Effective Intervention Strategies to Promote Occupational Performance

Among Individuals with Carpal Tunnel Syndrome

Madalyn Payne, OTS

Level II Fieldwork

Ireland Army Community Hospital, Fort Knox, KY Carpal Tunnel Syndrome in today’s society My mother

Identification of Topic

Compression of median nerve

Numbness, tingling, pain Sensory nerve distribution

Motor distribution

Carpal Tunnel Syndrome

Subjective statements Provocative tests

Tinels Phalens

EMG/Nerve conduction study

How is it diagnosed?

Occupational Performance!

Why do we care?

Tendon and nerve gliding exercises

Evidence-Based Treatments

Massage

techniques Ischemic

compression CTS targeted Soft tissue

mobilization Graston

Instrument

Evidence-Based Treatments

Splinting combined with lumbrical stretches

Evidence-Based Treatments

Full time splinting and formal education Ketoprofen phonophoresis combined with

splinting

Evidence-Based Treatments

Conservative treatment options to prevent/prolong

surgery All have been shown to decrease signs and symptoms

Treatment post-surgery Scar management ROM

Occupation-based treatments Need is only going to increase

Getting back to function!!

Clinical Implications for OT

Burke, J., Buchberger, D. J., Carey-Loghmani, M. T., Doughtery, P. E., Greco, D., & Dishman, D. (2007). A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. Journal of Manipulative and Physiological Therapeutics, 30(1), 50-61. doi: http://dx.doi.org/10.1016/j.jmpt.2006.11.014

Hains, G., Descarreaux, M., Lamy, A., & Hains, F. (2010). A randomized controlled (intervention) trial of ischemic compression therapy for chronic carpal tunnel syndrome. Journal Of The Canadian Chiropractic Association, 54(3), 155-163.

Horng, Y., Hsieh, S., Tu, Y., Lin, M., Horng, Y., & Wang, J. (2011). The Comparative Effectiveness of Tendon and Nerve Gliding Exercises in Patients with Carpal Tunnel Syndrome: A Randomized Trial. American Journal Of Physical Medicine & Rehabilitation, 90(6), 435-442. doi:10.1097/PHM.0b013e318214eaaf

Moraska, A., Chandler, C., Edmiston-Schaetzel, A., Franklin, G., Calenda, E. L., & Enebo, B. (2008). Comparison of a Targeted and General Massage Protocol on Strength, Function, and Symptoms Associated with Carpal Tunnel Syndrome: A Randomized Pilot Study. Journal Of Alternative & Complementary Medicine, 14(3), 259-267. doi:10.1089/acm.2007.0647

Nancy A. Baker, Krissy K. Moehling, Elaine N. Rubinstein, Ronit Wollstein, Norman P. Gustafson, Mark Baratz, (2012). The Comparative Effectiveness of Combined Lumbrical Muscle Splints and Stretches on Symptoms and Function in Carpal Tunnel Syndrome, Archives of Physical Medicine and Rehabilitation, Volume 93, Issue 1, January 2012, Pages 1-10, ISSN 0003-9993, http://dx.doi.org/10.1016/j.apmr.2011.08.013

References

Any questions/comments about CTS research? Other comments/suggestions…

Questions

Madalyn Payne, OTS

mpayne@spalding.edu

Contact Information