Barbara Hall, Hoe C. Lee, Helen Fitzgerald, Brent Byrne, Annette Barton, Andy H. Lee; Investigating the Effectiveness of Full-Time Wrist Splinting and Education in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial. Am J Occup Ther 2013;67(4):448-459. doi: 10.5014/ajot.2013.006031.
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© 2019 American Occupational Therapy Association
This study investigated the effects of wearing a wrist support splint for 8 wk and receiving a formal education program on patients with carpal tunnel syndrome (CTS), as well as factors associated with patients’ desire to seek surgical intervention. Participants were recruited from a hospital surgical wait list and randomly assigned to an intervention group (n = 30) or a control group (n = 24). Significant improvements in measures of symptom severity and functional status over the duration of the study appeared in the intervention group but not in the control group. Logistic regression for the intervention group showed that symptom severity (odds ratio [OR] = 1.53, 95% confidence interval [CI] [1.20–1.93]), functional deficits (OR = 1.31, 95% CI [1.08–1.57]), pain score (OR = 1.25, 95% CI [1.11–1.61]), and symptom duration (OR = 1.11, 95% CI [1.01–1.24]) were positively associated with the desire to seek surgical intervention. This conservative CTS treatment program conducted by occupational therapists can improve symptoms and hand function in CTS patients.
An 8-wk program of wrist splinting and structured education can effectively improve symptoms in people with CTS.
Structured education programs for CTS should include knowledge of the disease, risk factors, risk assessment, and goal setting.
Reliable outcome measures such as the Boston Carpal Tunnel Questionnaire provide information to enhance clinical decision making.
Patients whose symptoms do not resolve should seek further medical advice.
Provide splint prescription and fitting.
Give patient splint instructions handout and explain that he or she is to wear splint full time for 8 wk.
Give patient education handout “What Is Carpal Tunnel Syndrome?”
Instruct patient to remove splint (Figure A1) for showering or wet activities.
Complete splint checklist assessment form and necessary splint adjustments.
With the therapist guiding the 1:1 session, complete the Assessment of Risk Factors and Education for CTS form with patient:
Review patient education content and use risk factor form to review patient’s progress with action plan formulated in Session 2.
Provide splint follow-up or adjustments if required.
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