ABSTRACT
The Academy of Orthopaedic Physical Therapy and the Academy of Hand and Upper Extremity Physical Therapy have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for orthopaedic and sports physical therapy management and prevention of musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This particular guideline focuses on hand pain and sensory deficits in carpal tunnel syndrome. J Orthop Sports Phys Ther 2019;49(5):CPG1-CPG85. doi:10.2519/jospt.2019.0301.
Subject(s)
Carpal Tunnel Syndrome/physiopathology , Carpal Tunnel Syndrome/therapy , Hand/physiopathology , Physical Therapy Modalities , Somatosensory Disorders/physiopathology , Somatosensory Disorders/therapy , Humans , Physical ExaminationABSTRACT
The purpose of the study was to determine the intrarater and interrater reliability of the Skin Compliance Device, a tool to measure scar pliability. Three points on 25 scars and the corresponding areas on the uninvolved upper extremities were tested by two evaluators. Testing locations were standardized using a wound-tracing device. Intrarater reliability was excellent for both raters for all points tested on both extremities (intraclass correlation coefficient [ICC]>0.88). On the involved side, good inter-rater reliability was found for the most adherent point (ICC=0.79) and the most distal point (ICC=0.77). Fair interrater reliability was found for the most proximal point on the involved side (ICC=0.29) and fair-to-moderate reliability for all points on the unscarred extremity. The Skin Compliance Device demonstrates excellent intrarater reliability and good interrater reliability for measuring the most adherent aspect of scars.
Subject(s)
Cicatrix/physiopathology , Elasticity , Physical Examination/instrumentation , Physical Therapy Modalities/instrumentation , Skin Physiological Phenomena , Female , Humans , Male , Reproducibility of ResultsABSTRACT
Current best evidence for the conservative management of radial tunnel syndrome (RTS) consists primarily of expert opinion and inferences taken from studies on other nerve compressions and related syndromes. There are limited data reported in the literature of this particular disorder. This article reviews literature on modalities, therapeutic exercise, ergonomic interventions, and cortical reorganization, and how they may be considered for intervention with RTS. The author's preferred method of treatment, as based on theoretical constructs, for RTS is presented. Definitive evidence in the literature to support the conservative interventions suggested is lacking. Suggestions for clinical management and study are included in this therapist's clinical perspective.