systematic reviews and meta-analyses of carpal tunnel ...systematic reviews and meta-analyses of...

Systematic Reviews and Meta-Analyses of Carpal Tunnel Syndrome TreatmentsINCLUDED

Author Title Journal

O'Connor, et al.2003 Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome Cochrane Database Syst Rev

Verdugo, et al.2003 Surgical versus non-surgical treatment for carpal tunnel syndrome Cochrane Database Syst Rev

Marshall, et al.2002 Local corticosteroid injection for carpal tunnel syndrome Cochrane Database Syst Rev

Thoma, et al.2004

A meta-analysis of randomized controlled trials comparing endoscopic and open carpal tunnel decompression Plast Reconstr Surg

Scholten, et al.2004 Surgical treatment options for carpal tunnel syndrome Cochrane Database Syst Rev

Non

-Sur

gica

lS

urgi

cal

Evidence Tables.pdf of 236

Systematic Reviews and Meta-Analyses of Carpal Tunnel Syndrome TreatmentsEXCLUDED

Author Title Journal Reason for Exclusion

Crawford, et al.2007 Conservative treatment of work-related upper limb disorders: a review Occup Med (Lond) Search strategy not published

Verhagen, et al.2007 Exercise proves effective in a systematic review of work-related complaints of the arm, neck, or shoulder J Clin Epidemiol Search strategy not published

Jerosch-Herold, et al.2006

A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF)

as a reference toolBMC Musculoskelet Disord Search strategy not published

Verhagen, et al.2006

Ergonomic and physiotherapeutic interventions for treating work-related complaints of the arm, neck or shoulder in adults Cochrane Database Syst Rev Relevant studies did not meet

inclusion criteria (EDX)

Goodyear-Smith, et al.2004

What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management Ann Fam Med Search strategy not published

Muller, et al.2004

Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review J Hand Ther Unable to reproduce search

Gerritsen, et al.2002

Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials J Neurol No statistical pooling (meta-

analysis)

Feuerstein, et al.1999 Clinical management of carpal tunnel syndrome: a 12-year review of outcomes Am J Ind Med Search strategy not published

Thoma, et al.2004

A systematic review of reviews comparing the effectiveness of endoscopic and open carpal tunnel decompression Plast Reconstr Surg Unable to reproduce search

Chapell, et al.2003

Poor outcome for neural surgery (epineurotomy or neurolysis) for carpal tunnel syndrome compared withcarpal tunnel release alone: a meta-analysis of global outcomes Plast Reconstr Surg Unable to reproduce search

Gerritsen, et al.2001 Systematic review of randomized clinical trials of surgical treatment for carpal tunnel syndrome Br J Surg Search strategy not published

Boeckstyns, et al.1999

Does endoscopic carpal tunnel release have a higher rate of complications than open carpal tunnel release? An analysis of published series J Hand Surg [Br ] Search strategy not published

Jimenez, et al.1998 Endoscopic treatment of carpal tunnel syndrome: a critical review J Neurosurg Unable to reproduce search

Non

-Sur

gica

lS

urgi

cal


Systematic Reviews and Meta-Analyses of Carpal Tunnel Syndrome TreatmentsSurgical and Non-Surgical


Crawford, et al.2007 Conservative treatment of work-related upper limb disorders: a review Occup Med (Lond)

Verhagen, et al.2007 Exercise proves effective in a systematic review of work-related complaints of the arm, neck, or shoulder J Clin Epidemiol


A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF)

as a reference toolBMC Musculoskelet Disord


Ergonomic and physiotherapeutic interventions for treating work-related complaints of the arm, neck or shoulder in adults Cochrane Database Syst Rev

Goodyear-Smith, et al.2004

What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management Ann Fam Med

Muller, et al.2004

Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review J Hand Ther

O'Connor, et al.2003 Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome Cochrane Database Syst Rev



Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials J Neurol


Feuerstein, et al.1999 Clinical management of carpal tunnel syndrome: a 12-year review of outcomes Am J Ind Med

Non

-Sur

gica

l


Systematic Reviews and Meta-Analyses of Carpal Tunnel Syndrome TreatmentsSurgical and Non-Surgical



Thoma, et al.2004


Thoma, et al.2004

A systematic review of reviews comparing the effectiveness of endoscopic and open carpal tunnel decompression Plast Reconstr Surg

Chapell, et al.2003

Poor outcome for neural surgery (epineurotomy or neurolysis) for carpal tunnel syndrome compared with carpal tunnel release alone: a meta-analysis of global outcomes Plast Reconstr Surg

Gerritsen, et al.2001 Systematic review of randomized clinical trials of surgical treatment for carpal tunnel syndrome Br J Surg

Boeckstyns, et al.1999

Does endoscopic carpal tunnel release have a higher rate of complications than open carpal tunnel release? An analysis of published series J Hand Surg [Br ]

Jimenez, et al.1998 Endoscopic treatment of carpal tunnel syndrome: a critical review J Neurosurg

Sur

gica

l


Non-Operative/Conservative TreatmentExcluded Articles


Chan, et al.2007

The relationship between electrodiagnostic findings and patient symptoms andfunction in carpal tunnel syndrome Arch Phys Med Rehabil Not Relevant

Porrata, et al.2007

New carpal ligament traction device for the treatment of carpal tunnel syndrome unresponsive to conservative therapy J Hand Ther Not a controlled trial

Staal, et al.2007 Aetiology and management of work-related upper extremity disorders Best Pract Res Clin Rheumatol No Data

Kastrup, et al.2007

Steroid injection or surgery for the treatment of carpal tunnel syndrome? Comment MMW-Fortschritte der Medizin Foreign language

Mishra, et al.2006

Efficacy of splinting and oral steroids in the treatment of carpal tunnel syndrome: a prospective randomized clinical and electrophysiological study Neurol India > 20% bilateral

Jensen, et al.2006

The pain quality assessment scale: assessment of pain quality in carpal tunnelsyndrome J Pain Not Relevant

Nalamachu, et al.2006a

Lidocaine patch 5 for carpal tunnel syndrome: how it compares with injections:a pilot study J Fam Pract Uses non-validated outcome measure

Nalamachu, et al.2006b

A comparison of the lidocaine patch 5% vs naproxen 500 mg twice daily for the relief of pain associated with carpal tunnel syndrome: a 6-week,

randomized, parallel-group studyMedGenMed Uses non-validated outcome measure

Rempel, et al.2006

A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders

among computer operatorsOccup Environ Med Not CTS specific

Andreu, et al.2006

A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome Neurology Not Relevant

Werner, et al.2006 Evaluation of work-related carpal tunnel syndrome J Occup Rehabil Not Relevant

Baysal, et al.2006

Comparison of three conservative treatment protocols in carpal tunnel syndrome Int J Clin Pract > 20% bilateral, uses non-validated

outcome measure

Breuer, et al.2006

Clinically significant placebo analgesic response in a pilot trial of botulinum B in patients with hand pain and carpal tunnel syndrome Pain Med Less than 10 patients

Greening, et al.2006

Workshop: clinical implications for clinicians treating patients with non-specific arm pain, whiplash and carpal tunnel syndrome Man Ther No Data

Korthals-de, et al.2006

Surgery is more cost-effective than splinting for carpal tunnel syndrome in the Netherlands: results of an economic evaluation alongside a randomized

controlled trialBMC Musculoskelet Disord Not Relevant

Tsai, et al.2006

Efficacy of botulinum toxin type a in the relief of Carpal tunnel syndrome: A preliminary experience Clin Drug Investig Not a controlled trial





Ergonomic and physiotherapeutic interventions for treating work-related complaints of the arm, neck or shoulder in adults Cochrane Database Syst Rev Did not use electrodiagnostic testing for

diagnosis

Yagci, et al.2006

Comparison of splinting, splinting plus local steroid injection and surgery in carpal tunnel syndrome treatment Turk Fiz Tip Rehab Derg Foreign language

Pinar, et al.2005 Can we use nerve gliding exercises in women with carpal tunnel syndrome? Adv Ther > 20% bilateral

Boyd, et al.2005

Outcomes in carpal tunnel syndrome: symptom severity, conservative management and progression to surgery Clin Invest Med Not a controlled trial

Agarwal, et al.2005

A prospective study of the long-term efficacy of local methyl prednisolone acetate injection in the management of mild carpal tunnel syndrome Rheumatology (Oxford) Not a controlled trial

Anonymous 2005 Steroid injection equivalent to surgery for carpal tunnel syndrome Journal of Family Practice Not a controlled trial

Aygul, et al.2005

Determination of sensitive electrophysiologic parameters at follow-up of different steroid treatments of carpal tunnel syndrome J Clin Neurophysiol > 20% bilateral

Schrijver, et al.2005

Correlating nerve conduction studies and clinical outcome measures on carpaltunnel syndrome: lessons from a randomized controlled trial J Clin Neurophysiol Not treatment

Armitage, et al.2005

A new professional in the healthcare workforce: role, training, assessment andregulation Clin Med Not a controlled trial

Gerr, et al.2005

A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users Occup Environ Med Not CTS specific

Weber, et al.2005 Clinical outcomes of carpal tunnel release in patients 65 and older J Hand Surg [Am ] Surgery, not a controlled trial

Werner, et al.2005

Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome Arch Phys Med Rehabil Did not use electrodiagnostic testing for

diagnosis

Gokoglu, et al.2005

Evaluation of iontophoresis and local corticosteroid injection in the treatment of carpal tunnel syndrome Am J Phys Med Rehabil > 20% bilateral

Ly-Pen, et al.2005

Surgical decompression versus local steroid injection in carpal tunnel syndrome: a one-year, prospective, randomized, open, controlled clinical trial Arthritis Rheum > 20% bilateral

Mondelli, et al.2005

Sex differences in carpal tunnel syndrome: comparison of surgical and non-surgical populations Eur J Neurol Not a controlled trial

Wong, et al.2005

Single vs. two steroid injections for carpal tunnel syndrome: a randomised clinical trial Int J Clin Pract > 20% bilateral




Sato, et al.2005

Amelioration by mecobalamin of subclinical carpal tunnel syndrome involving unaffected limbs in stroke patients J Neurol Sci Not Relevant

Stasinopoulos, et al.2005

Treatment of carpal tunnel syndrome with polarized polychromatic noncoherent light (Bioptron light): a preliminary, prospective, open clinical trial Photomed Laser Surg Not a controlled trial

Bigat, et al.2005

Comparison of the effect of low-dose ropivacaine and lidocaine in intravenous regional anaesthesia: A randomised, double-blind clinical study Clin Drug Invest Not Relevant

Dakowicz, et al.2005

The value of iontophoresis combined with ultrasound in patients with the carpal tunnel syndrome Rocz Akad Med Bialymst Foreign Language

Martin, et al.2005

Randomized clinical trial of surgery versus conservative therapy for carpal tunnel syndrome BMC Musculoskelet Disord No data

Pazzaglia, et al.2005

Multicenter study on carpal tunnel syndrome and pregnancy incidence and natural course Acta Neurochir Suppl No treatment

Weintraub, et al.2005

Pulsed magnetic field therapy in refractory carpal tunnel syndrome: Electrodiagnostic parameters - Pilot study J Back Musculoskelet Rehabil Not Relevant

Weintraub, et al.2005

Time-Varying, Biaxial Magnetic Stimulation in Refractory Carpal Tunnel Syndrome: A Novel Approach. A Pilot Study Semin Integr Med Did not use electrodiagnostic testing for

diagnosis

Piravej, et al.2004

Effect of ultrasound thermotherapy in mild to moderate carpal tunnel syndrome J Med Assoc Thai > 20% bilateral

Hagebeuk, et al.2004

Clinical and electrophysiological follow-up after local steroid injection in the carpal tunnel syndrome Clin Neurophysiol Not a controlled trial

Graham, et al.2004

A prospective study to assess the outcome of steroid injections and wrist splinting for the treatment of carpal tunnel syndrome Plast Reconstr Surg Not a controlled trial

Irvine, et al.2004

Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome Muscle Nerve Less than 10 patients

Hui, et al.2004 Long-term outcome of carpal tunnel syndrome after conservative treatment Int J Clin Pract > 20% bilateral

Bakhtiary, et al.2004 Ultrasound and laser therapy in the treatment of carpal tunnel syndrome Aust J Physiother > 20% bilateral

Gerritsen, et al.2003 Splinting for carpal tunnel syndrome: prognostic indicators of success J Neurol Neurosurg Psychiatry No Data

Graham, et al.2003

Two weeks of prednisolone was as effective as four weeks in improving carpaltunnel syndrome symptoms J Bone Joint Surg Am Commentary




Wang, et al.2003 Pain levels after injection of corticosteroid to hand and elbow Am J Orthop Not a controlled trial


Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials J Neurol No Data

Naeser, et al.2002

Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: A controlled study Arch Phys Med Rehabil < 10 patients in each group

MacDermid, et al.2002 A hand brace improve symptoms and function in carpal tunnel syndrome Aust J Physiother Not a controlled trial

Wong, et al.2001 Local vs systemic corticosteroids in the treatment of carpal tunnel syndrome Neurology Duplicate Data

Hochberg, et al.2001

A randomized prospective study to assess the efficacy of two cold-therapy treatments following carpal tunnel release J Hand Ther Not Relevant


Splinting or surgery for carpal tunnel syndrome? Design of a randomized controlled trial BMC Neurol Design of study, no data

Li, et al.1999

Effectiveness of splinting for work-related carpal tunnel syndrome: A three-month follow-up study Technol Disabil Not a controlled trial

Banta, et al.1994

A prospective, nonrandomized study of iontophoresis, wrist splinting, and antiinflammatory medication in the treatment of early-mild carpal tunnel

syndromeJ Occup Med Not a controlled trial

Thomas, et al.1993 The effects of biofeedback on carpal tunnel syndrome Ergonomics Less than 10 patients

Girlanda, et al.1993

Local steroid treatment in idiopathic carpal tunnel syndrome: short- and long-term efficacy J Neurol > 20% bilateral

Laso, et al.1989 Carpal tunnel syndrome and vitamin B6 Klin Wochenschr Not a controlled trial


Non-Operative/Conservative TreatmentRelevant Articles from O'Connor, et al. / Marshall, et. al. / Verdugo, et al. Systematic Reviews



Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial JAMA

Carter, et al.2002

The effectiveness of magnet therapy for treatment of wrist pain attributed to carpal tunnel syndrome J Fam Pract

Chang, et al.2002

A randomised clinical trial of oral steroids in the treatment of carpal tunnel syndrome: a long term follow up J Neurol Neurosurg Psychiatry

Hui, et al.2001 Oral steroid in the treatment of carpal tunnel syndrome Ann Rheum Dis

Manente, et al.2001

An innovative hand brace for carpal tunnel syndrome: a randomized controlled trial Muscle Nerve

Davis, et al.1998

Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trail J Manipulative Physiol Ther

Stransky, et al.1989 Treatment of carpal tunnel syndrome with vitamin B6: a double-blind study South Med J

Garland, et al.1964 Surgical Treatment for the Carpal Tunnel Syndrome Lancet


Non-Operative/Conservative TreatmentIncluded Articles


Burke, et al.2007

A pilot study comparing two manual therapy interventions for carpal tunnel syndrome J Manipulative Physiol Ther

Evcik, et al.2007

Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial Photomed Laser Surg

Ucan, et al.2006

Comparison of splinting, splinting plus local steroid injection and open carpal tunnel release outcomes in idiopathic carpal tunnel syndrome Rheumatol Int

Dammers, et al.2006

Injection with methylprednisolone in patients with the carpal tunnel syndrome: a randomised double blind trial testing three different doses J Neurol

Habib, et al.2006

A novel approach of local corticosteroid injection for the treatment of carpal tunnel syndrome Clin Rheumatol

Premoselli, et al.2006

Neutral wrist splinting in carpal tunnel syndrome: a 3- and 6-months clinical and neurophysiologic follow-up evaluation of night-only splint therapy Eura Medicophys

Hui, et al.2005

A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome Neurology

Michlovitz, et al.2004 Continuous low-level heat wrap therapy is effective for treating wrist pain Arch Phys Med Rehabil

Sevim, et al.2004

Long-term effectiveness of steroid injections and splinting in mild and moderate carpal tunnel syndrome Neurol Sci

Armstrong, et al.2004

Intracarpal steroid injection is safe and effective for short-term management of carpal tunnel syndrome Muscle Nerve

O'Connor, et al.2003

Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome Cochrane Database Syst Rev


Demirci, et al.2002

Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome Rheumatol Int


Blankfield, et al.2001 Therapeutic touch in the treatment of carpal tunnel syndrome J Am Board Fam Pract

O'Gradaigh, et al.2000 Corticosteroid injection for the treatment of carpal tunnel syndrome Ann Rheum Dis


Non-Operative/Conservative TreatmentStudy Design and Quality

Author N Study Design Treatment(s) Duration Level of Evidence

Burke, et al.2007 26 RCT Graston Instrument vs.

