title: The effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration.
abstract: OBJECTIVE
  The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children with soft tissue injuries and neuropathies of the wrist and hand.
  
  
  METHODS
  We systematically searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials, accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text, accessed through EBSCO host, from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best evidence synthesis principles.
  
  
  RESULTS
  We screened 6618 articles and critically appraised 11 studies. Of those, 7 had low risk of bias: 5 addressed carpal tunnel syndrome (CTS) and 2 addressed de Quervain disease. We found evidence that various types of night splints lead to similar outcomes for the management of CTS. The evidence suggests that a night wrist splint is less effective than surgery in the short term but not in the long term. Furthermore, a night wrist splint and needle electroacupuncture lead to similar outcomes immediately postintervention. Finally, low-level laser therapy and placebo low-level laser therapy lead to similar outcomes. The evidence suggests that kinesio tape or a thumb spica cast offers short-term benefit for the management of de Quervain disease. Our search did not identify any low risk of bias studies examining the effectiveness of passive physical modalities for the management of other soft tissue injuries or neuropathies of the wrist and hand.
  
  
  CONCLUSIONS
  Different night orthoses provided similar outcomes for CTS. Night orthoses offer similar outcomes to electroacupuncture but are less effective than surgery in the short term. This review suggests that kinesio tape or a thumb spica cast may offer short-term benefit for the management of de Quervain disease.
authors: Graduate Student, Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Kevin
authors: K
authors: D'Angelo
authors: Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada. Electronic address: deborah.sutton@uoit.ca.
authors: Deborah
authors: D
authors: Sutton
authors: Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Oshawa, ON, Canada; Associate Professor, Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada; Director, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Toronto, ON, Canada.
authors: Pierre
authors: P
authors: Côté
authors: Graduate Student, Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Sarah
authors: S
authors: Dion
authors: Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Associate Clinical Research Scientist, Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Instructor, Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Jessica J
authors: JJ
authors: Wong
authors: Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Hainan
authors: H
authors: Yu
authors: Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Instructor, Division of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Kristi
authors: K
authors: Randhawa
authors: Research Coordinator, Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital, Toronto, ON, Canada.
authors: Danielle
authors: D
authors: Southerst
authors: Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Instructor, Division of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Sharanya
authors: S
authors: Varatharajan
authors: Graduate Student, Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Jocelyn
authors: J
authors: Cox Dresser
authors: Graduate Student, Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Courtney
authors: C
authors: Brown
authors: Graduate Student, Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Roger
authors: R
authors: Menta
authors: Professor, Departments of Orthopedic Surgery and Environmental Medicine, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York, NY.
authors: Margareta
authors: M
authors: Nordin
authors: Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Clinical Research Manager, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Senior Clinical Research Scientist, Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors: Heather M
authors: HM
authors: Shearer
authors: Lecturer, Certification Program in Insurance Medicine and Medico-legal Expertise, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
authors: Arthur
authors: A
authors: Ameis
authors: Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Postdoctoral Fellow, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada.
authors: Maja
authors: M
authors: Stupar
authors: Professor, School of Public Health and Injury Prevention Centre, University of Alberta, Edmonton, AB, Canada.
authors: Linda J
authors: LJ
authors: Carroll
authors: Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada.
authors: Anne
authors: A
authors: Taylor-Vaisey
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000534:rehabilitation*; D002648:Child; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D005260:Female; D006230:Hand Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods; D008297:Male; D009864:Ontario; D009989:Orthotic Devices / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D000078202:Systematic Reviews as Topic; D014464:Ultrasonic Therapy / Q000379:methods; D014954:Wrist Injuries / Q000175:diagnosis / Q000534:rehabilitation*
keywords: Carpal Tunnel Syndrome; De Quervain Disease; Laser Therapy; Low-Level; Orthotic Devices; Review Literature as Topic; Ultrasonography