Carpal Tunnel Syndrome. Part I: Effectiveness of Nonsurgical Treatments–A Systematic Review
Abstract Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments–a systematic review. Objective To review literature systematically concerning effectiveness of nonsurgical interventions for treating carpal...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2010-07, Vol.91 (7), p.981-1004 |
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| creator | Huisstede, Bionka M., PhD Hoogvliet, Peter, MD, PhD Randsdorp, Manon S., MD Glerum, Suzanne, MD van Middelkoop, Marienke, PhD Koes, Bart W., PhD |
| description | Abstract Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments–a systematic review. Objective To review literature systematically concerning effectiveness of nonsurgical interventions for treating carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs). Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies. Two reviews and 20 RCTs were included. Strong and moderate evidence was found for the effectiveness of oral steroids, steroid injections, ultrasound, electromagnetic field therapy, nocturnal splinting, and the use of ergonomic keyboards compared with a standard keyboard, and traditional cupping versus heat pads in the short term. Also, moderate evidence was found for ultrasound in the midterm. With the exception of oral and steroid injections, no long-term results were reported for any of these treatments. No evidence was found for the effectiveness of oral steroids in long term. Moreover, although higher doses of steroid injections seem to be more effective in the midterm, the benefits of steroids injections were not maintained in the long term. For all other nonsurgical interventions studied, only limited or no evidence was found. Conclusions The reviewed evidence supports that a number of nonsurgical interventions benefit CTS in the short term, but there is sparse evidence on the midterm and long-term effectiveness of these interventions. Therefore, future studies should concentrate not only on short-term but also on midterm and long-term results. |
| doi_str_mv | 10.1016/j.apmr.2010.03.022 |
| format | Article |
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Part I: Effectiveness of Nonsurgical Treatments–A Systematic Review</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Huisstede, Bionka M., PhD ; Hoogvliet, Peter, MD, PhD ; Randsdorp, Manon S., MD ; Glerum, Suzanne, MD ; van Middelkoop, Marienke, PhD ; Koes, Bart W., PhD</creator><creatorcontrib>Huisstede, Bionka M., PhD ; Hoogvliet, Peter, MD, PhD ; Randsdorp, Manon S., MD ; Glerum, Suzanne, MD ; van Middelkoop, Marienke, PhD ; Koes, Bart W., PhD</creatorcontrib><description>Abstract Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments–a systematic review. Objective To review literature systematically concerning effectiveness of nonsurgical interventions for treating carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs). Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies. Two reviews and 20 RCTs were included. Strong and moderate evidence was found for the effectiveness of oral steroids, steroid injections, ultrasound, electromagnetic field therapy, nocturnal splinting, and the use of ergonomic keyboards compared with a standard keyboard, and traditional cupping versus heat pads in the short term. Also, moderate evidence was found for ultrasound in the midterm. With the exception of oral and steroid injections, no long-term results were reported for any of these treatments. No evidence was found for the effectiveness of oral steroids in long term. Moreover, although higher doses of steroid injections seem to be more effective in the midterm, the benefits of steroids injections were not maintained in the long term. For all other nonsurgical interventions studied, only limited or no evidence was found. Conclusions The reviewed evidence supports that a number of nonsurgical interventions benefit CTS in the short term, but there is sparse evidence on the midterm and long-term effectiveness of these interventions. Therefore, future studies should concentrate not only on short-term but also on midterm and long-term results.