Soft tissue mobilization 18 Weeks ● ● ● ● ○ ○ ○ ● ● ● ● ● ● Level II

Evcik, et al.2007 81 RCT Laser Therapy & splint at night vs.

Placebo Laser & splint at night 12 Weeks ● ● ● ○ ● ● ● ● ● ● ● ● ● Level I

Ucan, et al.2006 67 RCT Splinting vs.

Splinting & Steroid injection / OCTR 6 Months ● ● ○ ● ○ ○ ▫ ● ● ● ● ● ▫ Level II

Dammers, et al.2006 132 RCT Steroid Injection vs.

Steroid Injection 12 Months ● ● ● ● ● ● ● ● ● ● ● ● ▫ Level I

Habib, et al.2006 42 RCT Novel Approach Steroid Injection vs.

Classic Approach Steroid Injection 12 Weeks ● ● ▫ ▫ ○ ○ ○ ● ● ● ● ● ▫ Level II

Premoselli, et al.2006 50 RCT Splinting vs.

Control 6 Months ○ ● ○ ○ ○ ○ ● ● ● ● ● ● ▫ Level II

Hui, et al.2005 50 RCT Steroid Injection vs.

OCTR 20 Weeks ● ● ● ● ○ ○ ● ● ● ● ● ● ● Level I

Michlovitz, et al.2004 94 RCT Heat therapy vs.

Control or Placebo 3 days ● ● ▫ ▫ ○ ○ ● ○ ○ ● ● ● ● Level II

Sevim, et al.2004 120 RCT Distal injection vs.

Proximal injection 11 Months ● ● ● ● ○ ○ ● ● ● ● ● ● ● Level I

Armstrong, et al.2004 81 RCT Steroid Injection vs.

Placebo 2 Weeks ● ● ● ● ● ● ● ● ● ● ● ● ● Level I

Demirci, et al.2002 90 RCT Steroid Injection vs.

OCTR 6 Months ● ● ▫ ▫ ○ ○ ▫ ● ● ● ● ● ▫ Level II

Blankfield, et al.2001 21 RCT Therapeutic Touch vs.

Control 6 weeks ● ● ▫ ▫ ● ○ ▫ ● ● ● ● ● ● Level II

O'Gradaigh, et al.2000 123 RCT Steroid Injection vs.

Steroid Injection 6 Months ▫ ● ▫ ▫ ● ○ ○ ▫ ● ● ● ● ▫ Level II

● = Yes ○ = No ▫ = Not Reported

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Non-Operative/Conservative TreatmentPatient Characteristics

Author Group Name N N Hands Mean Age Age Range

Age Std. Dev. N N Hands Mean Age Age

RangeAge Std.

Dev. N N Hands Mean Age Age Range

Age Std. Dev. Mean Range Std. Dev. Mean Range Std. Dev.

Burke, et al.2007

Gratson Instrument (GISTM) 12 12 39.8 NR ± 8.75 10 10 NR NR NR 2 2 NR NR NR NR NR NR NR NR NR

Soft tissue manipulation 10 10 43.4 NR ± 5.32 9 9 NR NR NR 1 1 NR NR NR NR NR NR NR NR NR

Evcik, et al.2007

Low Level Laser Therapy & splint at night 41 41 47.7 { 28-75 } ± 10.0 33 NR NR NR NR 8 NR NR NR NR NR NR NR NR NR NR

Placebo laser & wrist splint 40 40 51 { 26-78 } ± 11.8 37 NR NR NR NR 3 NR NR NR NR NR NR NR NR NR NR

Ucan, et al.2006 Splinting 23 23 44.50 NR ± 7.24 22 22 NR NR NR 1 1 NR NR NR 15.26

Months NR ± 7.19 28.13 NR ± 2.17

Splinting & Steroid Injection 23 23 44.46 NR ± 8.52 21 21 NR NR NR 2 2 NR NR NR 19.13Months NR ± 13 27.97 NR ± 4.46

OCTR 11 11 45.27 NR ± 13.19 10 10 NR NR NR 1 1 NR NR NR 21Months NR ± 11 28.25 NR ± 3.6

Dammers, et al.2006 Steroid Injection - 40mg 43 NR 51 NR NR 34 NR NR NR NR 9 NR NR NR NR 12

NR NR NR NR NR NR

Steroid Injection - 60mg 44 NR 54 NR NR 33 NR NR NR NR 11 NR NR NR NR 13NR NR NR NR NR NR

Steroid Injection - 20mg 45 NR 49 NR NR 35 NR NR NR NR 10 NR NR NR NR 12NR NR NR NR NR NR

Habib, et al.2006

Classic Approach Steroid Injection 21 NR 43.3 { 22-68 } ± 12.6 17 NR NR NR NR 4 NR NR NR NR 5.5

Months NR ± 2.946 NR NR NR

Novel Approach Steroid Injection 21 NR 41 { 21-63 } ± 11.3 16 NR NR NR NR 5 NR NR NR NR 6


Premoselli, et al.2006 Control 25 NR 46.5 NR ± 13.8 22 NR NR NR NR 3 NR NR NR NR NR NR NR NR NR NR

Splinting 25 NR 53.1 NR ± 13.3 23 NR NR NR NR 2 NR NR NR NR NR NR NR NR NR NR

Hui, et al.2005 Steroid Injection 25 NR 48.2 NR ± 6.5 24 NR NR NR NR 1 NR NR NR NR NR NR NR NR NR NR

OCTR 25 NR 50.8 NR ± 11.6 24 NR NR NR NR 1 NR NR NR NR NR NR NR NR NR NR

BMI (kg/m 2 )All Patients Symptom DurationMaleFemale





RangeAge Std.




Michlovitz, et al.2004 Heat wrap - nonCTS 29 NR 43.93 NR ± 11.19 0.53 NR NR NR NR 0.47 NR NR NR NR NR NR NR NR NR NR

Oral placebo - nonCTS 30 NR 43.33 NR ± 10.08 0.53 NR NR NR NR 0.47 NR NR NR NR NR NR NR NR NR NR

Oral acetaminophin - nonCTS 5 NR 46.6 NR ± 6.54 0 NR NR NR NR 1 NR NR NR NR NR NR NR NR NR NR

No Heat wrap - nonCTS 5 NR 47.6 NR ± 9.56 0.6 NR NR NR NR 0.4 NR NR NR NR NR NR NR NR NR NR

Heat wrap - CTS 10 NR 50.1 NR ± 8.82 0.1 NR NR NR NR 0.9 NR NR NR NR NR NR NR NR NR NR

Oral placebo - CTS 12 NR 45.08 NR ± 10.84 0.25 NR NR NR NR 0.75 NR NR NR NR NR NR NR NR NR NR

Oral acetaminophin - CTS 1 NR 30 NR ± 0 0 NR NR NR NR 1 NR NR NR NR NR NR NR NR NR NR

No Heat wrap - CTS 1 NR 51 NR ± 0 0 NR NR NR NR 1 NR NR NR NR NR NR NR NR NR NR

Sevim, et al.2004 Proximal injection 28 28 43.89 NR ± 10.54 27 27 NR NR NR 1 1 NR NR NR NR 5 Mo. -

30 Years NR NR NR NR

Distal Injection 29 29 45.45 NR ± 11.60 24 24 NR NR NR 5 5 NR NR NR NR NR NR NR NR NR

Splint 28 28 49.71 NR ± 9.75 22 22 NR NR NR 6 6 NR NR NR NR NR NR NR NR NR

Control 23 23 46.0 NR ± 7.9 19 19 NR NR NR 4 4 NR NR NR NR NR NR NR NR NR

Armstrong, et al.2004 Placebo 38 NR 51.2 NR ± 10.4 28 NR NR NR NR 10 NR NR NR NR NR NR NR 31.3 NR ± 6.8

Steroid Injection 43 NR 51.9 NR ± 13.3 35 NR NR NR NR 8 NR NR NR NR NR NR NR 30.8 NR ± 7.3

Demirci, et al.2002 OCTR 44 44 48 { 33-66 } ± 8.4 38 NR NR NR NR 6 NR NR NR NR NR NR NR NR NR NR

Steroid Injection 46 46 45.6 { 31-65 } ± 9.9 42 NR NR NR NR 4 NR NR NR NR NR NR NR NR NR NR

Blankfield, et al.2001 Therapeutic Touch 11 NR 57.4 NR ± 14.9 6 NR NR NR NR 5 NR NR NR NR NR NR NR NR NR NR

Sham Treatment 10 NR 55.2 NR ± 13.1 5 NR NR NR NR 5 NR NR NR NR NR NR NR NR NR NR

O'Gradaigh, et al.2000

25 mg Hydrocortisone injection 32 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

100 mg Hydrocortisone injection 32 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Controls 20 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

20 mg Triamcinolone Hexatonide (long acting) 18 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

100 mg Hydrocortisone 21 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR



Author Group Name N Co-Interventions Co-Morbidities Adverse Events Left Handed

Right Handed

w/ Persistent Symptoms

w/ Thenar Atrophy

w/ Axonal Loss

w/ Spontaneous

Remission

Want Surgery

Want Non-Surgical

TreatmentSeverity Severity

Determined by

Burke, et al.2007

Gratson Instrument (GISTM) 12 NR NR NR NR NR NR NR NR NR NR NR NR NR

Soft tissue manipulation 10 NR NR NR NR NR NR NR NR NR NR NR NR NR

Evcik, et al.2007

Low Level Laser Therapy & splint at night 41 NR NR NR NR NR NR NR NR NR NR NR NR NR

Placebo laser & wrist splint 40 NR NR NR NR NR NR NR NR NR NR NR NR NR

Ucan, et al.2006 Splinting 23 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Splinting & Steroid Injection 23 NR NR NR NR NR NR 0 NR NR NR NR NR NR

OCTR 11 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Dammers, et al.2006 Steroid Injection - 40mg 43 NR NR NR NR NR NR NR NR NR NR NR NR NR

Steroid Injection - 60mg 44 NR NR NR NR NR NR NR NR NR NR NR NR NR

Steroid Injection - 20mg 45 NR NR NR NR NR NR NR NR NR NR NR NR NR

Habib, et al.2006

Classic Approach Steroid Injection 21 NR 5 diabetes mellitus NR NR NR NR NR NR NR NR NR NR NR

Novel Approach Steroid Injection 21 NR 6 diabetes mellitus NR NR NR NR NR NR NR NR NR NR NR

Premoselli, et al.2006 Control 25 NR NR NR NR NR NR NR NR NR NR NR NR NR

Splinting 25 NR NR NR NR NR NR NR NR NR NR NR NR NR

Hui, et al.2005 Steroid Injection 25 NR NR 1 pt cellulitis, 4 pts pain at

injection site NR NR NR 0 NR NR NR NR NR NR

OCTR 25 NR NR 2 pts wound hematoma, 9 pts wound pain NR NR NR 0 NR NR NR NR NR NR

Number of Patients




Right Handed


w/ Thenar Atrophy

w/ Axonal Loss

w/ Spontaneous

Remission

Want Surgery

Want Non-Surgical

TreatmentSeverity Severity

Determined by

Number of Patients

Michlovitz, et al.2004 Heat wrap - nonCTS 29 NR NR NR NR NR NR NR NR NR NR NR NR

Oral placebo - nonCTS 30 NR NR NR NR NR NR NR NR NR NR NR NR

Oral acetaminophin - nonCTS 5 NR NR NR NR NR NR NR NR NR NR NR NR

No Heat wrap - nonCTS 5 NR NR NR NR NR NR NR NR NR NR NR NR

Heat wrap - CTS 10 NR NR NR NR NR NR NR NR NR NR NR NR

Oral placebo - CTS 12 NR NR NR NR NR NR NR NR NR NR NR NR

Oral acetaminophin - CTS 1 NR NR NR NR NR NR NR NR NR NR NR NR

No Heat wrap - CTS 1 NR NR NR NR NR NR NR NR NR NR NR NR

Sevim, et al.2004 Proximal injection 28 NR NR NR NR NR NR NR NR NR NR NR NR NR

Distal Injection 29 NR NR NR NR NR NR NR NR NR NR NR NR NR

Splint 28 NR NR NR NR NR NR NR NR NR NR NR NR NR

Control 23 NR NR NR NR NR NR NR NR NR NR NR NR NR

Armstrong, et al.2004 Placebo 38 Diabetes=5 Hypothyroidism=3 NR NR NR NR NR NR NR NR NR NR NR

Steroid Injection 43 Diabetes=1 Hypothyroidism=4 NR NR NR NR NR NR NR NR NR NR NR

Demirci, et al.2002 OCTR 44 NR NR NR NR NR NR NR NR NR NR NR NR NR

Steroid Injection 46 NR NR NR NR NR NR NR NR NR NR NR NR NR

Blankfield, et al.2001 Therapeutic Touch 11 NR diabetes = 9 NR 3 8 NR NR NR NR NR NR NR NR

Sham Treatment 10 NR diabetes = 3 NR 3 7 NR NR NR NR NR NR NR NR


25 mg Hydrocortisone injection 32 NR NR NR NR NR NR NR NR NR NR NR NR NR

100 mg Hydrocortisone injection 32 NR NR NR NR NR NR NR NR NR NR NR NR NR

Controls 20 NR NR NR NR NR NR NR NR NR NR NR NR NR

20 mg Triamcinolone Hexatonide (long acting) 18 NR NR NR NR NR NR NR NR NR NR NR NR NR

100 mg Hydrocortisone 21 NR NR NR NR NR NR NR NR NR NR NR NR NR

Daytime splint usage, NSAIDs, or nontraditional treatments permitted

* overall n=9, one of coldness in fingers (heat therapy), one of dyspepsia (acetaminophin) other 7 not reported


Non-Operative/Conservative TreatmentPatient Characteristics - Inclusion/Exclusion Criteria

Author N Treatment(s) Study Enrollement / Eligibility Criteria Study Exclusion Criteria

Burke, et al.2007 26 Graston Instrument vs.

