of symptoms of patients with carpal tunnel syndrome. Methods: This was a randomized controlled trial. This study as conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhakaduring the period from March 2014 to August 2014to evaluate the effect of ultrasound therapy on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly. The patients were divided in two groups by lottery. For group A patients treatment schedule (Ultrasound therapy+ Exercise+ Wrist splint +NSAIDs) and group B (Exercise+ Wrist splint+ NSAIDs) were applied for a period of 6 weeks. Group A were compared to group B byVisual Analog Scale after 3weeks and 6weeks of treatment.Statistical analysis of the finding was done with the help of statistical package for social science version (SPSS) 19. The student t test used to analyze the level of significance, p< 0.05. Results: This study showed mean visual analogue scale (VAS) at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3). Mean Visual Analogue scale in groupA- was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W 6) after 6 weeks . So these result reveled that group-A is significantly better than group-B. Conclusion: This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. Birdem Med J 2019; 9(1): 70-73


2015 ◽  
Vol 123 (5) ◽  
pp. 1230-1237 ◽  
Author(s):  
Daniele Vanni ◽  
Francesco Saverio Sirabella ◽  
Renato Galzio ◽  
Vincenzo Salini ◽  
Vincenzo Magliani

OBJECT The purpose of this study was to assess the effectiveness and safety of an alternative minimally invasive technique for the treatment of carpal tunnel syndrome (CTS). METHODS This was designed as a prospective, randomized, open-label, blinded end point evaluation (PROBE) study. The active comparison was double tunnels technique (DTT) (Group A, 110 patients) versus standard open decompression of the median nerve (control [Group B], 110 patients). Patient recruitment started in January 2011. The primary outcomes were the functional Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores and visual analog scale (VAS) scores for pain (pVAS) at Weeks 2 and 4, and at Months 3, 6, and 12. The secondary outcome was the aesthetics (aVAS) score at Weeks 2 and 4, and at Months 3, 6, and 12. RESULTS The Student t-test and ANOVA were used, and the results were considered statistically significant if the p value was ≤ 0.05 for continuous variables. The DTT is a tissue-sparing approach that allows the surgeon to limit the length of the incision (0.6 ± 0.05 cm) and to respect the palmar fascia and the subcutaneous tissue. Recovery from wrist pain, night pain, numbness, stiffness, and weakness was achieved more effectively and quickly compared with the standard approach. Better BCTSQ, pVAS, and aVAS scores were observed in Group A. CONCLUSIONS The DTT is a safe and effective approach for the treatment of CTS. This technique entails faster recovery times, better aesthetic outcomes, and lower risks of complications.


2008 ◽  
Vol 108 (5) ◽  
pp. 1033-1036 ◽  
Author(s):  
Vittoria Nazzi ◽  
Angelo Franzini ◽  
Giuseppe Messina ◽  
Giovanni Broggi

✓In the past few years, several different minimally invasive surgical techniques have been proposed to decompress the median nerve at the wrist. Use of these techniques has become widespread due to fewer local complications, faster functional recovery, and reduced surgical time. In this paper the authors compare 3 different minimally invasive surgical techniques used at their institution in the past 13 years. Between January 1994 and January 2007, 891 patients underwent 1272 surgeries at the authors' institution for carpal tunnel syndrome (CTS), for which a minimally invasive technique was used. In 473 cases (Group A), the transillumination technique with a single wrist incision and a “carpalotome” (a modified Paine retinaculotome) was used; in 216 cases (Group B), transillumination was abandoned and a single linear wrist incision for access with the carpalotome was performed; and in 583 cases (Group C), the techniques were further modified by making a second incision in the palm using the carpalotome. All 3 groups of patients were homogeneous for age, sex, and duration of the symptomatology. In 90% of the patients in Group A, in 88% of those in Group B, and 99.8% of patients in Group C, complete remission of symptoms was obtained. Due to persistence of symptoms, 44 patients in Group A, 24 in Group B, and only 1 in Group C underwent a repeated operation with the open technique. The only surgical complication requiring repeated operation of the 1272 operations was a lesion of the primitive median artery (1 patient in Group C). The technique of median nerve decompression at the wrist that was used for patients in Group C represents a valid alternative for treatment of CTS.


1994 ◽  
Vol 19 (5) ◽  
pp. 636-637 ◽  
Author(s):  
T. KONISHIIKE ◽  
H. HASHIZUME ◽  
K. NISHIDA ◽  
H. INOUE ◽  
T. NANBA

Patients receiving haemodialysis for more than 10 years were selected for this study in order to clarify an apparent sequential association of cystic lesions of carpal bones and carpal tunnel syndrome. X-rays and computed tomographs of 138 hands of 69 patients revealed cystic radio-lucency of carpal hones in 35% of the hands. Radiographs were classified into three groups: Group A—cyst growing, Group B—cyst not growing, and Group C—cyst absent. The prevalence of carpal tunnel syndrome was 100% (27/27) in Group A, 5.6% (1/18) in Group B, and 6.5% (6/93) in Group C. Growth of the cyst precedes the development of carpal tunnel syndrome by about 2 or 3 years. Growth of the bone cyst indicates that inflammation had already extended to the tenosynovium and median nerve. Cystic radio-lucency of the carpal bones appears to be a useful indicator of the onset of carpal tunnel syndrome.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Giorgio Pajardi ◽  
Paola Bortot ◽  
Veronica Ponti ◽  
Chiara Novelli

