Splinting for carpal tunnel syndrome

摘要: Background Carpal tunnel syndrome (CTS) is a condition where one of two main nerves in the wrist compressed, which can lead to pain hand, and sometimes arm, numbness tingling thumb, index long finger. Splinting usually offered people with mild moderate symptoms. However, effectiveness duration benefit splinting for this remain unknown. Objectives To compare carpal no treatment, placebo or another non-surgical intervention. Search methods We searched Cochrane Neuromuscular Disease Group Specialized Register (10 January 2011), CENTRAL, NHSEED DARE (The Library 2011, Issue 4), MEDLINE (January 1966 December EMBASE 1980 2012), AMED 1985 CINAHL Plus 1937 using time limits. We reference lists all included trials relevant reviews further studies. Selection criteria All randomised quasi-randomised comparing treatment (or placebo) other treatments were eligible inclusion. also studies splint type regimen versus another. excluded surgical treatment. There language restrictions. patients diagnosed unless they had undergone release. Data collection analysis Two review authors independently selected inclusion, performed data extraction. Two assessment risk bias. calculated measures effect as ratios (RR) dichotomous outcomes mean differences (MD) continuous outcomes, 95% confidence intervals (CI) reported statistical significance set at P < 0.05 outcome comparisons. Main results The 19 randomising 1190 participants syndrome. compared five different designs, splint-wearing regimens, seven delivered single intervention intervention, alongside interventions intervention. Only three concealing allocation sequence, only blinding participants. Three measured primary outcome, short-term overall improvement months less. One low quality study 80 wrists found that splints worn night more than tripled likelihood reporting end four weeks (RR 3.86, CI 2.29 6.51). lack patient unclear concealment suggests result should be interpreted caution. A very trial 90 wearing neutral doubled 'a lot complete relief' an extension 2.43, 1.12 5.28). The third did not report separately per group. Nine adverse effects either few discomfort swelling due splinting; however, precision RRs was low. Differences between groups secondary - symptoms, function, neurophysiologic parameters most commonly small CIs incorporating direction. Authors' conclusions Overall, there limited evidence effective short term, but insufficient regarding safety design over others, CTS. More research needed on long-term