Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome.

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.

Hand force of men and women over 65 years of age as measured by maximum pinch and grip force.

This cross-sectional study aimed to assess the impact of age and gender on 4 measures of grip and pinch force of well elderly community dwellers and to provide normative values. The hypotheses were that age and gender affect pinch and grip force and that these 2 factors might interact. Hand strength of 224 seniors 65-92 years old was tested. Grip and pinch force decreased in successively older age groups past 65 years. Men's grip force exceeded that of women in all age groups. Men's hand-force decline was steeper than that of women over successive age groups, suggesting that gender differences in force decreased with age. Trends were the same for all 4 types of grip- and pinch-force measurement but were most clearly visible in grip and key-pinch force. Norms were provided for seniors age 65-85+ years in 5-yr increments.

Development of the Functional Dexterity Test (FDT): construction, validity, reliability, and normative data.

Dexterity tests take time to administer; however, the information obtained is an important component of a comprehensive examination of the hand. This article introduces a dexterity test suitable for use as part of routine examination of the hand. The Functional Dexterity Test (FDT) was developed as a measure of dexterity that takes a minimum amount of time to administer, yet provides information regarding the patient's ability to use the hand for daily tasks requiring a 3-jaw chuck prehension between the fingers and the thumb. The test was developed over 20 years. Interrater and intrarater reliability ranges between good and excellent. Construct validity was confirmed in 2 clinical studies. Preliminary normative data were obtained in 6 samples of convenience. Along with statistical data, this article provides equipment standards and instructions.

Outcomes, treatment effectiveness, efficacy, and evidence-based practice: examples from the world of splinting.

Calls for outcome studies and evidence-based practice leave many therapists bewildered as to the meaning of various types of terminology. The objectives of this paper are to 1) review the structure of outcome reports and research; 2) describe the background and discuss the terms "treatment efficacy, "effectiveness," and "evidence-based practice"; 3) discuss these concepts as they apply to selected studies found in the literature that report the use of splints for patients with ailments that affect the use of their hands; and 4) provide some reflections that place these terms in the context of scientific inquiry and clinical practice. It is concluded that health care is being reviewed on an increasingly more systematic and grand scale. While studies that include large numbers of subjects are needed to substantiate the effectiveness of splinting, studies involving smaller numbers of subjects can contribute greatly as well, so long as they are performed with the highest level of study design and use standardized outcome measures that are valid for answering the designated research questions.