We investigated the clinical usefulness of oral supplementation with a combination product containing alpha-lipoic acid, curcumin phytosome, and B-group vitamins in 180 patients with carpal tunnel syndrome (CTS), scheduled to undergo surgical decompression of the median nerve. Patients in Group A (n=60) served as controls and did not receive any treatment either before or after surgery. Patients in Group B (n=60) received oral supplementation twice a day for 3 months both before and after surgery (totaling 6 months of supplementation). Patients in Group C (n=60) received oral supplementation twice a day for 3 months before surgery only. Patients in Group B showed significantly lower nocturnal symptoms scores compared with Group A subjects at both 40 days and 3 months after surgery (bothPvalues<0.05). Moreover, patients in Group B had a significantly lower number of positive Phalen’s tests at 3 months compared with the other study groups (P<0.05). We conclude that oral supplementation with alpha-lipoic acid, curcumin phytosome, and B-group vitamins twice a day both before and after surgery is safe and effective in CTS patients scheduled to undergo surgical decompression of the median nerve.


2018 ◽  
Vol 5 (1) ◽  
pp. 1923-1930 ◽  
Author(s):  
Reza Sabet ◽  
Karamatollah Rahmanian ◽  
Abdolreza Sotoodeh Jahromi ◽  
Abdolhossein Madani

Background: The most common type of neuropathy in adults is carpal tunnel syndrome (CTS) which is caused by compression of the median nerve at the wrist. Methods: This quasi-experimental study was conducted to determine the efficacy of gabapentin on nerve conduction studies in patients with mild CTS. The patients with mild CTS were randomly allocated into two groups. Group A received naproxen alone (500 mg/day, orally) while group B received both gabapentin (100-300 mg) and naproxen (500 mg/day, orally) for two months. Sensory nerve conduction velocity (SNCV) and distal motor latency (DML) were performed at baseline and two months after treatment. Results: There were no significant differences between the two groups with regards to the outcome parameters before initiation of intervention. The SNCV and DML showed no significant improvements in group A (p>0.05), whereas for group B the SNCV and DML of the median nerve were significantly improved at two months after treatment (p<0.001). Conclusion: Gabapentin was found to be effective for SNCV and DML in patients with mild CTS over a two-month period.


2016 ◽  
Vol 27 (4) ◽  
pp. 98-103
Author(s):  
Neeraj Gupta ◽  
Sunil Goenka ◽  
Manoj Verma

Abstract Introduction Carpal tunnel syndrome is the most common compressive neuropathy of upper extremity affecting predominantly females of middle age group. Symptoms include pain, paracsthesia, numbness in median nerve distribution of hand. Study design Comparative type of interventional study. Study area Department of Physical Medicine and Rehabilitation, SMS Medical College and attached group of hospitals, Jaipur. Duration of study One and a half years April 2014-October 2015. Aims and objective To compare the efficacy of local ultrasound therapy and local corticosteroid injection for carpal tunnel syndrome management. Study population A total of sixty patients with CTS (agep>18 years) were randomly assigned to the steroid treatment plus splinting(group A) or ultrasound treatment plus splinting(group B). Results The mean age of study population was 45.47±12.24 years with males comprising 13.3% and females 86.6% of whole study. At baseline all outcome variables were comparable statistically in both the groups (p>0.05). In follow-up assessment at 8th week, statistically significant improvement was obtained in all clinical and electrophysiological parameters in group A: Grip strength, symptom severity score, functional status score, median DML, sensory nerve conduction velocity (p<0.001 for each). Also the group B showed improvement in all parameters except grip strength. At the end of 24th week all outcome variables showed decline in improvement as comparative to 8th week, but still they were better than baseline in both groups. There was no significant difference between the groups in outcome variables except for the grip strength. Conclusion Ultrasound treatment provided improvement comparable to steroid injection in all clinical and electrophysiological parameters in patients with CTS except grip strength. Overall steroid therapy is more effective than ultrasound therapy. Effectiveness of treatment persist for at least 6 months then it lessens, so long follow-up is required.


Author(s):  
Ahmed M. Ahmed ◽  
Osama G. Hassan ◽  
Ahmed A. Khalifa

Abstract Background Carpal tunnel syndrome (CTS) is a common upper limb entrapment neuropathy; severe cases are treated surgically and mild to moderate can be managed conservatively. The purpose of this systematic review and meta-analysis was to define the efficacy of gabapentin as an adjuvant to splinting in the treatment of mild to moderate CTS. Methods A systematic search through 13 databases, randomized clinical trials (RCTs) reporting the use of gabapentin with splinting in CTS were included and analyzed. Results Three RCTs including 170 patients were eligible. There was no significant difference between gabapentin plus splinting and splinting alone in 5 measured parameters: (1) Symptom Severity Scale (SSS) [MD (95% CI) = − 0.76 (− 2.46–0.93), p = 0.378], (2) Functional Status Scale (FSS) [MD (95% CI) = − 0.23 (− 1.40–0.94), p = 0.701], (3) visual analogue scale (VAS) to assess pain [MD (95% CI) = − 0.6 (− 1.47–0.27), p = 0.174], (4) Grip strength [MD (95% CI) = − 0.11 (− 0.70–0.48), p = 0.718], and (5) pinch strength [MD (95% CI) = 0.72 (− 0.10–1.54), p = 0.083]. Conclusion This review provides low-quality evidence that gabapentin plus nocturnal splinting is not superior to splinting alone. More high-quality trials are needed to determine the role of this drug as an adjuvant in the management of CTS.


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