Longitudinal Outcomes Following a Randomized Controlled Trial of Dynamic Splint Stretching for Carpal Tunnel Syndrome

Abstract

Background: The incidence of carpal tunnel syndrome (CTS) is 48 million patients in the United States. The purpose of this longitudinal study was to determine whether Dynasplint stretching (immediately after diagnosis) had an effect on a patient's decision to seek surgical treatment for CTS. Methods: Fifty patients (10 men, 40 women, mean age 51.2 ± 12 years) were recruited for this randomized, controlled, longitudinal trial. Patients were diagnosed with CTS by physical examination and nerve conduction studies. The intervention used was Dynasplint stretching that delivered a prolonged duration of low load stretching. Patients who were randomly chosen for the Experimental category wore the device for two 30-minute sessions per day with regular increases in splint tension for 60 days. Control patients received nonsteroidal anti-inflammatory medication plus instructions on daily home stretching. Results: The final, longitudinal outcome showed a 72% reduction in surgery chosen by the experimental group (n = 25), compared with 38% reduction for control patients (n = 25). Conclusions: Immediate treatment with Dynasplint stretching showed a 2 to 1 reduction in surgery, with abundant financial savings.

Effectiveness of Orthosis for Carpal Tunnel Syndrome: A Narrative Review

“…Nine randomized controlled trials [6][7][8][9][10][11][12][13][14] have compared the effectiveness of orthoses with other conservative treatments for CTS.…”

“…Among the nine studies [6][7][8][9][10][11][12][13][14] included in the review, three [6,8,12] compared the efficacy of injection therapy and splints and one [9] investigated the efficacy of two different types of splints. In addition, two studies [7,11] compared the effects of splints with and without other conservative therapies, and one [13] compared the effects of injection therapy alone with those of combined injection and splinting.…”

“…In 2016, Willis et al [14] investigated the impact of dynasplint stretching (Dynasplint Systems, Inc., Severna Park, Maryland) on the decision to undergo surgery for CTS in patients scheduled for surgical treatment. They randomized 50 patients into an experimental group, which underwent dynasplint stretching for 60 days, and a control group, which received nonsteroidal anti-inflammatory drugs and home stretching exercises.…”

Carpal tunnel syndrome conservative treatment: a literature review

“…The main rationale behind the use of splints in CTS patients is the prevention of extensive flexion and extension of the wrist that causes an increase in the pres- sure inside the carpal tunnel. Sixty days of using a stretch- ing splint has been known to reduce the need for surgery 2 to 1 compared to stretching and NSAIDs [ 80 ]. Splints are also commonly used after surgical retinaculum release where they theoretically provide safety regarding flexor tendon bowstringing to prevent nerve subluxation and thus reduce postoperative pain.…”

A dynamic splint for the treatment of spasticity of the hand after stroke? Recognition of its design, functionality and limitations: A narrative review article

“…They further explained that the longer the finger; the greater the spring tension exerted on the tendon of the finger [36]. In a study by Willis et al [37] it was suggested that a dynamic splint should offer a prolonged duration of inactive; joint precise stretching with small-load power.…”