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2010.03.022</identifier><identifier>PMID: 20599038</identifier><identifier>CODEN: APMHAI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adrenal Cortex Hormones - therapeutic use ; Biological and medical sciences ; Carpal tunnel syndrome ; Carpal Tunnel Syndrome - therapy ; Complementary Therapies ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Dietary Supplements ; Diseases of the osteoarticular system ; Exercise Therapy ; Humans ; Magnetic Field Therapy ; Medical sciences ; Miscellaneous ; Nervous system (semeiology, syndromes) ; Neurology ; Physical Medicine and Rehabilitation ; Physical Therapy Modalities ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Randomized Controlled Trials as Topic ; Rehabilitation ; Review [publication type] ; Splints ; Treatment outcome ; Ultrasonic Therapy</subject><ispartof>Archives of physical medicine and rehabilitation, 2010-07, Vol.91 (7), p.981-1004</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2010 American Congress of Rehabilitation Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-22fa29cbd99114e81af231bae937b5ba083fb1a30a0c1acf2a6c68cd0b1919dd3</citedby><cites>FETCH-LOGICAL-c465t-22fa29cbd99114e81af231bae937b5ba083fb1a30a0c1acf2a6c68cd0b1919dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003999310002297$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23006042$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20599038$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huisstede, Bionka M., PhD</creatorcontrib><creatorcontrib>Hoogvliet, Peter, MD, PhD</creatorcontrib><creatorcontrib>Randsdorp, Manon S., MD</creatorcontrib><creatorcontrib>Glerum, Suzanne, MD</creatorcontrib><creatorcontrib>van Middelkoop, Marienke, PhD</creatorcontrib><creatorcontrib>Koes, Bart W., PhD</creatorcontrib><title>Carpal Tunnel Syndrome. Part I: Effectiveness of Nonsurgical Treatments–A Systematic Review</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments–a systematic review. Objective To review literature systematically concerning effectiveness of nonsurgical interventions for treating carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs). Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies. Two reviews and 20 RCTs were included. Strong and moderate evidence was found for the effectiveness of oral steroids, steroid injections, ultrasound, electromagnetic field therapy, nocturnal splinting, and the use of ergonomic keyboards compared with a standard keyboard, and traditional cupping versus heat pads in the short term. Also, moderate evidence was found for ultrasound in the midterm. With the exception of oral and steroid injections, no long-term results were reported for any of these treatments. No evidence was found for the effectiveness of oral steroids in long term. Moreover, although higher doses of steroid injections seem to be more effective in the midterm, the benefits of steroids injections were not maintained in the long term. For all other nonsurgical interventions studied, only limited or no evidence was found. Conclusions The reviewed evidence supports that a number of nonsurgical interventions benefit CTS in the short term, but there is sparse evidence on the midterm and long-term effectiveness of these interventions. Therefore, future studies should concentrate not only on short-term but also on midterm and long-term results.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Carpal tunnel syndrome</subject><subject>Carpal Tunnel Syndrome - therapy</subject><subject>Complementary Therapies</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Dietary Supplements</subject><subject>Diseases of the osteoarticular system</subject><subject>Exercise Therapy</subject><subject>Humans</subject><subject>Magnetic Field Therapy</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Physical Therapy Modalities</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Rehabilitation</subject><subject>Review [publication type]</subject><subject>Splints</subject><subject>Treatment outcome</subject><subject>Ultrasonic Therapy</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kd-K1DAUh4Mo7rjrC3ghvRGvWk-SaacREZZh1YVFF3cFbyScpieSsU3HpF2ZO9_BN9wnMWVGBS_2Kn_4fofD92PsCYeCA69ebArc9qEQkD5AFiDEPbbgpRR5Lfjn-2wBADJXSskj9ijGTXpWpeQP2ZGAUimQ9YJ9WWPYYpddT95Tl13tfBuGnorsEsOYnb_MzqwlM7ob8hRjNtjs_eDjFL46M6cC4diTH-Ptz1-nKR1H6nF0JvtIN45-nLAHFrtIjw_nMfv05ux6_S6_-PD2fH16kZtlVY65EBaFMk2rFOdLqjlaIXmDpOSqKRuEWtqGowQEw9FYgZWpatNCwxVXbSuP2fP93G0Yvk8UR927aKjr0NMwRb2SslrCileJFHvShCHGQFZvg-sx7DQHPVvVGz1b1bNVDVInqyn09DB-anpq_0b-aEzAswOAMXmxAb1x8R8nk3lYzoNe7TlKMpKgoKNx5A21LiTLuh3c3Xu8_i9uOufnJr7RjuJmmIJPmjXXUWjQV3P_c_08XYRQK_kbMPCr9w</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Huisstede, Bionka M., PhD</creator><creator>Hoogvliet, Peter, MD, PhD</creator><creator>Randsdorp, Manon S., MD</creator><creator>Glerum, Suzanne, MD</creator><creator>van Middelkoop, Marienke, PhD</creator><creator>Koes, Bart W., PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100701</creationdate><title>Carpal Tunnel Syndrome. Part I: Effectiveness of Nonsurgical Treatments–A Systematic Review</title><author>Huisstede, Bionka M., PhD ; Hoogvliet, Peter, MD, PhD ; Randsdorp, Manon S., MD ; Glerum, Suzanne, MD ; van Middelkoop, Marienke, PhD ; Koes, Bart W., PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-22fa29cbd99114e81af231bae937b5ba083fb1a30a0c1acf2a6c68cd0b1919dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Carpal tunnel syndrome</topic><topic>Carpal Tunnel Syndrome - therapy</topic><topic>Complementary Therapies</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Dietary Supplements</topic><topic>Diseases of the osteoarticular system</topic><topic>Exercise Therapy</topic><topic>Humans</topic><topic>Magnetic Field Therapy</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Physical Therapy Modalities</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Rehabilitation</topic><topic>Review [publication type]</topic><topic>Splints</topic><topic>Treatment outcome</topic><topic>Ultrasonic Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huisstede, Bionka M., PhD</creatorcontrib><creatorcontrib>Hoogvliet, Peter, MD, PhD</creatorcontrib><creatorcontrib>Randsdorp, Manon S., MD</creatorcontrib><creatorcontrib>Glerum, Suzanne, MD</creatorcontrib><creatorcontrib>van Middelkoop, Marienke, PhD</creatorcontrib><creatorcontrib>Koes, Bart W., PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huisstede, Bionka M., PhD</au><au>Hoogvliet, Peter, MD, PhD</au><au>Randsdorp, Manon S., MD</au><au>Glerum, Suzanne, MD</au><au>van Middelkoop, Marienke, PhD</au><au>Koes, Bart W., PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carpal Tunnel Syndrome. Part I: Effectiveness of Nonsurgical Treatments–A Systematic Review</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>91</volume><issue>7</issue><spage>981</spage><epage>1004</epage><pages>981-1004</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><coden>APMHAI</coden><abstract>Abstract Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments–a systematic review. Objective To review literature systematically concerning effectiveness of nonsurgical interventions for treating carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs). Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies. Two reviews and 20 RCTs were included. Strong and moderate evidence was found for the effectiveness of oral steroids, steroid injections, ultrasound, electromagnetic field therapy, nocturnal splinting, and the use of ergonomic keyboards compared with a standard keyboard, and traditional cupping versus heat pads in the short term. Also, moderate evidence was found for ultrasound in the midterm. With the exception of oral and steroid injections, no long-term results were reported for any of these treatments. No evidence was found for the effectiveness of oral steroids in long term. Moreover, although higher doses of steroid injections seem to be more effective in the midterm, the benefits of steroids injections were not maintained in the long term. For all other nonsurgical interventions studied, only limited or no evidence was found. Conclusions The reviewed evidence supports that a number of nonsurgical interventions benefit CTS in the short term, but there is sparse evidence on the midterm and long-term effectiveness of these interventions. Therefore, future studies should concentrate not only on short-term but also on midterm and long-term results.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20599038</pmid><doi>10.1016/j.apmr.2010.03.022</doi><tpages>24</tpages></addata></record> |
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| subjects | Adrenal Cortex Hormones - therapeutic use Biological and medical sciences Carpal tunnel syndrome Carpal Tunnel Syndrome - therapy Complementary Therapies Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction Dietary Supplements Diseases of the osteoarticular system Exercise Therapy Humans Magnetic Field Therapy Medical sciences Miscellaneous Nervous system (semeiology, syndromes) Neurology Physical Medicine and Rehabilitation Physical Therapy Modalities Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Randomized Controlled Trials as Topic Rehabilitation Review [publication type] Splints Treatment outcome Ultrasonic Therapy |
| title | Carpal Tunnel Syndrome. Part I: Effectiveness of Nonsurgical Treatments–A Systematic Review |
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