Soft tissue mobilization

patients needed to present with pain and paresthesis in the median nerve and 2 of the following:sleep disturbance, mean symptom severity score of at least 3 of 5, mean functional status score of at least 3 of 5, positive results on Tinel's sign, positive results on Phalen's sign, strength deficits, sensory defictis of touch, limited ROM

older than 50; previous surgery and/or steriod injection; history suggesting underlying cause of CTS (pregnancy, diabetes mellitus, thyroid disease, reflex sympathetic dysfunction, fibromyolagia); no pending law suits or insurance claims

Evcik, et al.2007 81 Laser Therapy & splint at night vs.

Placebo Laser & splint at nightdiagnosed with CTS based on clinical and electrophysiological evidence

Hand trauma, cervical raddiculopathy, thoracic outlet syndrome or neurologic, cognitive, inflammatory and tumoral disorders

Ucan, et al.2006 67 Splinting vs.

Splinting & Steroid injection / OCTRPatients with mild or moderate idiopathic CTS who experienced syptoms for over 6 months

Patients with advanced CTS or thenar atrophy; patients with underlying metabolic disorders such as diabetes mellitus, thyroid, kidney diseases, connective tissue disorders, malignity, distal radius fracture, and pregnancy in etiology; conditions that could affect

Dammers, et al.2006 132 Steroid Injection vs.

Steroid Injection

Patients with symptoms of CTS of more than 3 months duration confirmed by electrophysiological tests; >18 years old; diagnosis confirmed by sensory distal latency difference of the ring finger more than 0.4ms between median nerve and ulnar nerve stimulation

Patients already treated for symptoms of CTS; patients with underlying cause for CTS such as polyneuropathy; if electrodiagnostic tests showed severe motor denervation with reduction of amplitude of distal motor evoked potential and presence of fibrillations at rest

Habib, et al.2006 42 Novel Approach Steroid Injection vs.

Classic Approach Steroid Injection

Patients with symptoms of CTS; positive electrophysiological study; >18 years old; symptoms less than 1 year duration

Evidence of inflammatory arthritis, hypothyroidism, or pregnancy; injected or operated surgically at the tunnel before

Premoselli, et al.2006 50 Splinting vs.

Control

Those presenting CTS symptoms; CMAP median nerve distal latency <4.7; difference between median and ulnar SAP latencies >0.4ms

Diabetics; patients with clear CTS




Hui, et al.2005 50 Steroid Injection vs.

OCTR

diagnosis of CTS by electrophysiologic abnormalities present (median-ulnar palmar sensory latency difference >0.5 msec or prolonged median nerve DML > 4 msec)

1.patients with evidence of severe CTS defined by presence of thenar atrophy or unelicitable DML 2.patients with ulnar, radial neuropathy or proximal median neuropathy 3.coexisting disorders or conditions tha may mimic CTS such as brachial plexopathy, cervical radiculopathy, tenosynovitis 4.contraindication to steroid use such as active affective disorder and recent poptic ulcer 5.hx of underlying disorders associated with CTS such as DM, wrist trauma, rheumatoid arthritis, acromegaly, hypothyroidism 6.pregnancy

Michlovitz, et al.2004 94 Heat therapy vs.

Control or Placebo

healthy patients with wrist pain due to sprain or strain injury (n=57) with injury occuring less than 48 from enrollment date, clinically- diagnosed osteoarthritis (n=13) or show clinical signs of carpal tunnel syndrome (n=24); pain at least moderate or greater on a 6-point scale (0=none, 2=moderate, 5=very severe);

surgery to the treated wrist in the prior 6 months, evidence or history of radiculpathy or peripheral neuropathy of the upper extremities, fracture of the involved wrist within 6 months, collagen vascular disease or other systemic diseases causing joint pain, fibromyalgia, diabetes mellitus, peripheral vascular disease, osteoporosis, gastrointestinal ulcers, GI bleeding or perforation, renal disease, pulmonary edema, cardiomyopathy, liver disease, intrinsic coagulation defects, bleeding diseases or anticoagulant therapy; were taking antidepressant or antianxiety medication; had taken systemic corticosteroid medications within 30 days before taking the first dose of study medication or during the study; had taken systemic muscle relaxant medications, including mild tranquilaizers, within 24 hours before taking the first dose of the study medication or during the study; had received a corticosteroid injection into the involved wrist in the previous 6 months; had applied topical capsaicin within 2 weeks before enrollment; pregnancy; skin lesions on the wrist, history of alcohol or drug abuse, in

Sevim, et al.2004 120 Distal injection vs.

Proximal injection

referred to the electroneuromyography (ENMG) laboratory for the evaluation of CTS with symptoms of nocturnal paresthesias, pain in the median nerve distribution during activity or numbness in the median nerve distribution; distal latency in a median-versus-ulnar digit IV antidromic distal latency of at least 0.4 msec

patients with secondary CTS; used splints in the last 6 months; coincident cervical radiculopaty or ulnar-radial neuropathy; younger than 18 years of age; patients who had previous surgical treatment; received steroid injections in the last 6 months; median distal motor latency > 8ms on ENMG examination; pregnant women




Armstrong, et al.2004 81 Steroid Injection vs.

Placebo

Patients between 18 and 80 years of age with typical symptoms of CTS (nocturnal, postural or usage associated paresthesias in the median nerve distribution, with or without pain); symptoms of refractory to activity modification and use of a night splint for at least 6 weeks duration; electrophysiologic confirmation of CTS

CTR on symptomatic side; previous coricosteroid injection in either carpal tunnel; treatment with systemic (injected or oral) corticosteroids during the prior 6-month period; the current use of warfarin; pregnancy; serious illness; inability to complete an 18-month study; allergy to lidocaine or steroid medications; fracture in the affected wrist or hand in the 12 months prior to study entry; or current participation in an other study

Demirci, et al.2002 90 Steroid Injection vs.

OCTR

Patients referred with signs and symptoms of CTS lasting for at least 6 months; electrophysiologically proven CTS cases with unilateral involvement

Patients with underlying metabolic disorders such as diabetes or connective tissue and kidney or thyroid disease; patients with previous steroid injection into the carpal tunnel; prior carpal tunnel surgery; distal radius fracture

Blankfield, et al.2001 21 Therapeutic Touch vs.

Control

Patients with a diagnosis of CTS confirmed by electrodiagnostic testing and to have a median nerve distal latency greater than 4.2 msec using a portable electroneurometer; patients were eligible regardless of other medical conditions; patients eligible regardless of previous treatment, including surgery

Pregnant; <18 years of age

O'Gradaigh, et al.2000 123 Steroid Injection vs.

Steroid Injection

All patients attending or newly referred to the rheumatology department with a suspected diagnosis of CTS

secondary CTS; previous surgery for CTS; steroid injection in the previous 6 months


Non-Operative/Conservative TreatmentPatient Characteristics - Workers Compensation

Author Group Name N Number on Workers Compensation Occupation(s) Time at Job(s) Agreement between Workers

Compensation and Doctor(s)

Burke, et al.2007

Gratson Instrument (GISTM) 12 NR NR NR NR

Soft tissue manipulation 10 NR NR NR NR

Evcik, et al.2007

Low Level Laser Therapy & splint at night 41 NR NR NR NR

Placebo laser & wrist splint 40 NR NR NR NR

Ucan, et al.2006 Splinting 23 NR NR NR NR

Splinting & Steroid Injection 23 NR NR NR NR

OCTR 11 NR NR NR NR

Dammers, et al.2006 Steroid Injection - 40mg 43 NR NR NR NR

Steroid Injection - 60mg 44 NR NR NR NR

Steroid Injection - 20mg 45 NR NR NR NR

Habib, et al.2006

Classic Approach Steroid Injection 21 NR NR NR NR

Novel Approach Steroid Injection 21 NR NR NR NR

Premoselli, et al.2006 Control 25 NR NR NR NR

Splinting 25 NR NR NR NR

Hui, et al.2005 Steroid Injection 25 NR NR NR NR

OCTR 25 NR NR NR NR





Michlovitz, et al.2004 Heat wrap - nonCTS 29 0

( 0% ) NR NR NR

Oral placebo - nonCTS 30 0( 0% ) NR NR NR

Oral acetaminophin - nonCTS 5 0

( 0% ) NR NR NR

No Heat wrap - nonCTS 5 0( 0% ) NR NR NR

Heat wrap - CTS 10 0( 0% ) NR NR NR

Oral placebo - CTS 12 0( 0% ) NR NR NR

Oral acetaminophin - CTS 1 0( 0% ) NR NR NR

No Heat wrap - CTS 1 0( 0% ) NR NR NR

Sevim, et al.2004 Proximal injection 28 NR NR NR NR

Distal Injection 29 NR NR NR NR

Splint 28 NR NR NR NR

Control 23 NR NR NR NR

Armstrong, et al.2004 Placebo 38 NR NR NR NR

Steroid Injection 43 NR NR NR NR

Demirci, et al.2002 OCTR 44 NR NR NR NR






Blankfield, et al.2001 Therapeutic Touch 11 NR NR NR NR

Sham Treatment 10 NR NR NR NR


25 mg Hydrocortisone injection 32 NR NR NR NR

100 mg Hydrocortisone injection 32 NR NR NR NR

Controls 20 NR NR NR NR

20 mg Triamcinolone Hexatonide (long acting) 18 NR NR NR NR

100 mg Hydrocortisone 21 NR NR NR NR


Non-Operative/Conservative TreatmentContinuous Data Results

Author N Outcome Measure (unit) Duration Group Name Value Group Name Value p-value Statistical test

Burke, et al.2007 26 DML (ms) 0 baseline N Unc N All patients - CTS 22 4.87

± 1.119 SD All patients - control 22 4.25 ± 0.870 SD NR NR NR NR <0.05 t-test

Burke, et al.2007 26 DML (ms) 7 Weeks N Unc N All patients - CTS 22 4.58

± 0.984 SD All patients - control 22 4.25 ± 1.040 SD NR NR NR NR NR NR

Burke, et al.2007 26 DML (ms) 5 Months N Unc N All patients - CTS 22 4.65


Burke, et al.2007 26 DSL (ms) 0 baseline N Unc N All patients - CTS 22 3.90

± 0.644 SD All patients - control 22 3.51 ± 0.693 SD NR NR NR NR <0.05 t test

Burke, et al.2007 26 DSL (ms) 7 Weeks N Unc N All patients - CTS 22 3.65


Burke, et al.2007 26 DSL (ms) 5 Months N Unc N All patients - CTS 22 3.55


Burke, et al.2007 26 DML (ms) 0 baseline N Unc N GISTM patients - CTS 12 4.92

± 1.065 SD GISTM patients - control 12 4.25

± 0.893 SD NR NR NR NR NR NR

Burke, et al.2007 26 DML (ms) 7 Weeks N Unc N GISTM patients - CTS 12 4.58



Burke, et al.2007 26 DML (ms) 5 Months N Unc N GISTM patients - CTS 12 4.73



Burke, et al.2007 26 DSL (ms) 0 baseline N Unc N GISTM patients - CTS 12 3.99



Burke, et al.2007 26 DSL (ms) 7 Weeks N Unc N GISTM patients - CTS 12 3.82



Burke, et al.2007 26 DSL (ms) 5 Months N Unc N GISTM patients - CTS 12 3.65



Burke, et al.2007 26 DML (ms) 0 baseline N Unc N STM patients - CTS 10 4.81

± 1.193 SD STM patients - control 10 4.25 ± 0.889 SD NR NR NR NR NR NR

Burke, et al.2007 26 DML (ms) 7 Weeks N Unc N STM patients - CTS 10 458


Burke, et al.2007 26 DML (ms) 5 Months N Unc N STM patients - CTS 10 4.56


Burke, et al.2007 26 DSL (ms) 0 baseline N Unc N STM patients - CTS 10 3.80


Burke, et al.2007 26 DSL (ms) 7 Weeks N Unc N STM patients - CTS 10 3.43


Burke, et al.2007 26 DSL (ms) 5 Months N Unc N STM patients - CTS 10 3.43


Burke, et al.2007 26 VAS (none) 0 baseline Y Y Y All patients - CTS 22 61.1


Burke, et al.2007 26 VAS (none) 7 Weeks Y Y Y All patients - CTS 22 12.4


Burke, et al.2007 26 VAS (none) 5 Months Y Y Y All patients - CTS 22 20.3


Burke, et al.2007 26 Extension ROM (degree) 0 baseline Y Y N All patients - CTS 22 37.4


Burke, et al.2007 26 Extension ROM (degree) 7 Weeks Y Y N All patients - CTS 22 44.6


Burke, et al.2007 26 Extension ROM (degree) 5 Months Y Y N All patients - CTS 22 44.8


Burke, et al.2007 26 Extension ROM (degree) 0 baseline Y Y N All patients - CTS 22 46.0


Burke, et al.2007 26 Extension ROM (degree) 7 Weeks Y Y N All patients - CTS 22 52.7


Burke, et al.2007 26 Extension ROM (degree) 5 Months Y Y N All patients - CTS 22 49.6


Burke, et al.2007 26 pinch Strength - opposition (kg/) 0 baseline N Y N All patients - CTS 22 4.8


Burke, et al.2007 26 pinch Strength - opposition (kg/) 7 Weeks N Y N All patients - CTS 22 5.6


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NR = Not Reported NS = Not Significant

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Burke, et al.2007 26 pinch Strength - opposition (kg/) 5 Months Y N N All patients - CTS 22 5.6


Burke, et al.2007 26 Grip Strength (kg/) 0 baseline Unc Unc N All patients - CTS 22 21.7


Burke, et al.2007 26 Grip Strength (kg/) 7 Weeks Unc Unc N All patients - CTS 22 25.6


Burke, et al.2007 26 Grip Strength (kg/) 5 Months Unc Unc N All patients - CTS 22 25.1


Burke, et al.2007 26 Pinch Strength - key (kg/) 0 baseline Unc Unc Y All patients - CTS 22 5.0


Burke, et al.2007 26 Pinch Strength - key (kg/) 7 Weeks Unc Unc N All patients - CTS 22 6.4


Burke, et al.2007 26 Pinch Strength - key (kg/) 5 Months Unc Unc N All patients - CTS 22 6.3


Burke, et al.2007 26 VAS (none) 0 baseline Y Y Y GISTM patients - CTS 12 61.5



Burke, et al.2007 26 VAS (none) 5 Months Y Y Y GISTM patients - CTS 12 9.2



Burke, et al.2007 26 Extension ROM (degree) 0 baseline Y Unc Unc GISTM patients - CTS 12 38.1



Burke, et al.2007 26 VAS (none) 7 Weeks Y Y Y GISTM patients - CTS 12 9.8



Burke, et al.2007 26 Extension ROM (degree) 7 Weeks Y Unc Unc GISTM patients - CTS 12 45.4



Burke, et al.2007 26 Extension ROM (degree) 5 Months Y Unc Unc GISTM patients - CTS 12 43.9



Burke, et al.2007 26 Flexion ROM (degree) 0 baseline Y Unc N GISTM patients - CTS 12 44.8



Burke, et al.2007 26 Flexion ROM (degree) 7 Weeks Y Unc N GISTM patients - CTS 12 52.0



Burke, et al.2007 26 Flexion ROM (degree) 5 Months Y Unc N GISTM patients - CTS 12 49.9



Burke, et al.2007 26 Grip Strength (kg/) 0 baseline Unc Unc Unc GISTM patients - CTS 12 20.2



Burke, et al.2007 26 Grip Strength (kg/) 7 Weeks Unc Unc Unc GISTM patients - CTS 12 25.7



