Comparison of static wrist splint with static wrist and metacarpophalangeal splint in carpal tunnel syndrome

Bulut, Gul Tugba; Caglar, Nil Sayiner; Aytekin, Ebru; Özgönenel, Levent; Tutun, Sule; Demir, Saliha Eroglu

doi:10.3233/bmr-140580

Cited by 9 publications

(10 citation statements)

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“…This migration of lumbricals into the CT space is restricted by splints that incorporate the MCP joints but not the traditional splint, which allowed full finger flexion. The improvements demonstrated by the MCP splint over the traditional wrist splint in this study consolidate the findings from previous research 20–23…”

Section: Discussionsupporting

confidence: 89%

“…Several splint types have been used as conservative interventions to improve the symptoms of CTS. The traditional wrist cock-up splint, which immobilises the wrist in 0–5° of extension, is the most prevalent splint design used in hand therapy clinics, although the evidence of its effectiveness in comparison to other splint types is lacking 22 23. In this RCT, we used multiple standardised outcome measures to compare the effectiveness of the traditional wrist cock-up splint in comparison to a splint that incorporates the wrist and MCP joints to treat mild-to-moderate CTS.…”

Section: Discussionmentioning

confidence: 99%

“…A limitation of this study is that they compared the splint intervention group with a control group that did not receive any treatment. Three other studies found that splints that restricted the wrist and MCP had better outcomes than splinting the wrist only 21–23. A limitation of these studies is that their patients were instructed to wear splints only at night and were permitted to use their hands freely during the day.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial

Nadar,

Alotaibi,

Manee

2023

BMJ Open

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ObjectivesTo compare the efficacy of a traditional cock-up splint, which supports the wrist only, with a modified splint that supports the wrist and the metacarpophalangeal (MCP) joints of the medial four digits in the treatment of carpal tunnel syndrome (CTS).DesignAn assessor-blind randomised controlled trial.SettingHospital-based hand therapy clinics.ParticipantsFifty-nine adults with mild-to-moderate CTS were randomly assigned to wear a wrist splint (control group) or an MCP splint (intervention group) for 6 weeks.Outcome measuresThe standardised outcome measures used included grip and pinch strength, the static two-point discrimination test, Phalen’s manoeuvre test, Tinel’s sign and the Boston CTS Questionnaire.ResultsBoth groups improved significantly from splint use in some clinical features. The wrist splint and the MCP splint groups had significant improvements in lateral pinch strength (p=0.032 and p=0.002, respectively), two-point discrimination of the thumb (p=0.003 and p=0.041, respectively), two-point discrimination of the index (p=0.035 and p=0.023, respectively) and the Phalen’s manoeuvre symptoms (p=0.025 and p=0.002, respectively). The MCP splint group had additional improvements over the wrist splint group in tip pinch (p=0.012) and Palmar pinch (p=0.011) strength.ConclusionSplinting is a practical and effective intervention option for improving the symptoms of CTS. A wrist splint that incorporates the MCP joints is more effective than the traditional wrist-only splint, with long-lasting improvements that remained consistent after 6 months of the splint intervention. Using the more effective MCP splint may consequently reduce disability, facilitate return to work and lower the associated costs.Trial registration numberISRCTN13189602.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial

Nadar,

Alotaibi,

Manee

2023

BMJ Open

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“…Phalen's test [8] time for symptoms of tingling and numbness present Carpal tunnel syndrome Questionnaire (CTSQ) [9] -to assess problem because of CTS Pronator compression test [2] -time for pain to present Visual analog scale(VAS) [3] -for intensity of tingling, numbness and pain. Table 4 shows the outcomes at pre intervention, at 1 week, 2 weeks and at 4 weeks of physiotherapy treatment.…”

Section: Discussionmentioning

confidence: 99%

Compression of Median Nerve at the Carpal Tunnel and Pronator Teres Syndrome - A Case Report

Limbachiya

Sheth

Gahlot

2022

Int J Health Sci Res

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The median nerve can be compressed at four sites in its course - under the ligament of Struthers, between the two heads of the pronator teres, at bicipital aponeurosis and at the carpal tunnel. The presentation for each may be similar. But the management for each would be different focusing on the site of affection. Presenting the diagnosis and management of a case of carpal tunnel syndrome along with proximal compression of the median nerve. Key words: Median Nerve Compression, Carpal Tunnel Syndrome, Pronator Teres Syndrome, Carpal Tunnel Syndrome Questionnaire, Pronator Compression Test.

