Predicting outcomes of conservative treatment for patients with carpal tunnel syndrome: Group- and individual-based rehabilitation.
Mary Ml Chu, Josephine Chan, Chetwyn Ch Chan
PMID 34408558WHAT IT FOUND
Baseline symptom and hand-function scores helped identify who met discharge criteria after two-stage carpal tunnel treatment.
A symptom score cut-off guided group splint education; a function score cut-off guided intensive one-on-one care.
Key findings
01Of 166 patients admitted, 70 met Stage-One discharge criteria and 96 did not.
02Baseline Chinese SSS score was the only significant predictor of Stage-One outcome, with an optimal cutoff of 23.5.
03Baseline Chinese Quick DASH score was the only significant predictor of Stage-Two outcome, with an optimal cutoff of 27.4.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
There was no follow-up after patients completed the programmes, so outcomes were judged only at discharge. The Stage-Two analysis was small: only 49 of the 96 referred patients started it, and the authors say this could bias results and reduce power. The programme used typical non-surgical CTS interventions, not the most current interventions. The proposed decision tree has not been tested for validity or efficacy. The findings apply only to CTS patients with similar characteristics to those recruited.
The easy way to misread this
Do not treat the SSS and Quick DASH cutoff scores as proven triage rules. The paper says the decision tree still needs validity and efficacy tests, and the Stage-Two model was based on only 49 patients.