Burke, et al.2007 26 Grip Strength (kg/) 5 Months Unc Unc Unc GISTM patients - CTS 12 25.4



Burke, et al.2007 26 pinch Strength - opposition (kg/) 0 baseline N Y N GISTM patients - CTS 12 4.6



Burke, et al.2007 26 pinch Strength - opposition (kg/) 7 Weeks Unc Unc N GISTM patients - CTS 12 5.8



Burke, et al.2007 26 pinch Strength - opposition (kg/) 5 Months Unc Unc N GISTM patients - CTS 12 5.8



Burke, et al.2007 26 Pinch Strength - Key (kg/) 0 baseline Unc Unc Unc GISTM patients - CTS 12 4.9



Burke, et al.2007 26 Pinch Strength - Key (kg/) 7 Weeks Unc Unc Unc GISTM patients - CTS 12 6.2



Burke, et al.2007 26 Pinch Strength - Key (kg/) 5 Months Unc Unc Unc GISTM patients - CTS 12 6.6



Burke, et al.2007 26 VAS (none) 0 baseline Y Y Y STM patients - CTS 10 60.5


Burke, et al.2007 26 VAS (none) 7 Weeks Y Y Y STM patients - CTS 10 15.4


Burke, et al.2007 26 VAS (none) 5 Months Y Y Y STM patients - CTS 10 33.7


Burke, et al.2007 26 Extension ROM (degree) 0 baseline Y Y Unc STM patients - CTS 10 36.4





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Burke, et al.2007 26 Extension ROM (degree) 7 Weeks Y Y Unc STM patients - CTS 10 43.7


Burke, et al.2007 26 Extension ROM (degree) 5 Months Y Unc Unc STM patients - CTS 10 45.8

± 10.57 SD STM patients - control 12 NR NR NR NR NR NR NR NR

Burke, et al.2007 26 Flexion ROM (degree) 0 baseline Unc Unc Unc STM patients - CTS 10 47.5


Burke, et al.2007 26 Flexion ROM (degree) 7 Weeks Unc Unc Unc STM patients - CTS 10 53.6


Burke, et al.2007 26 Flexion ROM (degree) 5 Months Unc Unc Unc STM patients - CTS 10 49.3


Burke, et al.2007 26 Grip Strength (kg/) 0 baseline Unc Unc Unc STM patients - CTS 10 23.5


Burke, et al.2007 26 Grip Strength (kg/) 7 Weeks Unc Unc Unc STM patients - CTS 10 25.4


Burke, et al.2007 26 Grip Strength (kg/) 5 Months Unc Unc Unc STM patients - CTS 10 24.9


Burke, et al.2007 26 pinch Strength - opposition (kg/) 0 baseline Unc Unc Unc STM patients - CTS 10 5.1


Burke, et al.2007 26 pinch Strength - opposition (kg/) 7 Weeks Unc Unc Unc STM patients - CTS 10 5.4


Burke, et al.2007 26 pinch Strength - opposition (kg/) 5 Months Unc Unc Unc STM patients - CTS 10 5.4


Burke, et al.2007 26 Pinch Strength - Key (kg/) 0 baseline Unc Unc Unc STM patients - CTS 10 5.1


Burke, et al.2007 26 Pinch Strength - Key (kg/) 7 Weeks Unc Unc Unc STM patients - CTS 10 6.7


Burke, et al.2007 26 Pinch Strength - Key (kg/) 5 Months Unc Unc Unc STM patients - CTS 10 6.0


Burke, et al.2007 26 Functional Severity Score (none) 0 baseline Y Y Y STM patients - CTS 10 2.4

± 0.85 SD GISTM Patients 12 2.1 ± 1.6 SD NR NR NR NR NR NR

Burke, et al.2007 26 Functional Severity Score (none) 7 Weeks Y Y Y STM patients - CTS 10 1.7


Burke, et al.2007 26 Functional Severity Score (none) 5 Months Y Y Y STM patients - CTS 10 1.7


Burke, et al.2007 26 Functional Severity Score (none) 0 baseline Y Y Y All 22 2.2

± 0.88 SD n/a NR NR NR NR NR NR NR NR NR

Burke, et al.2007 26 Functional Severity Score (none) 7 Weeks Y Y Y All 22 1.7


Burke, et al.2007 26 Functional Severity Score (none) 5 Months Y Y Y All 22 1.6


Burke, et al.2007 26 Symptom Severity Score (none) 5 Months Y Y Y All 22 2.0


Burke, et al.2007 26 Symptom Severity Score (none) 7 Weeks Y Y Y All 22 1.9


Burke, et al.2007 26 Symptom Severity Score (none) 0 baseline Y Y Y All 22 2.9


Burke, et al.2007 26 Symptom Severity Score (none) 0 baseline Y Y Y GISTM - Patients 12 3.0

± 0.73 SD STM - Patients 10 2.7 ± 0.64 SD NR NR NR NR NR NR

Burke, et al.2007 26 Symptom Severity Score (none) 7 Weeks Y Y Y GISTM - Patients 12 1.8


Burke, et al.2007 26 Symptom Severity Score (none) 5 Months Y Y Y GISTM - Patients 12 1.8


Evcik, et al.2007 81 Handgrip Strength (kg/) 0 baseline Unc Y N Laser 41 19.4

± 6.3 SD Placebo 40 18.0 ± 7.3 SD NR NR NR NR NR NR

Evcik, et al.2007 81 Handgrip Strength (kg/) 4 Weeks Unc Y N Laser 41 22.4


Evcik, et al.2007 81 Handgrip Strength (kg/) 12 Weeks Unc Y N Laser NR 22.8

± 6.9 SD Placebo NR 19.6 ± 7.3 SD NR NR NR NR NR NR




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Evcik, et al.2007 81 Pinch Grip (kg/) 0 baseline Unc Y N Laser 41 4.4


Evcik, et al.2007 81 Pinch Grip (kg/) 4 Weeks Unc Y N Laser 41 5.2


Evcik, et al.2007 81 Pinch Grip (kg/) 12 Weeks Unc Y N Laser NR 5.7

± 1.6 SD Placebo NR 4.8 ± 1.5 SD NR NR NR NR NR NR

Evcik, et al.2007 81 VAS - DAY (none) 0 baseline Y Y Y Laser 41 4.5

{4.2 - 5.1} 95% CI Placebo 40 4.2 {3.8 - 4.8} 95% CI NR NR NR NR NR NR

Evcik, et al.2007 81 VAS - DAY (none) 4 Weeks Y Y Y Laser 41 2.9


Evcik, et al.2007 81 VAS - DAY (none) 12 Weeks Y Y Y Laser NR 2.1

{1.5 - 2.4} 95% CI Placebo NR 2.9 {2.3 - 3.5} 95% CI NR NR NR NR NR NR

Evcik, et al.2007 81 MDL - Laser (msn) 12 Weeks Unc Unc N Laser - Baseline 41 4.4

± 0.7 SD Laser - Post treatment NR 4.1 ± 0.7 SD NR NR NR NR 0.000 One-tailed T-test

Evcik, et al.2007 81 SDL (msn) 12 Weeks Unc Unc N Laser - Baseline 41 3.2


Evcik, et al.2007 81 Sensory amplitude (mu V) 12 Weeks Unc Unc N Laser - Baseline 41 28.5

± 13.4 SD Laser - Post treatment NR 29.6 ± 12.9 SD NR NR NR NR NS One-tailed T-test

Evcik, et al.2007 81 Motor Amplitude (mu V) 12 Weeks Unc Unc N Laser - Baseline 41 6.8


Evcik, et al.2007 81 Motor Nerve Velocity (m/s) 12 Weeks Unc Unc Unc Laser - Baseline 41 51.9


Evcik, et al.2007 81 sensory nerve amplitude (m/s) 12 Weeks Unc Unc Unc Laser - Baseline 41 40.2


Evcik, et al.2007 81 MDL (msec) 12 Weeks Unc Unc Unc Placebo - Baseline 41 4.2

± 1.0 SD Placebo - Post treatment NR 4.2 ± 1.08 SD NR NR NR NR NS t test

Evcik, et al.2007 81 SDL (ms) 12 Weeks Unc Unc Unc Placebo - Baseline 41 3.4


Evcik, et al.2007 81 Sensory amplitude (mu V) 12 Weeks Unc Unc Unc Placebo - Baseline 41 27.6


Evcik, et al.2007 81 Motor Amplitude (mu V) 12 Weeks Unc Unc Unc Placebo - Baseline 41 7.1


Evcik, et al.2007 81 Motor Nerve Velocity (m/s) 12 Weeks Unc Unc Unc Placebo - Baseline 41 49.7


Evcik, et al.2007 81 sensory nerve amplitude (m/s) 12 Weeks Unc Unc Unc Placebo - Baseline 41 39.0

± 8.9 SD Placebo - Post treatment NR 41.1 ± 7.1 SD NR NR NR NR 0.009 t test

Evcik, et al.2007 81 Vas - NIGHT (none) 12 Weeks Y Y Y Laser 41 5.8






Evcik, et al.2007 81 Symptom Severity Score (none) 0 baseline Y Y Y Laser 41 34

{32 - 36} 95% CI Placebo 40 32 {31 - 34} 95% CI NR NR NR NR NR NR

Evcik, et al.2007 81 Symptom Severity Score (none) 4 Weeks Y Y Y Laser 41 26

{25 - 28} 95% CI Placebo 40 25 {23 - 27} 95% CI NR NR NR NR NR NR

Evcik, et al.2007 81 Symptom Severity Score (none) 12 Weeks Y Y Y Laser NR 23

{21 - 25} 95% CI Placebo NR 23 {21 - 26} 95% CI NR NR NR NR NR NR

Ucan, et al.2006 67 median motor nerve distal latency 3 Months N Y N Splinting Group 0

months 23 4.14 ± 0.99 SD Splinting Group 3

months 23 3.64 ± 0.59 SD NR NR NR NR NR NR

Ucan, et al.2006 67 median motor nerve distal latency 6 Months N Y N Splinting Group 0



Ucan, et al.2006 67 median motor nerve distal latency 3 Months N Y N Splinting plus Steroid

Injection 0 months 23 4.13 ± 0.65 SD Splinting plus Steroid

Injection 3 months 23 3.52 ± 0.47 SD NR NR NR NR NR NR




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Ucan, et al.2006 67 median motor nerve distal latency 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 median motor nerve distal latency 3 Months N Y N OCTR 0 months 11 4.49

± 0.55 SD OCTR 3 months 11 3.63 ± 0.47 SD NR NR NR NR NR NR

Ucan, et al.2006 67 median motor nerve distal latency 6 Months N Y N OCTR 0 months 11 4.49


Ucan, et al.2006 67 median motor nerve velocity 3 Months N Y N Splinting Group 0



Ucan, et al.2006 67 median motor nerve velocity 6 Months N Y N Splinting Group 0



Ucan, et al.2006 67 median motor nerve velocity 3 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 median motor nerve velocity 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 median motor nerve velocity 3 Months N Y N OCTR 0 months 11 53.84


Ucan, et al.2006 67 median motor nerve velocity 6 Months N Y N OCTR 0 months 11 53.84


Ucan, et al.2006 67 CMAP wrist 3 Months N Y N Splinting Group 0



Ucan, et al.2006 67 CMAP wrist 6 Months N Y N Splinting Group 0



Ucan, et al.2006 67 CMAP wrist 3 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 CMAP wrist 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 CMAP wrist 3 Months N Y N OCTR 0 months 11 8.12


Ucan, et al.2006 67 CMAP wrist 6 Months N Y N OCTR 0 months 11 8.12


Ucan, et al.2006 67 CMAP elbow 3 Months N Y N Splinting Group 0



Ucan, et al.2006 67 CMAP elbow 6 Months N Y N Splinting Group 0



Ucan, et al.2006 67 CMAP elbow 3 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 CMAP elbow 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 CMAP elbow 3 Months N Y N OCTR 0 months 11 7.31


Ucan, et al.2006 67 CMAP elbow 6 Months N Y N OCTR 0 months 11 7.31


Ucan, et al.2006 67 Second digit-wrist median sensory nerve velocity 3 Months N Y N Splinting Group 0



Ucan, et al.2006 67 Second digit-wrist median sensory nerve velocity 6 Months N Y N Splinting Group 0



Ucan, et al.2006 67 Second digit-wrist median sensory nerve velocity 3 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 Second digit-wrist median sensory nerve velocity 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 Second digit-wrist median sensory nerve velocity 3 Months N Y N OCTR 0 months 11 33.47


Ucan, et al.2006 67 Second digit-wrist median sensory nerve velocity 6 Months N Y N OCTR 0 months 11 33.47





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Ucan, et al.2006 67 palm-wrist median sensory nerve velocity 3 Months N Y N Splinting Group 0



Ucan, et al.2006 67 palm-wrist median sensory nerve velocity 6 Months N Y N Splinting Group 0

months 23 27.26 ± 5.3 SD Splinting Group 6months 23 29.56


Ucan, et al.2006 67 palm-wrist median sensory nerve velocity 3 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 palm-wrist median sensory nerve velocity 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 palm-wrist median sensory nerve velocity 3 Months N Y N OCTR 0 months 11 23.98


Ucan, et al.2006 67 palm-wrist median sensory nerve velocity 6 Months N Y N OCTR 0 months 11 23.98


Ucan, et al.2006 67 SNAP digit 3 Months N Y N Splinting Group 0

months 23 19 ± 13.41 SD Splinting Group 3


Ucan, et al.2006 67 SNAP digit 6 Months N Y N Splinting Group 0

months 23 19 ± 13.41 SD Splinting Group 6


Ucan, et al.2006 67 SNAP digit 3 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 SNAP digit 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 SNAP digit 3 Months N Y N OCTR 0 months 11 17.46


Ucan, et al.2006 67 SNAP digit 6 Months N Y N OCTR 0 months 11 17.46


Ucan, et al.2006 67 SNAP palm 3 Months N Y N Splinting Group 0



Ucan, et al.2006 67 SNAP palm 6 Months N Y N Splinting Group 0



Ucan, et al.2006 67 SNAP palm 3 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 SNAP palm 6 Months N Y N Splinting plus Steroid



Ucan, et al.2006 67 SNAP palm 3 Months N Y N OCTR 0 months 11 39.04


Ucan, et al.2006 67 SNAP palm 6 Months N Y N OCTR 0 months 11 39.04


Ucan, et al.2006 67 FSS 3 Months Y Y Y Splinting Group 0



Ucan, et al.2006 67 FSS 6 Months Y Y Y Splinting Group 0



Ucan, et al.2006 67 FSS 3 Months Y Y Y Splinting plus Steroid



Ucan, et al.2006 67 FSS 6 Months Y Y Y Splinting plus Steroid



Ucan, et al.2006 67 FSS 3 Months Y Y Y OCTR 0 months 11 2.7


Ucan, et al.2006 67 FSS 6 Months Y Y Y OCTR 0 months 11 2.7


Ucan, et al.2006 67 SSS 3 Months Y Y Y Splinting Group 0



Ucan, et al.2006 67 SSS 6 Months Y Y Y Splinting Group 0



Ucan, et al.2006 67 SSS 3 Months Y Y Y Splinting plus Steroid






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Ucan, et al.2006 67 SSS 6 Months Y Y Y Splinting plus Steroid



Ucan, et al.2006 67 SSS 3 Months Y Y Y OCTR 0 months 11 3.09


Ucan, et al.2006 67 SSS 6 Months Y Y Y OCTR 0 months 11 3.09


Habib, et al.2006 42 VAS score for pain of procedure 0 Weeks Y Y Y Novel Approach Steroid

