The strongest evidence supports postsurgical early active motion protocol s and splinting for various conditions .
Very few studies have examined occupation-based interventions .
Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity .
It is imperative that practitioners underst and the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purpose ful occupations .
This systematic review provides an up date to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question , What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm , wrist , and h and ?
The comparative effectiveness of combined lumbrical muscle splints and stretches on symptoms and function in carpal tunnel syndrome.
OBJECTIVE To compare the effectiveness of an intensive lumbrical splint/stretch combination with 3 less intensive lumbrical splint/stretch combinations on  carpal tunnel symptoms and function . DESIGN R and omized Clinical Trial . SETTING Outpatient h and therapy clinics . PARTICIPANTS Volunteers ( N=124 ) with mild to moderate carpal tunnel syndrome . INTERVENTIONS A 4-week home regimen of nocturnal splints ( lumbrical splints or cock-up splints ) combined with stretches ( lumbrical intensive or general ) performed 6 times daily . MAIN OUTCOME MEASURES The effect of the intervention on carpal tunnel symptoms and function was examined with the Carpal Tunnel Symptom Severity and Function Question naire ( CTQ ) and Disabilities of the Arm , Shoulder , and H and ( DASH ) . We also evaluated whether subjects obtained surgery at 24 weeks . RESULTS There were significant main effects over time for all outcome measures at 4 , 12 , and 24 weeks . There was a significant interaction effect for the CTQ-Function and DASH at 12 weeks . Post hoc analyses indicated significant differences between the lumbrical splint/general stretch and general splint/lumbrical stretch groups and the other 2 groups . At 24 weeks , a significantly greater percentage of subjects in the general splint/lumbrical stretch group achieved a clinical ly important improvement on the CTQ-Function . By 24 weeks , only 25.5 % of subjects had elected to undergo surgery . CONCLUSIONS A combination of a cock-up splint with lumbrical intensive stretches was the most effective combination for improvements in functional gains at 24 weeks postbaseline . Our findings support further evaluation of this combination as a method of conservative carpal tunnel syndrome treatment
The strongest evidence supports postsurgical early active motion protocol s and splinting for various conditions .
Very few studies have examined occupation-based interventions .
Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity .
It is imperative that practitioners underst and the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purpose ful occupations .
This systematic review provides an up date to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question , What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm , wrist , and h and ?