Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial.
OBJECTIVE
To compare the effects of a neutral wrist and metacarpophalangeal (MCP) splint with a wrist cock-up splint, with and without exercises, for the treatment of carpal tunnel syndrome (CTS).


METHODS
A 2x2x3 randomized factorial design with 3 main factors: splint (neutral wrist and MCP and wrist cock-up), exercise (exercises, no exercise), and time (baseline, 4wk, 8wk).


METHODS
Subjects were evaluated in an outpatient hand therapy clinic.


METHODS
Sixty-one subjects with mild to moderate CTS; 51 subjects completed the study.


METHODS
There were 4 groups: the neutral wrist and MCP group and the neutral wrist and MCP-exercise group received fabricated customized splints that supported the wrist and MCP joints; the wrist cock-up group and the wrist cock-up-exercise group received wrist cock-up splints. The neutral wrist and MCP-exercise and wrist cock-up-exercise groups also received tendon and nerve gliding exercises and were instructed to perform exercises 3 times a day. All subjects were instructed to wear the assigned splint every night for 4 weeks.


METHODS
We used the CTS Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) to assess CTS symptoms and functional status.


RESULTS
Analysis of variance showed a significant main effect for splint and time on the SSS (P<.001, P=.014) and FSS (P<.001, P=.029), respectively. There were no interaction effects.


CONCLUSIONS
Our results validate the use of wrist splints for the treatment of CTS, and suggest that a splint that supports the wrist and MCP joints in neutral may be more effective than a wrist cock-up splint.
Brininger
Teresa L
TL
Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
Rogers
Joan C
JC
Holm
Margo B
MB
Baker
Nancy A
NA
Li
Zong-Ming
ZM
Goitz
Robert J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D004867:Equipment Design; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D008662:Metacarpophalangeal Joint / Q000503:physiopathology; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D013165:Splints; D013710:Tendons / Q000503:physiopathology*; D014955:Wrist Joint / Q000503:physiopathology