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“…Splinting, which is the most commonly recommended conservative treatment option for the CTS, restricts wrist movements and decreases grip strength. [14,15] In order to minimize the impact of nerve injury and immobilization, unsplinted patients with moderate or severe CTS, and who demonstrated electrodiagnostic motor and sensory deficits, were selected for the study.…”

Section: Discussionmentioning

confidence: 99%

Isokinetic evaluation of wrist muscle strength in patients of carpal tunnel syndrome

Ağırman

Kara

Durmuş

et al. 2017

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada orta veya ağır karpal tünel sendromu (KTS) hastalarında el bileğinin fleksiyon, ekstansiyon, supinasyon, pronasyon, radial ve ulnar deviyasyon kas gücünün izokinetik özellikleri araştırıldı. Hastalar ve yöntemler: Ocak 2016-Nisan 2016 tarihleri arasında yapılan bu çalışmada orta veya ağır KTS olan 13 hasta (23 el) (2 erkek, 11 kadın; ort. yaş 45 yıl; dağılım 29-60 yıl) ile altı sağlıklı kontrol deneği (12 el) (2 erkek, 4 kadın; ort. yaş 41 yıl; dağılım 27-63 yıl) karşılaştırıldı. El bileği fleksiyon, ekstansiyon, supinasyon, pronasyon, radial ve ulnar deviasyon kas gücü izokinetik dinamometre ile 30º/saniye (5 set) açısal hızda ölçüldü. Kavrama gücü el dinamometresi ile (kilogram) ölçüldü. Klinik değerlendirme için Boston Anketi kullanıldı. Bulgular: Karpal tünel sendromu hastalarında kavrama gücü (p= 0.003); el bileği fleksiyonu 30º/saniye (p= 0.014); ekstansiyonu 30º/saniye (p= 0.016) ve ulnar deviasyonu 30º/saniye (p= 0.017) kas güçleri kontrol grubuna göre daha düşük idi. Semptom süresine göre yapılan değerlendirme, izokinetik testlerde pronasyon 30º/saniye (p=0.039, r= -0.432) ve ulnar deviasyon 30º/saniye (p= 0.034, r= 0.443) dışında KTS hastalarında anlamlı ilişki göstermedi. Boston Anketi, kavrama gücü ve izokinetik test sonuçları arasında anlamlı ilişki saptanmadı. Sonuç: El bileği kas gücünün izokinetik dinamometreler ile sayısal olarak ölçülmesi KTS hastalarının konservatif egzersiz tedavileri ve motor değerlendirmelerinde faydalıdır.Anahtar sözcükler: Karpal tünel sendromu; el gücü; kas gücü dinamometresi. ABSTRACTObjectives: This study aims to investigate the isokinetic characteristics of wrist strength in flexion, extension, supination, pronation, radial, and ulnar deviation in patients with moderate or severe carpal tunnel syndrome (CTS). Patients and methods: Thirteen patients (23 hands) (2 males, 11 females; mean age 45 years; range 29 to 60 years) with moderate or severe CTS were compared to six healthy control subjects (12 hands) (2 males, 4 females; mean age 41 years; range 27 to 63 years) in this study, which was conducted between January 2016 and April 2016. Wrist flexion, extension, supination, pronation, radial, and ulnar deviation muscle strengths were measured at 30º/second (5 sets) angular velocity with isokinetic dynamometer. Grip strength was measured with hand dynamometer (kilograms). Boston Questionnaire was used for clinical assessment. Results: Grip strength (p= 0.003); wrist flexion 30º/second (p= 0.014); extension 30º/second (p= 0.016); and ulnar deviation 30º/second (p= 0.017) muscle strengths were lower in CTS patients compared with the control group. An evaluation according to symptom duration did not reveal any significant relationship in any of the isokinetic tests with the exception of pronation 30º/second (p=0.039, r= -0.432) and ulnar deviation 30º/second (p= 0.034, r= 0.443) in CTS patients. No significant relationship was found between Boston Questionnaire, grip strength, and isokinetic test results. Conclusion: Quantitative wrist strength measure...

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Comparison of static wrist splint with static wrist and metacarpophalangeal splint in carpal tunnel syndrome

Abstract: The position of MCP joints seems to be an important factor for the treatment of CTS and should be considered while prescribing a splint to the patients with CTS.

Cited by 9 publications

References 0 publications

Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial

Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial

Compression of Median Nerve at the Carpal Tunnel and Pronator Teres Syndrome - A Case Report

Isokinetic evaluation of wrist muscle strength in patients of carpal tunnel syndrome

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