Injection 21 3.62 ± 1.071 SD Classic Approach

Steroid Injection 21 4.38 ± 1.523 SD NR NR NR NR 0.065 t-test

Premoselli, et al.2006 50 SSS 0 Months Y Y Y Splinted Group 25 2.70

± 0.41 SD Control Group 25 2.55 ± 0.50 SD NR NR NR NR 0.43 Two-tailed T-test





Premoselli, et al.2006 50 FSS 0 Months Y Y Y Splinted Group 25 2.27






Premoselli, et al.2006 50 SSS 3 Months Y Y Y Splinted Group Mean

Change 0-3 months 24 1.07 ± 0.39 SD Control Group Mean

Change 0-3 months 24 -0.02 ± 0.24 SD NR NR NR NR 0.001 Two-tailed T-test

Premoselli, et al.2006 50 FSS 3 Months Y Y Y Splinted Group Mean



Premoselli, et al.2006 50 FSS 6 Months Y Y Y Splinted Group Mean


Change 0-6 months 16 0.04 ± 0.30 SD NR NR NR NR 0.0004 Two-tailed T-test

Premoselli, et al.2006 50 SSS 6 Months Y Y Y Splinted Group Mean



Premoselli, et al.2006 50 SSS 6 Months Y Y Y Splinted Group 0 months 25 2.70

± 0.41 SD Splinted Group 6 months 18 1.48 ± 0.19 SD NR NR 1.22

± 0.39 SD NR NR

Premoselli, et al.2006 50 SSS 3 Months Y Y Y Splinted Group 0 months 25 2.70


± 0.39 SD NR NR

Premoselli, et al.2006 50 FSS 6 Months Y Y Y Splinted Group 0 months 25 2.27


± 0.28 SD NR NR

Premoselli, et al.2006 50 FSS 3 Months Y Y Y Splinted Group 0 months 25 2.27


± 0.22 SD NR NR

Premoselli, et al.2006 50 FSS 3 Months Y Y Y Control Group 0 months 25 1.81

± 0.29 SD Control Group 3 months 24 1.96 ± 0.27 SD NR NR -0.15

± 0.43 SD NR NR

Premoselli, et al.2006 50 FSS 6 Months Y Y Y Control Group 0 months 25 1.81

± 0.29 SD Control Group 6 months 16 1.77 ± 0.79 SD NR NR 0.04

± 0.30 SD NR NR

Premoselli, et al.2006 50 SSS 6 Months Y Y Y Control Group 0 months 25 2.55


± 0.29 SD NR NR

Premoselli, et al.2006 50 SSS 3 Months Y Y Y Control Group 0 months 25 2.55


± 0.24 SD NR NR

Premoselli, et al.2006 50 Sensory Velocity (m/s) 0 Months N Y N Splinted Group 25 44.5


Premoselli, et al.2006 50 Sensory Latency (ms) 0 Months N Y N Splinted Group 25 2.74


Premoselli, et al.2006 50 Sensory amplitude (uV) 0 Months N Y N Splinted Group 25 14.53


Premoselli, et al.2006 50 Motor Latency (ms) 0 Months N Y N Splinted Group 25 3.76


Premoselli, et al.2006 50 Motor Velocity (m/s) 0 Months N Y N Splinted Group 25 56.08





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Premoselli, et al.2006 50 Motor Amplitude (mV) 0 Months N Y N Splinted Group 25 9.95






Premoselli, et al.2006 50 Sensory Latency (ms) 3 Months N Y N Splinted Group Mean

Change 0-3 months 24 -0.15 ± 0.29 SD Control Group Mean


Premoselli, et al.2006 50 Sensory Latency (ms) 6 Months N Y N Splinted Group Mean


Change 0-6months 16 -0.08 ± 0.32 SD NR NR NR NR 0.02 Two-tailed T-test

Premoselli, et al.2006 50 Sensory Velocity (m/s) 6 Months N Y N Splinted Group Mean


Change 0-6months 16 0.59 ± 0.36 SD NR NR NR NR 0.68 Two-tailed T-test

Premoselli, et al.2006 50 Sensory Velocity (m/s) 3 Months N Y N Splinted Group Mean

Change 0-3months 24 2.78 ± 6.08 SD Control Group Mean






Premoselli, et al.2006 50 Sensory amplitude (uV) 6 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Sensory amplitude (uV) 3 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Motor Velocity (ms) 3 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Motor Latency (m/s) 3 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Motor Amplitude (mV) 3 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Motor Amplitude (mV) 6 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Motor Latency (ms) 6 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Motor Velocity 6 Months N Y N Splinted Group Mean




± 3.58 SD Control Group Mean 24 52.65 ± 3.99 SD NR NR NR NR 0.01 Two-tailed T-test















Premoselli, et al.2006 50 Sensory Velocity (m/s) 3 Months N Y N Splinted Group 0 months 25 44.50


± 6.08 SD NR NR

Premoselli, et al.2006 50 Sensory Latency (ms) 3 Months N Y N Splinted Group 0 months 25 2.74

± 0.28 SD Splinted Group 3 months 24 2.59 ± 0.39 SD NR NR -0.15

± 0.29 SD NR NR




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Premoselli, et al.2006 50 Sensory amplitude (uV) 3 Months N Y N Splinted Group 0 months 25 14.53


± 4.91 SD NR NR

Premoselli, et al.2006 50 Motor Latency (ms) 3 Months N Y N Splinted Group 0 months 25 3.76


± 0.34 SD NR NR

Premoselli, et al.2006 50 Motor Velocity (m/s) 3 Months N Y N Splinted Group 0 months 25 56.08


± 4.82 SD NR NR

Premoselli, et al.2006 50 Motor Amplitude (mV) 3 Months N Y N Splinted Group 0 months 25 9.95


± 2.97 SD NR NR

Premoselli, et al.2006 50 Motor Amplitude (mV) 6 Months N Y N Splinted Group 0 months 25 9.95


± 2.86 SD NR NR

Premoselli, et al.2006 50 Sensory Latency (ms) 6 Months N Y N Splinted Group 0 months 25 2.74


± 1.27 SD NR NR

Premoselli, et al.2006 50 Sensory Velocity (m/s) 6 Months N Y N Splinted Group 0 months 25 44.50


± 0.34 SD NR NR

Premoselli, et al.2006 50 Sensory amplitude (uV) 6 Months N Y N Splinted Group 0 months 25 14.53


± 0.34 SD NR NR

Premoselli, et al.2006 50 Motor Latency (ms) 6 Months N Y N Splinted Group 0 months 25 3.76


± 0.38 SD NR NR

Premoselli, et al.2006 50 Motor Velocity (m/s) 6 Months N Y N Splinted Group 0 months 25 56.08


± 5.31 SD NR NR

Premoselli, et al.2006 50 Sensory Latency (ms) 3 Months N Y N Control Group 0 months 25 2.79


± 3.84 SD NR NR

Premoselli, et al.2006 50 Sensory Velocity (m/s) 3 Months N Y N Control Group 0 months 25 42.87


± 4.07 SD NR NR

Premoselli, et al.2006 50 Sensory amplitude (uV) 3 Months N Y N Control Group 0 months 25 16.04


± 3.84 SD NR NR

Premoselli, et al.2006 50 Motor Latency (ms) 3 Months N Y N Control Group 0 months 25 3.62


± 0.41 SD NR NR

Premoselli, et al.2006 50 Motor Velocity (m/s) 3 Months N Y N Control Group 0 months 25 53.90


± 3.36 SD NR NR

Premoselli, et al.2006 50 Motor Amplitude (mV) 3 Months N Y N Control Group 0 months 25 10.35


± 3.84 SD NR NR

Premoselli, et al.2006 50 Sensory Latency (ms) 6 Months N Y N Control Group 0 months 25 2.79


± 0.32 SD NR NR

Premoselli, et al.2006 50 Sensory Velocity (m/s) 6 Months N Y N Control Group 0 months 25 42.87


± 0.36 SD NR NR

Premoselli, et al.2006 50 Sensory amplitude (uV) 6 Months N Y N Control Group 0 months 25 16.04


± 0.32 SD NR NR

Premoselli, et al.2006 50 Motor Latency (ms) 6 Months N Y N Control Group 0 months 25 3.62


± 3.35 SD NR NR

Premoselli, et al.2006 50 Motor Velocity (m/s) 6 Months N Y N Control Group 0 months 25 53.90


± 3.96 SD NR NR

Premoselli, et al.2006 50 Motor Amplitude (mV) 6 Months N Y N Control Group 0 months 25 10.35


± 3.35 SD NR NR

Premoselli, et al.2006 50 Pressure Provocative Test (s) 3 Months N Y N Control Group 0 months 25 18.61


± 4.31 SD NR NR

Premoselli, et al.2006 50 Pressure Provocative Test (s) 6 Months N Y N Control Group 0 months 25 18.61


± 8.11 SD NR NR

Premoselli, et al.2006 50 Phalens sign (s) 3 Months N Y N Control Group 0 months 25 22.62


± 14.42 SD NR NR

Premoselli, et al.2006 50 Phalens sign (s) 6 Months N Y N Control Group 0 months 25 22.62


± 19.60 SD NR NR

Premoselli, et al.2006 50 Phalens sign (s) 3 Months N Y N Splinted Group 0 months 25 16.29


± 7.89 SD NR NR




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Premoselli, et al.2006 50 Phalens sign (s) 6 Months N Y N Splinted Group 0 months 25 16.29


± 5.80 SD NR NR

Premoselli, et al.2006 50 Pressure Provocative Test (s) 6 Months N Y N Splinted Group 0 months 25 10.43


± 10.73 SD NR NR

Premoselli, et al.2006 50 Pressure Provocative Test (s) 3 Months N Y N Splinted Group 0 months 25 10.43


± 9.85 SD NR NR

Premoselli, et al.2006 50 Pressure Provocative Test (s) 0 Months N Y N Splinted Group 25 10.43






Premoselli, et al.2006 50 Pressure Provocative Test (s) 3 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Pressure Provocative Test (s) 6 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Phalens sign (s) 6 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Phalens sign (s) 3 Months N Y N Splinted Group Mean



Premoselli, et al.2006 50 Phalens sign (s) 0 Months N Y N Splinted Group 25 16.29






Hui, et al.2005 50 GSS 0 Weeks Y Y Y Steroid Injection 25 25.2

± 10.5 SD OCTR 25 28.6 ± 11 SD NR NR NR NR NR NR

Hui, et al.2005 50 Grip Strength (kg) 20 Weeks N Y N Steroid Injection 0 weeks 25 24.2

± 7 SD Steroid Injection 20 weeks 25 26.6

± 7.4 SD NR NR 2.4 ± 5.5 SD 0.04 t-test

Hui, et al.2005 50 Distal Motor Latency (ms) 20 Weeks N Y N Steroid Injection 0 weeks 25 4.8


± 0.9 SD NR NR -0.4 ± 0.8 SD 0.032 t-test

Hui, et al.2005 50 Sensory Conduction Velocity (m/s) 20 Weeks N Y N Steroid Injection 0 weeks 25 37.3


± 6.3 SD NR NR 3.2 ± 6.1 SD 0.018 t-test

Hui, et al.2005 50 GSS 6 Weeks Y Y Y OCTR 0 weeks 25 28.6

± 11 SD OCTR 6 weeks 25 5.5 ± 7.3 SD NR NR NR NR <0.001 t-test


± 11 SD OCTR 20 weeks 25 4.3 ± 5.6 SD NR NR -24.2

± 11 SD <0.001 t-test

Hui, et al.2005 50 Grip Strength 20 Weeks N Y N OCTR 0 weeks 25 23.4

± 8.2 SD OCTR 20 weeks 25 21.8 ± 7.9 SD NR NR -1.7

± 5.1 SD 0.11 t-test

Hui, et al.2005 50 Distal Motor Latency (ms) 20 Weeks N Y N OCTR 0 weeks 25 5.4


± 1.1 SD <0.001 t-test

Hui, et al.2005 50 Sensory Conduction Velocity 20 Weeks N Y N OCTR 0 weeks 25 34.2

± 7.9 SD OCTR 20 weeks 25 42.2 ± 8 SD NR NR 8

± 3.8 SD <0.001 t-test

Hui, et al.2005 50 GSS 20 Weeks Y Y Y Steroid Injection mean

change 25 -8.7 ± 13 SD OCTR mean change 25 -24.2

± 11 SD NR NR NR NR <0.001 ANOVA

Hui, et al.2005 50 Grip Strength 20 Weeks N Y N Steroid Injection mean

change 25 2.4 ± 5.5 SD OCTR mean change 25 -1.7

± 5.1 SD NR NR NR NR 0.009 ANOVA

Hui, et al.2005 50 Distal Motor Latency 20 Weeks N Y N Steroid Injection mean

change 25 -0.4 ± 0.8 SD OCTR mean change 25 -1.2


Hui, et al.2005 50 Sensory Conduction Velocity 20 Weeks N Y N Steroid Injection mean

change 25 3.2 ± 6.1 SD OCTR mean change 25 8



± 8.1 SD OCTR 25 5.5 ± 7.3 SD NR NR NR NR NR NR




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Hui, et al.2005 50 Grip Strength (kg) 0 Weeks N Y N Steroid Injection 25 24.2

± 7 SD OCTR 25 23.4 ± 8.2 SD NR NR NR NR NR NR



Hui, et al.2005 50 Distal Motor Latency (ms) 0 Weeks N Y N Steroid Injection 25 4.8




Hui, et al.2005 50 Sensory Conduction Velocity (m/s) 0 Weeks N Y N Steroid Injection 25 37.3




Hui, et al.2005 50 GSS 20 Weeks Y Y Y Steroid Injection 0 weeks 25 25.2

± 10.5 SD Steroid Injection 20 weeks 25 16.2

± 12.3 SD NR NR -8.7 ± 13 SD 0.003 t-test


± 10.5 SD Steroid Injection 6 weeks 25 11.5 ± 8.1 SD NR NR NR NR <0.001 t-test



Hui, et al.2005 50 Grip Strength (kg) 20 Weeks N Y N Steroid Injection 0 weeks 25 24.2


± 7.4 SD NR NR 2.4 ± 5.5 SD 0.04 t-test

Hui, et al.2005 50 Distal Motor Latency (ms) 20 Weeks N Y N Steroid Injection 0 weeks 25 4.8


± 0.9 SD NR NR -0.4 ± 0.8 SD 0.032 t-test

Hui, et al.2005 50 Sensory Conduction Velocity (m/s) 20 Weeks N Y N Steroid Injection 0 weeks 25 37.3


± 6.3 SD NR NR 3.2 ± 6.1 SD 0.018 t-test


± 11 SD OCTR 6 weeks 25 5.5 ± 7.3 SD NR NR NR NR <0.001 t-test


± 11 SD OCTR 20 weeks 25 4.3 ± 5.6 SD NR NR -24.2

± 11 SD <0.001 t-test

Hui, et al.2005 50 Grip Strength 20 Weeks N Y N OCTR 0 weeks 25 23.4


± 5.1 SD 0.11 t-test

Hui, et al.2005 50 Distal Motor Latency (ms) 20 Weeks N Y N OCTR 0 weeks 25 5.4


± 1.1 SD <0.001 t-test

Hui, et al.2005 50 Sensory Conduction Velocity 20 Weeks N Y N OCTR 0 weeks 25 34.2

