Presentation M P12

M P12 (Poster Presentation):
Rehabilitation after Carpal Tunnel Release

Presented by: Susan E Peters

Authors

Peters SE1,2, Page MJ3, Coppieters MW1,4, Ross M2,5,6, Johnston V1

  1. School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Australia
  2. Brisbane Hand and Upper Limb Research Institute, Brisbane, Australia
  3. School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.
  4. VU University, Amsterdam, Netherlands
  5. School of Medicine, The University of Queensland, Brisbane, Australia
  6. Department of Orthopaedics, Princess Alexandra Hospital, Brisbane, Australia

Abstract

Background

Various rehabilitation treatments may be offered following carpal tunnel release (CTR). The effectiveness of these interventions remains unclear.The effectiveness or benefit of these interventions remains unclear. The objective of this systematic review was to determine the effectiveness of rehabilitation treatments following CTR including time to return to work.

Methods

Review was completed according to Cochrane guidelines. Randomised or quasi-randomised controlled trials comparing any post-operative intervention with no intervention, a placebo or another post-operative intervention were included. Two reviewers independently selected trials for inclusion, extracted data and assessed the risk of bias in the included studies. Risk ratios and mean differences were calculated. Studies were narratively described. Heterogeniety between studies limited meta-analysis.

Results

23 studies randomising 1554 of individuals were included. A variety of rehabilitation treatments were assessed including hand therapy, mobilisation, immobilisation, laser therapy, and drug treatments. Overall the studies were low in quality. No studies found an effective intervention that facilitated return to work.

Conclusions

There is limited and, in general, low quality evidence for the benefit of the reviewed interventions. People who have had CTS surgery should be informed about the limited evidence of the effectiveness of postoperative rehabilitation interventions. Until the results of more high quality trials that assess the effectiveness and safety of various rehabilitation treatments have been reported, the decision to provide rehabilitation following CTS surgery should be based on the clinician’s expertise, the patient’s preferences and the context of the rehabilitation environment. It is important for researchers to identify patients who respond to a certain treatment and those who do not, and to undertake high quality studies that evaluate the severity of iatrogenic symptoms from the surgery, measure function and return-to-work rates, and control for confounding variables.

Schedule Details

Monday September 29
12:45 - 13:45 Poster Viewing
Session: RTW interventions