Efficacy of night splinting and ultrasound in Carpal Tunnel Syndrome . A randomized controlled clinical trial

AbstrAct Objective: To compare the efficacy of night wrist immobilization using an ulnar splint in neutral angle versus the use of ultrasound (US) in patients with mild and moderate Carpal Tunnel Syndrome (CTS). Materials and Methods: Study population included over 18 years of age that were treated for electromyography-confirmed CTS between October 2007 and March 2010 at a Buenos Aires hospital. A sexand age-stratified randomization was performed by using randomly permuted blocks, allocating patients into the experimental group (EG) and control group (CG). Pulsed US therapy was administered for 15 minutes to all patients three times a week for six weeks at a frequency of 1 MHz. In addition, EG patients were also prescribed night splint. Pain and paresthesia were evaluated using a 100mm Visual Analogue Scale (VAS), the Patient Specific Functional Scale (PSFS), and the Moberg pickup test (MPUT) at baseline, at 3 and 6 weeks, and follow-up at 1, 3 and 6 months after treatment by a blinded investigator. results: Study population consisted of 85 cases (65 patients) that were randomly allocated to CG (n=42) or EG (n=43). Twenty were eliminated, so 32 in the CG and 33 in EG were analyzed. Improvement of all the variables was observed at the end of treatment in both groups, with a 1.64 (95% CI: 0.38-2.91, P=0.012) statistically significant difference in means for pain in favor of the EG at 3 weeks of treatment, but without a significant clinical difference. No adverse effects were observed. conclusion: The efficacy of combined night splint and US therapy is not superior to the US alone treatment in CTS patients.