Splinting for carpal tunnel syndrome

Comparison of the effect of nocturnal use of commercial versus custom-made wrist orthoses, in addition to gliding exercises, in the function and symptoms of carpal tunnel syndrome: A pilot randomized trial Figueiredo, D., Ciol, M., da Conceição dos Santos, M., de Araújo Silva, L., Bidin Brooks, J., Santos Diniz, R., & Tucci, H. Level of Evidence: 2b Follow recommendation: 👍 👍 Type of study: Therapeutic Topic: Carpal Tunnel Syndrome (CTS) conservative treatment - custom vs commercial orthosis. This is a pilot randomised controlled trial (n = 24) assessing the effectiveness of night use of a custom vs commercial splint in combination with tendon and median nerve gliding exercises in people with Carpal Tunnel Syndrome (CTS). The assessment was performed at baseline and after 45 days of therapy. The results showed that pain reduced to a statistically significant level in both groups with an improvement of 0.5/10 and 1.5/10 points in the commercial and custom splint group respectively. The reduction in pain was not clinically significant for either group, however, there was a trend for greater improvement in the custom-made splint. Functional improvement reached a clinically significant improvement in the custom-made splint with a 20% chance of this finding just being due to chance. Pulp to pulp and tripod pinch improved for both groups between 3% and 13% without a significant difference between groups. The authors also assessed extensor carpi radialis and flexor carpi ulnaris activation through EMG and found no difference before and after the intervention or between groups. Clinical Take Home Message: Hand therapists may decide to use a night splint to improve symptoms in people with CTS. There appears to be no difference between a custom made and a commercially available splint. Some functional and strength improvements may be evident after 6 weeks splinting, however, they may not reach a clinically significant level. URL: https://www.mskscienceandpractice.com/article/S2468-7812(19)30357-1/fulltext

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