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J Manipulative Physiol Ther. 2015 Sep;38(7):493-506. doi: 10.1016/j.jmpt.2015.06.006. Epub 2015 Aug 21.

The effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration.

Author information

1
Graduate Student, Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
2
Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada. Electronic address: deborah.sutton@uoit.ca.
3
Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Oshawa, ON, Canada; Associate Professor, Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada; Director, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Toronto, ON, Canada.
4
Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Associate Clinical Research Scientist, Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Instructor, Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
5
Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
6
Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Instructor, Division of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
7
Research Coordinator, Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital, Toronto, ON, Canada.
8
Professor, Departments of Orthopedic Surgery and Environmental Medicine, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York, NY.
9
Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Clinical Research Manager, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Senior Clinical Research Scientist, Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
10
Lecturer, Certification Program in Insurance Medicine and Medico-legal Expertise, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
11
Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada; Postdoctoral Fellow, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada.
12
Professor, School of Public Health and Injury Prevention Centre, University of Alberta, Edmonton, AB, Canada.
13
Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada.

Abstract

OBJECTIVE:

The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children with soft tissue injuries and neuropathies of the wrist and hand.

METHODS:

We systematically searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials, accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text, accessed through EBSCO host, from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best evidence synthesis principles.

RESULTS:

We screened 6618 articles and critically appraised 11 studies. Of those, 7 had low risk of bias: 5 addressed carpal tunnel syndrome (CTS) and 2 addressed de Quervain disease. We found evidence that various types of night splints lead to similar outcomes for the management of CTS. The evidence suggests that a night wrist splint is less effective than surgery in the short term but not in the long term. Furthermore, a night wrist splint and needle electroacupuncture lead to similar outcomes immediately postintervention. Finally, low-level laser therapy and placebo low-level laser therapy lead to similar outcomes. The evidence suggests that kinesio tape or a thumb spica cast offers short-term benefit for the management of de Quervain disease. Our search did not identify any low risk of bias studies examining the effectiveness of passive physical modalities for the management of other soft tissue injuries or neuropathies of the wrist and hand.

CONCLUSIONS:

Different night orthoses provided similar outcomes for CTS. Night orthoses offer similar outcomes to electroacupuncture but are less effective than surgery in the short term. This review suggests that kinesio tape or a thumb spica cast may offer short-term benefit for the management of de Quervain disease.

KEYWORDS:

Carpal Tunnel Syndrome; De Quervain Disease; Laser Therapy; Low-Level; Orthotic Devices; Review Literature as Topic; Ultrasonography

PMID:
26303967
DOI:
10.1016/j.jmpt.2015.06.006
[Indexed for MEDLINE]
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