Clinical and electrophysiological evaluation of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome

Abstract

[Purpose] To prospectively assess the effectiveness of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome (CTS) by using clinical scores and nerve conduction studies (NCS). [Subjects and Methods] Forty-one patients enrolled in the study were clinically evaluated by a symptom severity scale (SSS) and functional status scale (FSS), and were electrophysiologically evaluated by conventional NCS; distal motor latency (DML), sensory conduction velocity (SCV), and difference in sensory latency between the median and ulnar nerves (ΔDSL) were measured. Subjects were treated with wrist splinting. Patients who showed no improvement in symptoms were treated with other conservative treatments, the remaining patients continued to wear splints. SSS, FSS, and NCS were evaluated after splinting as well. [Results] The follow-up was completed in 20 patients (31 wrists) with splinting. SSS and FSS decreased, the DML shortened and ΔDSL decreased significantly after splinting for 3.03 ± 1.16 months. There were significant correlations between SSS and DML, SCV of wrist digit 2, and SCV of wrist digit 4. No correlations were found between SSS and ΔDSL, and FSS and the parameters of NCS. [Conclusion] Neutral wrist nocturnal splinting is effective in at least short term for CTS patients. There is a weak correlation between clinical scores and NCS, which suggests that both approaches should be used to effectively assess the therapeutic effect of CTS treatment.

Effect of myofascial release on electrophysiological and clinical measures of pregnant women with carpal tunnel syndrome

“…This can be explained by observations by Kruger et al [17], who showed motor latency improvement in the symptom relief group, while there was motor latency deterioration in the non-relief group; the motor latency improvement was possibly associated with the patient's perception of relief. in contrast, Weng et al [18] reported a significant decrease in median nerve dML and both SSS and FSS. They concluded that neutral wrist splinting at night was an effective method for CTS patients treatment.…”

Carpal Tunnel Syndrome: Evaluation of the Effects of Low‐Level Laser Therapy With Ultrasound Strain Imaging

“…Furthermore, low‐level laser therapy leads to an increase in myelin production, which results in nerve regeneration . In addition to low‐level laser therapy, wrist splinting is a widely used option for conservative treatment of CTS, especially in patients with mild or moderate CTS . Although some studies demonstrated that splinting provided significant improvement, especially in clinical symptoms of CTS, most of the studies revealed that the combination of low‐level laser therapy and splinting had better therapeutic outcomes for both clinical symptoms and electrophysiologic tests compared to splinting alone in the treatment of CTS .…”

The use of orthoses in the treatment of carpal tunnel syndrome. A review of the literature from the last 10 years

“…In the period of exacerbation of symptoms, it is advisable to use it also during the day during everyday activity [1,7]. Similarly, Weng et al [5] believe that wrist immobilization is an effective method of treatment, especially when it is also used during the day. Farahmand et al [14] suggest wearing the orthosis at night, and during the day only when the patients so wish.…”

“…Some authors, for example Lewis et al [11], suggest that immobilization in an orthosis should be combined with patient education and home exercises (flexor tendon sliding exercises) [11,12]. Similarly, Weng et al [5] recommended wearing an orthosis while sleeping, and additionally instructed patients to avoid bending their wrists during everyday activities such as washing clothes, cycling, working at the computer, and carrying heavy shopping bags. Kaplan et al [13] confirmed that the addition of kinesiotaping to the night use of the orthosis was more effective in achieving improvement than the orthosis alone or the additional use of paraffin in patients with mild and moderate CTS.…”

“…A review of the literature from the last 10 years quite clearly shows that immobilization of the wrist in the splint (orthosis) is the most effective, initial method of conservative treatment of carpal tunnel syndrome (CTS). The spe-cific advantages of the described method of treatment include: availability, low cost, good patient tolerance, simplicity and a negligible number of complications [1][2][3][4][5]. The American Academy of Orthopedic Surgeons (AAOS) guidelines on CTS suggest that there is strong evidence to support the use of splint (orthosis) fixation to improve Reumatologia 2022; 60/6 patient-reported outcomes [6].…”