Document Type : Original Articles

Authors

1 Department of Occupational Therapy, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Physical Medicine & Rehabilitation, Shiraz Medical School, Shiraz, Iran

4 Department of Biostatistics, Shahid Beheshti University Of Medical Sciences, Tehran, Iran

Abstract

Background: Splinting is the most common conservative method of treatingpatients with mild and moderate Carpal Tunnel Syndrome (CTS). The aim ofthis study was to determine the effectiveness of the limited dynamic wrist splinton the symptoms, function, and strength of women with CTS. In this controlledtrial study, the subjects wore a splint of a new design called the “limited dynamicwrist splint”, which allowed the wrist motion in the range (between 15-degreeflexion and 15-degree extension) that exerts minimum pressure on the mediannerve and prevents extra pressure on the nerve by limiting the range of motionsout of the allowed range.Methods: In this study, 24 women diagnosed with mild to moderate CTS wereinitially evaluated on the basis of the Boston questionnaire, the dexterity testof the Purdue pegboard, grip and pinch strength, distal sensory latency, andsensory nerve conduction velocity. The subjects were randomly divided intotwo groups, control and treatment. Both groups received routine rehabilitationtreatment for six weeks. The treatment group received the limited dynamic wristsplint for about six to eight hours a day. After six weeks, the initial examinationswere repeated. The SPSS-16, independent t, and paired t-tests were used for dataanalysis.Results: All the variables in the treatment and the control groups showedimprovement. The function test of the Boston questionnaire, the Purduepegboard test, and the pinch strength were significantly improved in thetreatment group. The “severity of the symptoms” test of the Boston questionnaireand the pinch strength in the control group showed a statistically significantdifference (P < 0.05). In a comparison of the two groups, the function test of theBoston questionnaire showed a significant difference.Conclusion: This study showed that the use of the limited dynamic wrist splintfor about six weeks for six to eight hours a day could have a significant effect onthe function, dexterity, and the pinch strength of patients with CTS. Not onlycan the patients receive treatment by this method, but they can also performtheir daily activities to some extent.

Keywords

  1. Brininger TL, Rogers JC, Holm MB, Baker NA, Li Z-M, Goitz RJ.
  2. Efficacy of a fabricated customized splint and tendon and nerve
  3. gliding exercises for the treatment of carpal tunnel syndrome: a
  4. randomized controlled trial. Archives of physical medicine and
  5. rehabilitation. 2007; 88(11):1429-35.
  6. De-la-Llave-Rincon AI, Ortega-Santiago R, Ambite-Quesada
  7. S, Gil-Crujera A, Puentedura EJ, Valenza MC, et al. Response
  8. of pain intensity to soft tissue mobilization and neurodynamic
  9. technique: a series of 18 patients with chronic carpal tunnel
  10. syndrome. Journal of manipulative and physiological therapeutics
  11. ; 35(6):420-7.
  12. Raigani M, Mokhtarirad M, Bahrami M, Eliaspoor D, Valaie
  13. N. Prevalence of carpal tunnel syndrome and related factors in
  14. patients with upper extremities pain. Research journal of Shahid
  15. Beheshti university of medical science 2009; 70(4):219-223.
  16. Heidari Safa M. Carpal tunnel syndrome: systematic review
  17. .Novin Pezeshki journal 2011.
  18. Walker WC, Metzler M, Cifu DX, Swartz Z. Neutral wrist
  19. splinting in carpal tunnel syndrome: a comparison of night-only
  20. versus full-time wear instructions. Archives of physical medicine
  21. and rehabilitation 2000; 81(4):424-8.
  22. Forough B, Mohammadi A, Azad A. Comparison of therapeutic
  23. effect of two kind of cock-up splint in patients with carpal tunnel
  24. syndrome. J Gorgan Uni Med Sci 2009; 10(4): 18-21.
  25. R.Lutechi PA. Carpal tunnal syndrom. R.Lutechi PA, editor.
  26. Verlag Berlin Heidelberg New York: Springer; 2007. PP 105-109.
  27. Kuo M-H, Leong C-P, Cheng Y-F, Chang H-W. Static wrist
  28. position associated with least median nerve compression:
  29. sonographic evaluation. American journal of physical medicine
  30. & rehabilitation 2001; 80(4):256-60.
  31. Kavousipor S, Mahmoudi R, Jaladat M, Ashraf A. can impairment
  32. interfere with performance by women with carpal tunnel
  33. syndrome according to international classification of function?
  34. Journal of Rehabilitation Sciences and Research 2015; 2(1): 12-16.
  35. Rezazadeh A, Bakhtiari A, Samaie A, Moghimi J. Validity and
  36. reliability of the Persian Boston questionnaire in Iranian patients
  37. with carpal tunnel syndrome. Koomesh 2014; 15(2): 138-145.
  38. Pendleton HM, Schultz-krohn W. The occupational therapy
  39. practice framework and the practice of occupational therapy for
  40. people with physical disabilities. In: Pendleton HM, Schultzkrohn
  41. W, editors. Pedretti’s occupational therapy: practice skills for
  42. physical dysfunction. 6th ed. ST Louis: Mosby; 2006. p. 5.
  43. Amirjani N, Ashworth N.Validity and reliability of the purdue
  44. pegboard test in carpal tunnel syndrome, Muscle & Nerve,
  45. 171-177.
  46. Hashempur MH, Homayouni K, Ashraf A. Effect of Linum
  47. usitatissimum L.(linseed) oil on mild and moderate carpal tunnel
  48. syndrome: a randomized, double-blind, placebo-controlled
  49. clinical trial. DARU Journal of Pharmaceutical Sciences
  50. 22(1):1-9.
  51. Williams GR. Dynamic splint for carpal tunnel syndrome
  52. treatment. Google Patents; 2004.
  53. Salek Zamani M, Ahadi T, Jalil Zadeh Sh, Ghasemi M, Ganjali
  54. Zadeh S. Determination of optimal angel of wrist splinting in
  55. carpal tunnel syndrome based on electrodiagnostic parameters.
  56. Medical journal of Tabriz university of medical science 2008;
  57. (1): 65-70.
  58. Manente G, Torrieri F, Di Blasio F, Staniscia T, Romano F,Uncini
  59. A. An innovative hand brace for carpal tunnel syndrome: a
  60. randomized controlled trial. Muscle Nerve 2001; 24:424 - 429.
  61. Bye r, hajiaqai b, forough b.comparison between efficacy of Manu
  62. splint and cock-up splint in carpal tunnel syndrome treatment. J
  63. Babol Univ Med Sci 2011; 13(1): 51-57.
  64. O¨ zgen M, Gu¨ngen G, Sarsan A, Ardic F, S¸ alis kan A, Sabir
  65. N, et.al. Determination of the position on which the median
  66. nerve compression is at the lowest in carpal tunnel syndrome and
  67. clinical effectiveness of custom splint application. Rheumatol
  68. Int 2011; 31:1031–1036.
  69. Bagheri A, Raeisi M, Vahab Kashani R. Comparison of
  70. therapeutic effcets of dorsal wrist splint with cockup splint
  71. in carpal tunnel syndrome based on median sensory nerve
  72. conduction measurements. Journal of Gorgan University of
  73. Medical Sciences 2011; 13(3):42-47.