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 ?
A randomized controlled (intervention) trial of ischemic compression therapy for chronic carpal tunnel syndrome.
STUDY DESIGN R and omized clinical trial . OBJECTIVE The aim of this study was to evaluate the effect of ischemic compression therapy in the treatment of chronic carpal tunnel syndrome . METHOD Fifty-five patients suffering from carpal tunnel syndrome were r and omized to two groups . Thirty-seven patients received 15 experimental treatments which consisted of ischemic compressions at trigger points located in the axilla of the shoulder , the length of the biceps muscle , at the bicipital aponeurosis and at the pronator teres muscle in the hollow of the elbow . Eighteen patients received the control treatment involving ischemic compression on trigger points located in the deltoid muscle , supraspinatus muscle and infraspinatus muscle . Of the 18 patients forming the control group , 13 agreed to receive the experimental treatments after the 15 control treatments . Outcome measures included a vali date d 18- question question naire to assess the severity of symptoms and functional status in carpal tunnel syndrome , and a quantification of the patients ' perceived improvement , using a scale from 0 % to 100 % . Outcome measures evaluations were completed at baseline , after 15 treatments , 30 days following the last treatment , and 6 months later . RESULTS For the disability question naire , a significant reduction of symptoms was noted only in the experimental group . In the experimental group the outcome at baseline was 33.5 ( SD , 10.3 ) ; after 15 treatments it was 18.6 ( SD , 7.0 ) . The control group outcome at baseline was 36.3 ( SD , 15.2 ) ; after 15 treatments it was 26.4 ( SD , 9.9 ) and after the crossover ( 15 control treatments plus 15 experimental treatments ) 20.2 ( SD , 12.2 ) . A significant between group difference ( P < 0.021 ) was noted in the patients ' perceived improvement after 15 treatments : 67 ( SD , 26 ) percent and 50 ( SD , 25 ) percent respectively for the experimental and control groups . CONCLUSION This practice -based clinical trial suggests that myofascial therapy using ischemic compression the length of the biceps , at the bicipital aponeurosis , at the pronator teres and at the subscapularis muscles could be a useful approach to reduce symptoms associated with the carpal tunnel syndrome . Patients ' perceived improvement in functional capacities persisted over a 6-month period
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 ?