Article

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.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS