关键词: Hand & wrist Musculoskeletal disorders REHABILITATION MEDICINE

Mesh : Adult Humans Carpal Tunnel Syndrome / therapy Wrist Occupational Therapy Hand Strength Metacarpophalangeal Joint Treatment Outcome

来  源:   DOI:10.1136/bmjopen-2023-076961   PDF(Pubmed)

Abstract:
To compare the efficacy of a traditional cock-up splint, which supports the wrist only, with a modified splint that supports the wrist and the metacarpophalangeal (MCP) joints of the medial four digits in the treatment of carpal tunnel syndrome (CTS).
An assessor-blind randomised controlled trial.
Hospital-based hand therapy clinics.
Fifty-nine adults with mild-to-moderate CTS were randomly assigned to wear a wrist splint (control group) or an MCP splint (intervention group) for 6 weeks.
The standardised outcome measures used included grip and pinch strength, the static two-point discrimination test, Phalen\'s manoeuvre test, Tinel\'s sign and the Boston CTS Questionnaire.
Both groups improved significantly from splint use in some clinical features. The wrist splint and the MCP splint groups had significant improvements in lateral pinch strength (p=0.032 and p=0.002, respectively), two-point discrimination of the thumb (p=0.003 and p=0.041, respectively), two-point discrimination of the index (p=0.035 and p=0.023, respectively) and the Phalen\'s manoeuvre symptoms (p=0.025 and p=0.002, respectively). The MCP splint group had additional improvements over the wrist splint group in tip pinch (p=0.012) and Palmar pinch (p=0.011) strength.
Splinting is a practical and effective intervention option for improving the symptoms of CTS. A wrist splint that incorporates the MCP joints is more effective than the traditional wrist-only splint, with long-lasting improvements that remained consistent after 6 months of the splint intervention. Using the more effective MCP splint may consequently reduce disability, facilitate return to work and lower the associated costs.
ISRCTN13189602.
摘要:
目的:比较传统的旋塞夹板的疗效,只支撑手腕,在腕管综合征(CTS)的治疗中,使用改良的夹板支撑腕部和内侧四指的掌指关节(MCP)。
方法:一项评估盲随机对照试验。
方法:以医院为基础的手部治疗诊所。
方法:59名患有轻度至中度CTS的成年人被随机分配佩戴腕带夹板(对照组)或MCP夹板(干预组),为期6周。
方法:使用的标准化结果测量包括握力和捏力,静态两点判别测试,Phalen的动作测试,Tinel的标志和波士顿CTS问卷。
结果:两组在某些临床特征上使用夹板后均有显著改善。腕部夹板和MCP夹板组有显著的改善横向夹捏强度(分别为p=0.032和p=0.002),拇指的两点辨别(分别为p=0.003和p=0.041),指数(分别为p=0.035和p=0.023)和Phalen操纵症状(分别为p=0.025和p=0.002)的两点区分。MCP夹板组在尖端捏(p=0.012)和手掌捏(p=0.011)强度方面比手腕夹板组有其他改善。
结论:Splinting是改善CTS症状的一种实用有效的干预选择。结合了MCP关节的手腕夹板比传统的仅手腕夹板更有效,在夹板干预6个月后,长期的改善仍然是一致的。使用更有效的MCP夹板可以减少残疾,有利于重返工作岗位,降低相关成本。
背景:ISRCTN13189602。
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