± 7.9 SD OCTR 20 weeks 25 42.2 ± 8 SD NR NR 8

± 3.8 SD <0.001 t-test

Hui, et al.2005 50 GSS 20 Weeks Y Y Y Steroid Injection mean

change 25 -8.7 ± 13 SD OCTR mean change 25 -24.2

± 11 SD NR NR NR NR <0.001 ANOVA

Hui, et al.2005 50 Grip Strength 20 Weeks N Y N Steroid Injection mean

change 25 2.4 ± 5.5 SD OCTR mean change 25 -1.7


Hui, et al.2005 50 Distal Motor Latency 20 Weeks N Y N Steroid Injection mean

change 25 -0.4 ± 0.8 SD OCTR mean change 25 -1.2


Hui, et al.2005 50 Sensory Conduction Velocity 20 Weeks N Y N Steroid Injection mean

change 25 3.2 ± 6.1 SD OCTR mean change 25 8















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± 10.5 SD Steroid Injection 20 weeks 25 16.2

± 12.3 SD NR NR -8.7 ± 13 SD 0.003 t-test


± 10.5 SD Steroid Injection 6 weeks 25 11.5 ± 8.1 SD NR NR NR NR <0.001 t-test

Michlovitz, et al.2004 94 pain relief (6-point scale) () 3 days Y Y Y nonCTS-heat 29 1.68

± 0.23 SE nonCTS-oral placebo 30 1.15 ± 0.21 SE NR NR NR NR 0.045 GEE - 1-tailed Z test

Michlovitz, et al.2004 94 pain relief (6-point scale) () 3 days Y Y Y CTS-heat 10 2.18

± 0.34 SE CTS-oral placebo 12 0.95 ± 0.25 SE NR NR NR NR 0.001 GEE - 1-tailed Z test

Michlovitz, et al.2004 94 joint stiffness (101-point rating scale) () baseline Y Unc Y nonCTS-heat 29 53.03

± 21.14 SD nonCTS-oral placebo 30 54.87 ± 21.54 SD NR NR NR NR NR NR

Michlovitz, et al.2004 94 joint stiffness (101-point rating scale) () baseline Y Unc Y nonCTS-oral APAP 5 65

± 13.69 SD nonCTS-no heat wrap 5 58 ± 25.15 SD NR NR NR NR NR NR

Michlovitz, et al.2004 94 joint stiffness (101-point rating scale) () 3 days Y Unc Y nonCTS-heat 29 15.7

± 4.2 SE nonCTS-oral placebo 30 9.9 ± 3 SE NR NR NR NR 0.13 GEE - 1-tailed Z test

Michlovitz, et al.2004 94 joint stiffness (101-point rating scale) () baseline Y Unc Y CTS-heat 10 57.5

± 30.3 SD CTS-oral placebo 12 61.58 ± 21.76 SD NR NR NR NR NR NR

Michlovitz, et al.2004 94 joint stiffness (101-point rating scale) () 3 days Y Unc Y CTS-heat 10 21.8

± 5.5 SE CTS-oral placebo 12 4.9 ± 3.1 SE NR NR NR NR 0.004 GEE - 1-tailed Z test

Michlovitz, et al.2004 94 grip-strength dynamometer () baseline N Y N nonCTS-all 69 19.2

± 12.8 SD NR NR NR NR NR NR NR NR NR NR

Michlovitz, et al.2004 94 grip-strength dynamometer () 3 days N Y N nonCTS-heat 29 6.44

± 1.34 SE nonCTS-oral placebo 30 2.48 ± 1.34 SE NR NR NR NR 0.021 ANCOVA

Michlovitz, et al.2004 94 grip-strength dynamometer () 5 days N Y N nonCTS-heat 29 6.14

± 1.41 SE nonCTS-oral placebo 30 3.31 ± 1.42 SE NR NR NR NR 0.08 ANCOVA

Michlovitz, et al.2004 94 grip-strength dynamometer () baseline N Y N CTS-all 24 10.7


Michlovitz, et al.2004 94 grip-strength dynamometer () 3 days N Y N CTS-heat 10 6.6

± 1.6 SE CTS-oral placebo 12 -0.3 ± 1.5 SE NR NR NR NR 0.003 ANCOVA

Michlovitz, et al.2004 94 grip-strength dynamometer 5 days N Y N CTS-heat 10 6.1

± 1.6 SE CTS-oral placebo 12 0.8 ± 1.4 SE NR NR NR NR 0.012 ANCOVA

Michlovitz, et al.2004 94 PRWE () baseline Y Y Y nonCTS-heat 29 57.43

± 16.13 SD nonCTS-oral placebo 30 57.76 ± 19.09 SD NR NR NR NR NR NR

Michlovitz, et al.2004 94 PRWE () baseline Y Y Y nonCTS-oral APAP 5 70.93

± 9.97 SD nonCTS-no heat wrap 5 58.43 ± 16.67 SD NR NR NR NR NR NR

Michlovitz, et al.2004 94 PRWE () 3 day Y Y Y nonCTS-heat 29 13

± 2.3 SD nonCTS-oral placebo 30 12.1 ± 2.2 SD NR NR NR NR 0.39 ANCOVA

Michlovitz, et al.2004 94 PRWE () 5 day Y Y Y nonCTS-heat 29 NR nonCTS-oral placebo 30 NR NR NR NR NR NR 0.15 ANCOVA

Michlovitz, et al.2004 94 PRWE () baseline Y Y Y CTS-heat 10 63.38


Michlovitz, et al.2004 94 PRWE () baseline Y Y Y CTS-oral APAP 1 41.11

± 0 SD CTS-non heat wrap 1 69.89 ± 0 SD NR NR NR NR NR NR

Michlovitz, et al.2004 94 PRWE () 3 day Y Y Y CTS-heat 10 27.1

± 5.2 SD CTS-oral placebo 12 2.67 ± 4.81 SD NR NR NR NR 0.0015 ANCOVA

Michlovitz, et al.2004 94 PRWE () 5 day Y Y Y CTS-heat 10 27.3

± 5.9 SD CTS-oral placebo 12 7.9 ± 5.39 SD NR NR NR NR 0.013 ANCOVA

Michlovitz, et al.2004 94 Symptom Severity Scale () baseline Y Y Y CTS-heat 10 3.21





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Michlovitz, et al.2004 94 Symptom Severity Scale () baseline Y Y Y CTS-oral APAP 1 2.55


Michlovitz, et al.2004 94 Symptom Severity Scale () 3 day Y Y Y CTS-heat 10 0.9


Michlovitz, et al.2004 94 Symptom Severity Scale () 5 day Y Y Y CTS-heat 10 0.97

± 0.16 SE CTS-oral placebo 12 0.14 ± 0.14 SE NR NR NR NR ≤.001 ANCOVA

Michlovitz, et al.2004 94 Functional Status Scale () baseline Y Y Y CTS-heat 10 2.84


Michlovitz, et al.2004 94 Functional Status Scale () baseline Y Y Y CTS-oral APAP 1 2.5


Michlovitz, et al.2004 94 Functional Status Scale () 3 day Y Y Y CTS-heat 10 0.65

± 0.16 SE CTS-oral placebo 12 0 ± 0.16 SE NR NR NR NR 0.006 ANCOVA

Michlovitz, et al.2004 94 Functional Status Scale () 5 day Y Y Y CTS-heat 10 0.57


Sevim, et al.2004 120 MAMSA Control (m/s) 11 Months N Y N Baseline 23 43.07

± 6.1 SD Follow-up 23 43.33 ± 5.84 SD NR NR NR NR NR NR

Sevim, et al.2004 120 MAMSV - Proximal Injection (m/s) 11 Months N Y N Baseline 28 41.15


Sevim, et al.2004 120 MAMSV Distal Injection (m/s) 11 Months N Y N Baseline 29 42.52


Sevim, et al.2004 120 MAMSV - Splint (m/s) 11 Months N Y N Baseline 28 44.45


Sevim, et al.2004 120 MUSCD-IV - Control (m/s) 11 Months N Y Y Baseline 23 0.97


Sevim, et al.2004 120 MUSCD-IV - Proximal Injection (m/s) 11 Months N Y N Baseline 28 0.96


Sevim, et al.2004 120 MUSCD-IV - Distal Injectionl (m/s) 11 Months N Y N Baseline 29 0.96


Sevim, et al.2004 120 MUSCD-IV - Splint (m/s) 11 Months N Y N Baseline 28 0.99


Sevim, et al.2004 120 MUDML - Control (m/s) 11 Months N Y N Baseline 23 0.68


Sevim, et al.2004 120 MUDMl _ Proximal (m/s) 11 Months N Y N Baseline 28 0.86


Sevim, et al.2004 120 MUDML - Distal (m/s) 11 Months N Y N Baseline 29 0.74


Sevim, et al.2004 120 MuDML - Splint (m/s) 11 Months N Y N Baseline 28 0.68


Sevim, et al.2004 120 Neurologic Symptom Score - Control (m/s) 11 Months Y Unc N Baseline 23 14.74


Sevim, et al.2004 120 Neurologic Symptom Score - Proximal (none) 11 Months Y Unc N Baseline 28 17.18


Sevim, et al.2004 120 Neurologic Symptom Score - Distal (none) 11 Months Y Unc Y Baseline 29 15.90


Sevim, et al.2004 120 Neurologic Symptom Score -Splint (none) 11 Months Y Unc Y Baseline 28 16.03


Sevim, et al.2004 120 MAMSV Control (m/s) 11 Months N Y N Baseline 23 43.07


Sevim, et al.2004 120 MAMSV - Proximal Injection (m/s) 11 Months N Y N Baseline 28 41.15


Sevim, et al.2004 120 MAMSV Distal Injection (m/s) 11 Months N Y N Baseline 29 42.52


Sevim, et al.2004 120 MAMSV - Splint (m/s) 11 Months N Y N Baseline 28 44.45





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Sevim, et al.2004 120 MUSCD-IV - Control (m/s) 11 Months N Y Y Baseline 23 0.97


Sevim, et al.2004 120 MUSCD-IV - Proximal Injection (m/s) 11 Months N Y N Baseline 28 0.96


Sevim, et al.2004 120 MUSCD-IV - Distal Injectionl (m/s) 11 Months N Y N Baseline 29 0.96


Sevim, et al.2004 120 MUSCD-IV - Splint (m/s) 11 Months N Y N Baseline 28 0.99


Sevim, et al.2004 120 MUDML - Control (m/s) 11 Months N Y N Baseline 23 0.68


Sevim, et al.2004 120 MUDMl _ Proximal (m/s) 11 Months N Y N Baseline 28 0.86


Sevim, et al.2004 120 MUDML - Distal (m/s) 11 Months N Y N Baseline 29 0.74


Sevim, et al.2004 120 MuDML - Splint (m/s) 11 Months N Y N Baseline 28 0.68


Sevim, et al.2004 120 Neurologic Symptom Score - Control (m/s) 11 Months Y Unc N Baseline 23 14.74


Sevim, et al.2004 120 Neurologic Symptom Score - Proximal (none) 11 Months Y Unc N Baseline 28 17.18


Sevim, et al.2004 120 Neurologic Symptom Score - Distal (none) 11 Months Y Unc Y Baseline 29 15.90


Sevim, et al.2004 120 Neurologic Symptom Score -Splint (none) 11 Months Y Unc Y Baseline 28 16.03


Armstrong, et al.2004 81 SSS 2 Weeks Y Y Y Steroid Injection 0 weeks 43 2.5

± 0.7 SD Steroid Injection 2 weeks 43 NR NR NR NR -0.78 ± 0.8 SD NR NR

Armstrong, et al.2004 81 SSS 2 Weeks Y Y Y Placebo Group 0 weeks 38 2.6

± 0.9 SD Placebo Group 2 weeks 38 NR NR NR NR -0.19 ± 0.62 SD NR NR

Armstrong, et al.2004 81 FSS 2 Weeks Y Y Y Placebo Group 0 weeks 38 2.5


Armstrong, et al.2004 81 FSS 2 Weeks Y Y Y Steroid Injection 0 weeks 43 2.3


Armstrong, et al.2004 81 Median MDL 2 Weeks N Y N Steroid Injection 0 weeks 43 5.6


Armstrong, et al.2004 81 Median MDL 2 Weeks N Y N Placebo Group 0 weeks 38 5.7


Armstrong, et al.2004 81 Median Sensory Latency 2 Weeks N Y N Placebo Group 0 weeks 38 NR NR Placebo Group 2 weeks 38 NR NR NR NR -0.04

± 0.14 SD NR NR

Armstrong, et al.2004 81 Median Sensory Latency 2 Weeks N Y N Steroid Injection 0 weeks 43 NR NR Steroid Injection 2 weeks 43 NR NR NR NR -0.19

± 0.27 SD NR NR

Armstrong, et al.2004 81 Ulnar Sensory Latency 2 Weeks N Y N Steroid Injection 0 weeks 43 NR NR Steroid Injection 2 weeks 43 NR NR NR NR 0.001

± 0.16 SD NR NR

Armstrong, et al.2004 81 Ulnar Sensory Latency 2 Weeks N Y N Placebo Group 0 weeks 38 NR NR Placebo Group 2 weeks 38 NR NR NR NR -0.07

± 0.014 SD NR NR

Armstrong, et al.2004 81 Median Sensory Latency 2 Weeks N Y N Steroid Injection mean

change 43 -0.19 ± 0.27 SD Placebo Group mean

change 38 -0.04 ± 0.14 SD NR NR NR NR 0.01 t-test

Armstrong, et al.2004 81 Median MDL 2 Weeks N Y N Steroid Injection mean



Armstrong, et al.2004 81 Ulnar Sensory Latency 2 Weeks N Y N Steroid Injection mean

change 43 0.001 ± 0.16 SD Placebo Group mean


Armstrong, et al.2004 81 FSS 2 Weeks Y Y Y Steroid Injection mean


change 38 -0.13 ± 0.44 SD NR NR NR NR <0.01 t-test

Armstrong, et al.2004 81 SSS 2 Weeks Y Y Y Steroid Injection mean


change 38 -0.19 ± 0.62 SD NR NR NR NR <0.01 t-test




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Demirci, et al.2002 90 SSS 0 Months Y Y Y OCTR 44 3.4

± 0.7 SD Steroid Injection 46 3.3 ± 0.7 SD NR NR NR NR NS Mann-Whitney U-test




± 0.3 SD Steroid Injection 46 1.7 ± 0.8 SD NR NR NR NR 0.003 Mann-Whitney U-test

Demirci, et al.2002 90 FSS 0 Months Y Y Y OCTR 44 3.3

± 1 SD Steroid Injection 46 3 ± 0.8 SD NR NR NR NR NS Mann-Whitney U-test





Demirci, et al.2002 90 Median MDL (ms) 0 Months N Y N OCTR 44 5.9

± 1.4 SD Steroid Injection 46 5.5 ± 1 SD NR NR NR NR NS t-test


± 0.9 SD Steroid Injection 46 5.1 ± 0.9 SD NR NR NR NR NS t-test


± 0.9 SD Steroid Injection 46 5 ± 1 SD NR NR NR NR NS t-test

Demirci, et al.2002 90 mMNCV (m/s) 0 Months N Y N OCTR 44 51.6






Demirci, et al.2002 90 Median Motor CMAPa 0 Months N Y N OCTR 44 8.6






Demirci, et al.2002 90 mSDL 0 Months N Y N OCTR 44 3.9

± 0.6 SD Steroid Injection 46 4 ± 0.7 SD NR NR NR NR NS t-test


± 0.5 SD Steroid Injection 46 3.7 ± 0.8 SD NR NR NR NR 0.002 t-test



Demirci, et al.2002 90 mSNCV 0 Months N Y N OCTR 44 36.6






Demirci, et al.2002 90 Median Sensory SNAPa 0 Months N Y N OCTR 44 15.4






Demirci, et al.2002 90 Ulnar MDL (ms) 0 Months N Y N OCTR 44 2.9









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Demirci, et al.2002 90 Ulnar Motor CV (m/s) 0 Months N Y N OCTR 44 62.7






