Rehabilitation following carpal tunnel release

摘要: Background Various rehabilitation treatments may be offered following carpal tunnel syndrome (CTS) surgery. The effectiveness of these interventions remains unclear. This is the first update a review published in 2013. Objectives To and safety CTS surgery compared with no treatment, placebo, or another intervention. Search methods On 29 September 2015, we searched Cochrane Neuromuscular Specialised Register, Register Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL Plus, AMED, LILACS, PsycINFO. We also PEDro (3 December 2015) clinical trials registers 2015). Selection criteria Randomised quasi-randomised that any postoperative intervention either intervention, individuals who had undergone Data collection analysis Two authors independently selected for inclusion, extracted data, assessed risk bias, quality body evidence primary outcomes using GRADE (Grades Recommendation, Assessment, Development Evaluation) approach according to standard methodology. Main results In this included 22 total 1521 participants. were newly identified at update. studied different including immobilisation wrist orthosis, dressings, exercise, controlled cold therapy, ice multi-modal hand rehabilitation, laser electrical modalities, scar desensitisation, arnica. Three treatment four control, three care, 15 various one another.Overall, studies very low quality. Thirteen explicitly reported random sequence generation; these, five adequately concealed allocation sequence. Four achieved blinding both participants outcome assessors. Five high bias from incompleteness data more time intervals, eight selective reporting bias.These heterogeneous terms provided, duration interventions, nature timing measured, setting. Therefore, not able pool across trials.Four our outcome, change self functional ability months more. Of provided sufficient inclusion review. One small high-quality trial desensitisation programme revealed statistically significant benefit based on Boston Carpal Tunnel Questionnaire (BCTQ) (mean difference (MD) -0.03, 95% confidence interval (CI) -0.39 0.33). low-quality six post Disabilities Arm, Shoulder Hand (DASH) questionnaire found between formal therapy group given two-week course commenced seven days (MD 1.00, CI -4.44 6.44). function BCTQ early (plaster orthosis worn until suture removal) splint late mobilisation 0.39, -0.45 1.23).Differences secondary measures (change measured less than months; symptoms; CTS-related impairment measures; presence iatrogenic symptoms surgery; return work occupation; neurophysiological parameters) generally significant. Few adverse events. Authors' conclusions There limited and, general, reviewed interventions. People have should informed about Until researchers provide assess treatments, decision clinician's expertise, patient's preferences context environment. It important identify patients respond particular those do not, undertake evaluate severity surgery, measure return-to-work rates, control confounding variables.