Date of Award

5-1-2023

Degree Type

DPT Project

Degree Name

Doctor of Physical Therapy (DPT)

Advisor

Kevin Browne

Abstract

Aims and Objectives: To assess the effectiveness of active interventions, such as manual therapy and gliding exercises compared to passive interventions, such as kinesiotaping, splints, and modalities utilizing the Boston Carpal Tunnel Questionnaire in patients with carpal tunnel syndrome.

Background: A large number of people worldwide suffer from carpal tunnel syndrome, which is a type of entrapment neuropathy. Treatment includes active interventions (manual therapy and gliding exercises) and passive interventions (splinting, kinesiotaping, and modalities). The Boston Carpal Tunnel Questionnaire is the most widely used self-administered outcome scale to measure the improvement of carpal tunnel syndrome. The effectiveness of the various physical therapy interventions for patients with carpal tunnel syndrome has been examined in several studies. The purpose of this systematic review is to provide the outcomes of the selected studies and give a better understanding of active and passive interventions.

Design: A systematic review and meta-analysis of 5 randomized controlled trials.

Methods: A review and meta-analysis of 5 randomized controlled trials were conducted. PubMed was used to select the qualified studies for this systematic review. PEDro scale was utilized to evaluate the quality of the studies. The main outcome included is Boston Carpal Tunnel Questionnaire score. Online tools were used to analyze data on the effectiveness of active interventions for treating carpal tunnel syndrome. The analysis focused on comparing active to passive interventions and included various comparisons of scores before and after treatment.

Results: The results of the study indicate that active interventions have a greater impact on the Symptom Severity Scale and Functional Status Scale of the Boston Carpal Tunnel Questionnaire compared to passive interventions. The effect sizes, as measured by Hedge's g, for active interventions are found to be statistically significant and fell in the large range. The Symptom Severity Scale showed an effect size of -1.49 (95% CI: [-1.80, -1.19]), while the Functional Status Scale showed an effect size of -1.03 (95% CI: [-1.31, -0.75]), both indicating a large impact on functional and symptom improvement. These findings suggest that active interventions may be more effective than passive interventions in improving scores on the Boston Carpal Tunnel Questionnaire. A comparison of scores between two groups revealed that the combination of active and passive interventions had a slight advantage over active interventions alone. The Symptom Severity Scale score had a Hedge’s g effect size of -0.30 (95% CI [-0.67; 0.07]) with a p-value of 0.02, indicating a statistically significant difference between the groups. However, the Functional Status Scale score had an effect size of -0.13 (95% CI [-0.49; 0.24]) with a p-value of 0.15, indicating no statistically significant difference between the groups.

Download

Share

COinS