Ultrasound-guided percutaneous carpal tunnel release: A systematic review.

OBJECTIVE: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment mononeuropathy. The purpose of this systematic review is to evaluate the reported clinical effectiveness and safety of ultrasound-guided percutaneous carpal tunnel release (USCTR) for the treatment of CTS. LITERATURE SURVEY: PubMed, EMBASE, and ScienceDirect databases were queried from database inception to February 20, 2021, to identify clinical studies on USCTR. METHODOLOGY: Two reviewers independently completed title, abstract, and full-text screening, and they extracted data in duplicate for analysis. Procedure techniques, outcome measures, and complications were descriptively analyzed. SYNTHESIS: Eighty-seven studies were eligible for screening. Twenty studies (three randomized controlled trials, three prospective cohort studies, and 14 case series) met inclusion criteria, with a total of 1772 USCTR cases. The overall level of evidence was very low, with seven studies with at least moderate risk of bias. Thirteen studies exceeded the minimal clinically important difference (MCID) for the Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SS) and Boston Carpal Tunnel Questionnaire Functional Status Scale (BCTQ-FS), and six studies exceeded the MCID for the Quick Disabilities of Arm, Shoulder & Hand (QDASH). Five studies reported statistically significant improvement in these functional outcome measures as early as the first week post-procedure. A major complication occurred in one patient who developed suspected compartment syndrome, and minor complications were reported in 24 patients. CONCLUSIONS: Based on very low level of evidence, early studies suggest that USCTR may be an effective treatment for CTS, with potential for short post-procedure recovery times.

Effects of hybrid-functional electrical stimulation (FES) rowing whole-body exercise on neurologic improvement in subacute spinal cord injury: secondary outcomes analysis of a randomized controlled trial.

STUDY DESIGN: Secondary outcome measures analysis of a randomized, controlled study. OBJECTIVE: To assess the effects of hybrid-functional electrical stimulation (FES) rowing on motor and sensory recovery in individuals with spinal cord injury (SCI) 6-18 months post injury. SETTING: Outpatient rehabilitation network. METHODS: 25 participants 6-12 months after SCI were randomly assigned to hybrid-FES rowing (n = 10) or standard of care (n = 15) groups. The hybrid-FES rowing group completed 6 months of rowing scheduled 3 times per week for 26 weeks at an exercise intensity of 70-85% of maximal heart rate. The standard of care group either participated in an arm ergometer exercise program (n = 6) or a waitlist without an explicit exercise program (n = 9). Changes in motor score and combined sensory score of the International Standards for Neurological Classification of SCI (ISNCSCI) were analyzed. RESULTS: Both groups demonstrated increases in motor and combined sensory scores, but no significant differences were noted between intervention groups (motor difference mean ↑1.3 (95% CI, -1.9 to 4.4), combined sensory difference mean ↓10 (-30 to 18)). There was an average of 63% adherence to the hybrid-FES rowing protocol, with no significant correlation in changes in motor or combined sensory score in the hybrid-FES rowing group with total distance or time rowed. CONCLUSIONS: No significant effects to neurologic improvement were found with hybrid-FES rowing when compared with standard of care interventions in individuals with SCI 6-18 months post injury.

A comparison of molecular assays for Mycoplasma pneumoniae in pediatric patients.

Three commercial molecular assays for detecting Mycoplasma pneumoniae were evaluated for their relative performances and hands-on time. They performed comparably well in clinical sensitivity and specificity.