Efficacy of a Fabricated Customized Splint and Tendon and Nerve Gliding Exercises for the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial

Teresa L. Brininger, Joan C. Rogers, Margo B. Holm, Nancy A. Baker, Zong Ming Li, Robert J. Goitz

Research output: Contribution to journalArticlepeer-review

67 Scopus citations

Abstract

Brininger TL, Rogers JC, Holm MB, Baker NA, Li Z-M, Goitz RJ. 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). Design: A 2×2×3 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). Setting: Subjects were evaluated in an outpatient hand therapy clinic. Participants: Sixty-one subjects with mild to moderate CTS; 51 subjects completed the study. Interventions: 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. Main Outcome Measures: 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.

Original languageEnglish (US)
Pages (from-to)1429-1435
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume88
Issue number11
DOIs
StatePublished - Nov 2007
Externally publishedYes

Keywords

  • Carpal tunnel syndrome
  • Rehabilitation
  • Splints
  • Treatment outcome

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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