Demirci, et al.2002 90 Ulnar Motor CMAPa 0 Months N Y N OCTR 44 12.9



± 4 SD Steroid Injection 46 12.3 ± 3.4 SD NR NR NR NR NS t-test



Demirci, et al.2002 90 Ulnar Sensory DL (ms) 0 Months N Y N OCTR 44 2.5






Demirci, et al.2002 90 Ulnar Sensory CV (m/s) 0 Months N Y N OCTR 44 57.5




Demirci, et al.2002 90 Ulnar Sensory CV (m/s) 6 Months N Y N OCTR 44 55


Demirci, et al.2002 90 Ulnar Sensory SNAPa (μv) 0 Months N Y N OCTR 44 26.3

± 14 SD Steroid Injection 46 25.4 ± 11 SD NR NR NR NR NS t-test





Demirci, et al.2002 90 SSS 6 Months Y Y Y OCTR 0 months 44 3.4

± 0.7 SD OCTR 6 months 44 1.3 ± 0.3 SD NR NR NR NR <0.001 t-test




± 0.3 SD OCTR 6 months 44 1.3 ± 0.3 SD NR NR NR NR 0.006 t-test

Demirci, et al.2002 90 SSS 3 Months Y Y Y Steroid Injection 0

months 46 3.3 ± 0.7 SD Steroid Injection 3

months 46 1.5 ± 0.5 SD NR NR NR NR <0.001 t-test






months 46 1.7 ± 0.8 SD NR NR NR NR 0.09 t-test

Demirci, et al.2002 90 FSS 3 Months Y Y Y OCTR 0 months 44 3.3

± 1 SD OCTR 3 months 44 1.5 ± 0.4 SD NR NR NR NR <0.001 t-test


± 1 SD OCTR 6 months 44 1.4 ± 0.3 SD NR NR NR NR <0.001 t-test



Demirci, et al.2002 90 FSS 3 Months Y Y Y Steroid Injection 0

months 46 3 ± 0.8 SD Steroid Injection 3











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Demirci, et al.2002 90 Median MDL (ms) 3 Months N Y N OCTR 0 months 44 5.9






Demirci, et al.2002 90 Median MDL (ms) 3 Months N Y N Steroid Injection 0

months 46 5.5 ± 1 SD Steroid Injection 3




months 46 5 ± 1 SD NR NR NR NR <0.001 t-test



months 46 5 ± 1 SD NR NR NR NR 0.654 t-test

Demirci, et al.2002 90 mSDL (ms) 3 Months N Y N OCTR 0 months 44 3.9






Demirci, et al.2002 90 mSDL (ms) 3 Months N Y N Steroid Injection 0









Demirci, et al.2002 90 mSNCV (m/s) 3 Months N Y N OCTR 0 months 44 36.8






Demirci, et al.2002 90 mSNCV 3 Months N Y N Steroid Injection 0









Demirci, et al.2002 90 SNAPa (μv) 3 Months N Y N OCTR 0 months 44 15.4






Demirci, et al.2002 90 SNAPa (μv) 3 Months N Y N Steroid Injection 0


months 46 21.6 ± 16 SD NR NR NR NR 0.03 t-test
















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± 1 SD Steroid Injection 46 3 ± 0.8 SD NR NR NR NR NS Mann-Whitney U-test










± 0.9 SD Steroid Injection 46 5 ± 1 SD NR NR NR NR NS t-test












4.1 SD Steroid Injection 46 10.2 4.5 SD NR NR NR NR NS t-test


0.6 SD Steroid Injection 46 4 0.7 SD NR NR NR NR NS t-test


0.5 SD Steroid Injection 46 3.7 0.8 SD NR NR NR NR 0.002 t-test










12.1 SD Steroid Injection 46 16.2 14 SD NR NR NR NR NS t-test




















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4 SD Steroid Injection 46 12.3 3.4 SD NR NR NR NR NS t-test













Demirci, et al.2002 90 Ulnar Sensory CV (m/s) 6 Months N Y N OCTR 44 55



14 SD Steroid Injection 46 25.4 11 SD NR NR NR NR NS t-test






0.7 SD OCTR 6 months 44 1.3 0.3 SD NR NR NR NR <0.001 t-test




0.3 SD OCTR 6 months 44 1.3 0.3 SD NR NR NR NR 0.006 t-test


months 46 3.3 0.7 SD Steroid Injection 3

months 46 1.5 0.5 SD NR NR NR NR <0.001 t-test






months 46 1.7 0.8 SD NR NR NR NR 0.09 t-test


1 SD OCTR 3 months 44 1.5 0.4 SD NR NR NR NR <0.001 t-test


1 SD OCTR 6 months 44 1.4 0.3 SD NR NR NR NR <0.001 t-test




months 46 3 0.8 SD Steroid Injection 3

















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months 46 5.5 1 SD Steroid Injection 3




months 46 5 1 SD NR NR NR NR <0.001 t-test



months 46 5 1 SD NR NR NR NR 0.654 t-test







































months 46 21.6 16 SD NR NR NR NR 0.03 t-test







Blankfield, et al.2001 21 Motor Distal Latency (msec) 0 weeks N Y N Therapeutic Touch 11 5.4

0.9 SD Sham Treatment 10 6.1 1.8 SD NR NR NR NR 0.36 t-test

Blankfield, et al.2001 21 Motor Distal Latency (msec) 6 weeks N Y N Therapeutic Touch 11 5.2

1.1 SD Sham Treatment 10 5.9 1 SD NR NR NR NR 0.15 t-test

Blankfield, et al.2001 21 VAS pain () 0 weeks Y Y Y Therapeutic Touch 11 4.8


Blankfield, et al.2001 21 VAS pain () 6 weeks Y Y Y Therapeutic Touch 11 3.7


Blankfield, et al.2001 21 VAS relaxation () 0 weeks Y Y Y Therapeutic Touch 3 5

5 SD Sham Treatment 5 3 2.6 SD NR NR NR NR 0.56 t-test

Blankfield, et al.2001 21 VAS relaxation () 6 weeks Y Y Y Therapeutic Touch 4 2.7





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Blankfield, et al.2001 21 Motor Distal Latency () 6 weeks N Y N Therapeutic Touch 0

weeks 11 5.4 0.9 SD Therapeutic Touch 6

weeks 11 5.2 1.1 SD NR NR -0.21

0.32 SD 0.06 t-test

Blankfield, et al.2001 21 VAS pain () 6 weeks Y Y Y Therapeutic Touch 0

weeks 11 4.8 2.7 SD Therapeutic Touch 6

weeks 11 3.7 2.55 SD NR NR -0.65

0.89 SD 0.08 t-test

Blankfield, et al.2001 21 VAS relaxation () 6 weeks Y Y Y Therapeutic Touch 0

weeks 7 5 5 SD Therapeutic Touch 6

weeks 7 2.7 3.1 SD NR NR -0.81

1.11 SD 0.11 t-test

Blankfield, et al.2001 21 Motor Distal Latency () 6 weeks N Y N Sham Treatment 0

weeks 10 6.1 1.8 SD Sham Treatment 6

weeks 10 5.9 1 SD NR NR -0.16

0.17 SD 0.01 t-test

Blankfield, et al.2001 21 VAS pain () 6 weeks Y Y Y Sham Treatment 0

weeks 10 3.4 2.3 SD Sham Treatment 6

weeks 10 3.8 2.4 SD NR NR -1.11

1.41 SD 0.04 t-test

Blankfield, et al.2001 21 VAS relaxation () 6 weeks Y Y Y Sham Treatment 0

weeks 6 3 2.6 SD Sham Treatment 6

weeks 6 5.4 2.7 SD NR NR -1.39

1.5 SD 0.07 t-test

Blankfield, et al.2001 21 Motor Distal Latency () 6 weeks N Y N Therapeutic Touch Mean

Change 11 -0.21 0.32 SD Sham Treatment Mean

Change 10 -0.16 0.17 SD NR NR NR NR 0.71 t-test

Blankfield, et al.2001 21 VAS pain () 6 weeks Y Y Y Therapeutic Touch Mean



Blankfield, et al.2001 21 VAS relaxation () 6 weeks Y Y Y Therapeutic Touch Mean



Blankfield, et al.2001 21 Motor Distal Latency () 6 weeks N Y N Therapeutic Touch

Crossover Mean Change 17 -0.21 0.29 SD Sham Treatment

Crossover Mean Change 16 -0.2 0.25 SD NR NR NR NR 0.95 t-test

Blankfield, et al.2001 21 VAS pain () 6 weeks Y Y Y Therapeutic Touch



Blankfield, et al.2001 21 VAS relaxation () 6 weeks Y Y Y Therapeutic Touch



Blankfield, et al.2001 21 Motor Distal Latency () 6 weeks N Y N Therapeutic Touch

Crossover 0 weeks 17 NR NR Therapeutic Touch Crossover 6 weeks 17 NR NR NR NR -0.21

0.29 SD 0.01 t-test

Blankfield, et al.2001 21 VAS pain () 6 weeks Y Y Y Therapeutic Touch


1.1 SD 0.03 t-test

Blankfield, et al.2001 21 VAS relaxation () 6 weeks Y Y Y Therapeutic Touch


1.21 SD 0.02 t-test

Blankfield, et al.2001 21 Motor Distal Latency () 6 weeks N Y N Sham Treatment

Crossover 0 weeks 16 NR NR Sham Treatment Crossover 6 weeks 16 NR NR NR NR -0.2

0.25 SD 0.005 t-test

Blankfield, et al.2001 21 VAS pain () 6 weeks Y Y Y Sham Treatment


1.2 SD 0.001 t-test

Blankfield, et al.2001 21 VAS relaxation () 6 weeks Y Y Y Sham Treatment


1.22 SD 0.005 t-test


Non-Operative/Conservative Treatment Dichotomous Data Results

Author N Outcome Measure (unit) Duration Statisic Reported Group Name Value Group Name Value Comparison Value p-value Statistical test

Burke, et al.2007 26 Patient Satification - neutral (%) 7 Weeks Y Unc Y Percent GISTM 12 0 NR STM 10 10 NR NR NR NR NR NR

Burke, et al.2007 26 Patient Satification - neutral (%) 5 Months Y Unc Y Percent GISTM 12 0 NR STM 10 20 NR NR NR NR NR NR

Burke, et al.2007 26 Patient Satification -Satified (%) 5 Months Y Unc Y Percent GISTM 12 58 NR STM 10 40 NR NR NR NR NR NR

Burke, et al.2007 26 Patient Satification -Satified (%) 7 Weeks Y Unc Y Percent GISTM 12 25 NR STM 10 50 NR NR NR NR NR NR

Burke, et al.2007 26 Patient Satification - Very Satified (%) 7 Weeks Y Unc Y Percent GISTM 12 75 NR STM 10 40 NR NR NR NR NR NR

Burke, et al.2007 26 Patient Satification - Very Satified (%) 5 Months Y Unc Y Percent GISTM 12 42 NR STM 10 40 NR NR NR NR NR NR

Evcik, et al.2007 81 Tinel Sign Positive (percentage) 0 baseline N Y N Percent Laser 41 55 NR Placebo 40 56 NR NR NR NR NR NR

Evcik, et al.2007 81 Phalens sign (positive) (percentage) 0 baseline N Unc N Percent Laser 41 66 NR Placebo 40 65 NR NR NR NR NR NR

Evcik, et al.2007 81 Buda Test (positive) (percentage) 0 baseline Unc Unc Unc Percent Laser 41 61 NR Placebo 40 69 NR NR NR NR NR NR

Evcik, et al.2007 81 Flick test (positive) (percentage) 0 baseline Unc Unc N Percent Laser 41 90 NR Placebo 40 85 NR NR NR NR NR NR

Ucan, et al.2006 67 Completely Normal Hands by EMG 6 Months Y N N Number Improved Splinting Group 3 months 23 8 NR Splinting Group 6 months 23 5 NR NR NR NR NR NR

Ucan, et al.2006 67 Completely Normal Hands by EMG 6 Months Y N N Number Improved Splinting plus Steroid

Injection 3 months 23 10 NR Splinting plus Steroid Injection 6 months 23 7 NR NR NR NR NR NR

Ucan, et al.2006 67 Completely Normal Hands by EMG 6 Months Y N N Number Improved OCTR 3 months 11 4 NR OCTR 6 months 11 5 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Completely Satisfied 6 Months Y N Y Number Improved Splinting Group 3 months 23 2 NR Splinting Group 6 months 23 0 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Almost Satisfied 6 Months Y N Y Number Improved Splinting Group 3 months 23 14 NR Splinting Group 6 months 23 8 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Moderately Satisfied 6 Months Y N Y Number Improved Splinting Group 3 months 23 7 NR Splinting Group 6 months 23 15 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Completely Satisfied 6 Months Y N Y Number Improved Splinting plus Steroid


Ucan, et al.2006 67 Patient Satisfaction - Almost Satisfied 6 Months Y N Y Number Improved Splinting plus Steroid


Ucan, et al.2006 67 Patient Satisfaction - Moderately Satisfied 6 Months Y N Y Number Improved Splinting plus Steroid


Ucan, et al.2006 67 Patient Satisfaction - Completely Satisfied 6 Months Y N Y Number Improved OCTR 3 months 11 1 NR OCTR 6 months 11 3 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Moderately Satisfied 6 Months Y N Y Number Improved OCTR 3 months 11 4 NR OCTR 6 months 11 7 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Almost Satisfied 6 Months Y N Y Number Improved OCTR 3 months 11 3 NR OCTR 6 months 11 0 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Somewhat Satisfied 6 Months Y N Y Number Improved OCTR 3 months 11 2 NR OCTR 6 months 11 0 NR NR NR NR NR NR

Ucan, et al.2006 67 Patient Satisfaction - Dissatisfied 6 Months Y N Y Number Improved OCTR 3 months 11 1 NR OCTR 6 months 11 1 NR NR NR NR NR NR

Mea

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Non-Operative/Conservative Treatment Dichotomous Data Results

Author N Outcome Measure (unit) Duration Statisic Reported Group Name Value Group Name Value Comparison Value p-value Statistical testMea

sure

of D

ispe

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n


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Dammers, et al.2006 132 Responders to Treatment 12 Months Y N Y Number 20 mg injection 6 months 44 25 NR 20 mg injection 12

months 44 21 NR NR NR NR NR NR

Dammers, et al.2006 132 Responders to Treatment 12 Months Y N Y Number 40 mg injection 6 months 43 23 NR 40 mg injection 12


Dammers, et al.2006 132 Responders to Treatment 12 Months N Y Y Number 60 mg injection 6 months 43 32 NR 60 mg injection 12


Dammers, et al.2006 132 Non-Responders to Treatment 12 Months Y N Y Number 60 mg injection 6 months 43 11 NR 60 mg injection 12


Dammers, et al.2006 132 Non-Responders to Treatment 12 Months Y N Y Number 20 mg injection 6 months 44 19 NR 20 mg injection 12


Dammers, et al.2006 132 Non-Responders to Treatment 12 Months N Y Y Number 40 mg injection 6 months 44 20 NR 40 mg injection 12


Armstrong, et al.2004 81 Patient Satisfaction 2 Weeks Y N Y Number Steroid Injection 43 30 NR Placebo Group 38 13 NR NR NR NR 0.001 t-test

O'Gradaigh, et al.2000 123 Symptom Improvement - better or much better 6 Weeks Y Unc Y Number 25 mg 32 21 NR Controls 20 5 NR NR NR NR <0.05 Chi Square

O'Gradaigh, et al.2000 123 Symptom Improvement - better or much better 6 Weeks Y Unc Y Number 100 mg 32 20 NR Controls 20 5 NR NR NR NR <0.02 Chi Square

O'Gradaigh, et al.2000 123 Symptom Improvement - better or much better 6 Months Y Unc Y Number 25 mg 21 14 NR 100 mg 20 10 NR NR NR NR >0.05 Chi Square

O'Gradaigh, et al.2000 123 Symptom Improvement - better or much better 6 Weeks Y Unc Y Number 20 mg triamcinolone 18 13 NR 100 mg 21 14 NR NR NR NR >0.5 Chi Square

O'Gradaigh, et al.2000 123 Symptom Improvement - better or much better 6 Months N Y Y Number 20 mg triamcinolone 13 8 NR 100 mg 14 7 NR NR NR NR >0.5 Chi Square

O'Gradaigh, et al.2000 123 Symptom Improvement - better or much better 6 Weeks Y Unc Y Number 25 mg 32 21 NR 100 mg 32 20 NR NR NR NR >0.5 Chi Square


Non-Operative/Conservative Treatment with > 20% BilateralRelevant Articles from O'Connor, et al. / Marshall, et. al. / Verdugo, et al. Systematic Reviews


Celiker, et al.2002

Corticosteroid injection vs. nonsteroidal antiinflammatory drug and splinting in carpal tunnel syndrome Am J Phys Med Rehabil

Akalin, et al.2002 Treatment of carpal tunnel syndrome with nerve and tendon gliding exercises Am J Phys Med Rehabil

Garfinkel, et al.1998 Yoga-based intervention for carpal tunnel syndrome: a randomized trial JAMA

Ebenbichler, et al.1998

Ultrasound treatment for treating the carpal tunnel syndrome: randomised 'sham' controlled trial BMJ

Oztas, et al.1998 Ultrasound therapy effect in carpal tunnel syndrome Arch Phys Med Rehabil


Non-Operative/Conservative Treatment with > 20% BilateralIncluded Articles


Mishra, et al.2006

Efficacy of splinting and oral steroids in the treatment of carpal tunnel syndrome: a prospective randomized clinical and electrophysiological study Neurol India

Pinar, et al.2005 Can we use nerve gliding exercises in women with carpal tunnel syndrome? Adv Ther

Aygul, et al.2005

Determination of sensitive electrophysiologic parameters at follow-up of different steroid treatments of carpal tunnel syndrome J Clin Neurophysiol

Gokoglu, et al.2005

Evaluation of iontophoresis and local corticosteroid injection in the treatment of carpal tunnel syndrome Am J Phys Med Rehabil

Ly-Pen, et al.2005

Surgical decompression versus local steroid injection in carpal tunnel syndrome: a one-year, prospective, randomized, open, controlled clinical trial Arthritis Rheum

Wong, et al.2005

Single vs. two steroid injections for carpal tunnel syndrome: a randomised clinical trial Int J Clin Pract

Piravej, et al.2004

Effect of ultrasound thermotherapy in mild to moderate carpal tunnel syndrome J Med Assoc Thai

Hui, et al.2004 Long-term outcome of carpal tunnel syndrome after conservative treatment Int J Clin Pract

Bakhtiary, et al.2004 Ultrasound and laser therapy in the treatment of carpal tunnel syndrome Aust J Physiother

Girlanda, et al.1993

Local steroid treatment in idiopathic carpal tunnel syndrome: short- and long-term efficacy J Neurol


Non-Operative/Conservative Treatment with > 20% BilateralStudy Design and Quality


Mishra, et al.2006 40 RCT Oral Prednisolone vs.

Splinting 3 Months ● ● ● ● ○ ○ ○ ● ● ● ● ● ● Level II

Pinar, et al.2005 26 RCT Nerve Gliding exercise + modified activity + splint vs.

Splinting + Activity Modification 10 Weeks ● ● ○ ● ○ ○ ○ ● ● ● ● ● ● Level II

Aygul, et al.2005 33 RCT Steroid Injection vs.

Iontophoresis or Phonophoresis 4 Months ● ● ● ● ○ ○ ○ ● ● ● ● ● ● Level II

Gokoglu, et al.2005 30 RCT Steroid Injection vs.

Iontophoresis 8 Weeks ● ● ▫ ▫ ○ ○ ● ● ● ● ● ● ▫ Level II

Ly-Pen, et al.2005 101 RCT Steroid Injection vs.

OCTR 12 Months ▫ ● ● ● ○ ○ ▫ ● ● ● ● ● ▫ Level I

Wong, et al.2005 40 RCT Two Steroid Injections vs.

Single Steroid Injection 40 Weeks ● ● ▫ ● ● ● ● ● ● ● ● ● ▫ Level I

Piravej, et al.2004 18 RCT Ultrasound thermotherapy vs.

Diclofenac 4 Weeks ● ● ● ● ● ○ ● ● ● ● ● ● ○ Level I

Hui, et al.2004 60 RCT Steroid Injection vs.

Oral Corticosteroid 80 Weeks ● ● ● ● ● ○ ● ● ● ● ● ● ● Level I

Bakhtiary, et al.2004 50 RCT Ultrasound thermotherapy vs.

Low Level Laser Therapy 7 Weeks ● ● ● ○ ○ ○ ● ● ● ● ● ● ● Level II

Girlanda, et al.1993 32 RCT Steroid Injection vs.

Control or Placebo 2 Months ● ● ● ● ● ● ● ● ● ● ● ● ● Level I

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Non-Operative/Conservative Treatment with > 20% BilateralPatient Characteristics



RangeAge Std.



Mishra, et al.2006 Splint 20 36 42.91 NR ± 9.39 17 NR NR NR NR 3 NR NR NR NR 6.40

Months NR ± 7.09 23.87 NR ± 2.23

Oral Steroid 20 35 41.57 NR ± 9.26 16 NR NR NR NR 4 NR NR NR NR 6.31Months NR ± 7.50 23.84 NR ± 2.41

Pinar, et al.2005

Nerve gliding + modified activity + splinting 14 19 NR NR NR 14 9 NR NR NR 0 0 NR NR NR NR NR NR NR NR NR

Modified activity + splinting 12 16 NR NR NR 12 16 NR NR NR 0 0 NR NR NR NR NR NR NR NR NR

Aygul, et al.2005 Steroid Injection 12 20 46.0 NR ± 6.4 NR NR NR NR NR 0 0 NR NR NR NR NR NR NR NR NR

Iontophoresis 9 18 46.1 NR ± 13.5 9 18 NR NR NR 0 0 NR NR NR NR NR NR NR NR NR

Phonophoresis 10 18 44.1 NR ± 5.7 10 18 NR NR NR 0 0 NR NR NR NR NR NR NR NR NR

All Groups 31 56 45.4 NR ± 9 31 56 NR NR NR 0 0 NR NR NR 51Months NR ± 60.4 NR NR NR

Gokoglu, et al.2005 Iontophoresis 15 28 49.2 NR ± 8.2 15 NR NR NR NR 0 NR NR NR NR 50.4


All Groups 30 48 48 { 29-61 } ± 8.2 27 NR NR NR NR 3 NR NR NR NR NR NR NR NR NR NR

Steroid Injection 15 20 46.2 NR ± 8 12 NR NR NR NR 3 NR NR NR NR 42.1Months NR ± 43.3 NR NR NR

Ly-Pen, et al.2005 OCTR NR 80 50.52 NR ± 10.87 NR NR NR NR NR NR NR NR NR NR 31.12

Weeks NR ± 7.27 NR NR NR

Steroid Injection NR 83 53.17 NR ± 13.93 NR NR NR NR NR NR NR NR NR NR 33.25Weeks NR ± 8.17 NR NR NR

Wong, et al.2005 Two Injections 20 36 47.3 NR ± 9.6 17 NR NR NR NR 3 NR NR NR NR NR NR NR NR NR NR

Single Injection 20 35 46.4 NR ± 5.6 17 NR NR NR NR 3 NR NR NR NR NR NR NR NR NR NR

Piravej, et al.2004 Diclofenac 8 15 44.87 { 33-57 } ± 7.55 8 15 44.87 { 33-57 } ± 7.55 0 0 NR NR NR 6.67

Months1-12

Months ± 4.32 NR NR NR

Ultrasound 10 15 49.07 { 33-68 } ± 8.88 10 15 49.07 { 33-68 } ± 8.8 0 0 NR NR NR 6.4Months

1-12Months ± 4.5 NR NR NR

Hui, et al.2004 Steroid Injection 30 38 51 NR NR 27 NR NR NR NR 3 NR NR NR NR NR NR NR NR NR NR

Oral Steroid 30 36 47 NR NR 26 NR NR NR NR 4 NR NR NR NR NR NR NR NR NR NR

Bakhtiary, et al.2004 Low Level Laser Therapy 40 40 48 NR ± 13.4 40 40 48 NR ± 13.4 NR NR NR NR NR NR NR NR NR NR NR

Ultrasound 45 45 48 NR ± 13.4 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Girlanda, et al.1993 Steroid Injection 16 27 43.9 NR ± 14.42 14 NR NR NR NR 2 NR NR NR NR 4.69

Years1 mo. -

20 Years ± 5.32 NR NR NR

Placebo 16 26 47.06 NR ± 12.43 12 NR NR NR NR 4 NR NR NR NR 4.22Years

2 mos. - 20 Years ± 5.15 NR NR NR



Non-Operative/Conservative Treatment with > 20% BilateralPatient Characteristics


Right Handed


w/ Thenar Atrophy

w/ Axonal Loss

w/ Spontaneous

Remission

Want Surgery

Want Non-Surgical

TreatmentSeverity Severity Determined

by

Mishra, et al.2006 Splint 20 NR NR NR NR NR NR 0 0 NR NR NR NR NR

Oral Steroid 20 NR NR NR NR NR NR 0 0 NR NR NR NR NR

Pinar, et al.2005

Nerve gliding + modified activity + splinting 14 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Modified activity + splinting 12 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Aygul, et al.2005 Steroid Injection 12 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Iontophoresis 9 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Phonophoresis 10 NR NR NR NR NR NR 0 NR NR NR NR NR NR

All Groups 31 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Gokoglu, et al.2005 Iontophoresis 15 NR NR NR NR NR NR 0 NR NR NR NR NR NR

All Groups 30 NR NR NR 5 25 NR 0 NR NR NR NR NR NR

Steroid Injection 15 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Ly-Pen, et al.2005 OCTR NR NR NR NR NR NR NR 0 NR NR NR NR NR NR

Steroid Injection NR NR NR NR NR NR NR 0 NR NR NR NR NR NR

Wong, et al.2005 Two Injections 20 NR NR

6 pts pain and tenderness at injection site with radiation over the median nerve distribution after second injection lasting 1 to 5 days

NR NR NR 0 NR NR NR NR NR NR

Single Injection 20 NR NR2 patients with pain and tenderness at injection site with radiation over the median nerve distribution after second injection lasting 1 to 5 days

NR NR NR 0 NR NR NR NR NR NR

Piravej, et al.2004 Diclofenac 8 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Ultrasound 10 NR NR NR NR NR NR 0 NR NR NR NR NR NR

Hui, et al.2004 Steroid Injection 30 NR NR NR NR NR NR NR NR NR NR NR NR NR

Oral Steroid 30 NR NR NR NR NR NR NR NR NR NR NR NR NR

Bakhtiary, et al.2004 Low Level Laser Therapy 40 40 had ultrasound to

opposite arm NR NR 0 45 NR NR 0 NR NR NR NR NR

Ultrasound 4540 of the patients had opposite hand in LLLT treatment group

NR NR 0 45 NR NR 0 NR NR NR NR NR

Girlanda, et al.1993 Steroid Injection 16 NR NR NR NR NR NR NR NR NR NR NR NR NR

Placebo 16 NR NR NR NR NR NR NR NR NR NR NR NR NR

Number of Patients


Non-Operative/Conservative Treatment with > 20% BilateralPatient Characteristics - Inclusion/Exclusion Criteria


Mishra, et al.2006 40 Oral Prednisolone vs.

Splinting

Diagnosed to have CTS in neurology department of a tertiary care center between July 2003 and December 2004- Median nerve MDL recording at abductor pollicis brevis and stimulating at wrist > 4.4 ms- median nerve antidromic sensory peak latency recording at digit II > 3.5 ms- difference between antidromic median sensory latency and ulnar sensory latency at digit IV > 0.5ms- antidromic latency difference .0.5ms between median nerve digit II and ulnar nerve digit V using the same distance of measurement

- patient with diabetes mellitus, trauma to the wrist and deformity- any patient with evidency of generalized neuropathy/radiculopathy on electrodiagnostic study- patients with advaned CTS having wasting, marked weakness wwith marked axonal loss on nerve conduction study or nonstimulatable nerves- patients with a history of peptic ulcer- patients treated previously for CTS using medical or surgical therapy- pregnant women with CTS- patients with systemic disorders like rheumatoid arthritis, hypothyroidism, amyloidosis, etc

Pinar, et al.2005 26

Nerve Gliding exercise + modified activity + splint vs.

Splinting + Activity Modification

women between the ages of 35-55clinical and electrophysiological test result postive for CTS

not pregnant, no history of trauma and had not previously undergone physiotherapy

Aygul, et al.2005 33 Steroid Injection vs.

Iontophoresis or Phonophoresis

Mild or Moderate CTS symptoms occurring longer than 3 months before study with a presence of median and ulnar nerve sensory and motor responses during electrophysiologic testing

Corticosteroid injection before the study; physical or medical therapy in the previous month; muscle atrophy due to CTS; evidence of obvious underlying causes of CTS such as hypothyroidism, diabetes mellitus, arthritis of the wrist, or pregnancy; clinical or electrophysiologic evidence of accompanying conditions that could mimic CTS or interfere with its evaluation such as cervical radiculopathy or polyneuropathy; presence of either fibrillation potentials or reinnervation on needle electromyography in the abductro pollicis brevis muscle




Gokoglu, et al.2005 30 Steroid Injection vs.

IontophoresisClinical and electrophysiologic evidence of CTS; mild or moderate CTSonly

Patients who previously had received any treatment for CTS; patient who had a disease leading to secondary CTS; thenar atrophy

Ly-Pen, et al.2005 101 Steroid Injection vs.

OCTR

At least 18 years old, suggestive symptoms of CTS of at least 3 month duration, consecutively referred by their primary care physicians to a CTS unit specifically created for this study, had a presumptive diagnosis of CTS, and had been unresponsive to a course of at least 2 weeks of nonsteriodal antiinflammatory drugs (NSAIDs) and splinting- Clinical and electrophysiological diagnosis of CTS

Thenar atrophy, previous carpal tunnel release surgery, local injection for CTS, pregnancy, Diabetes Mellitus, hypothroidism, inflammatory arthropathy, polyneuropathy

Wong, et al.2005 40 Two Steroid Injections vs.

Single Steroid Injection

CTS less than 12 months but more than 3 months; sensory symptoms over median nerve distribution, confirmatory electrophysiological: prolonged median nerve DML>4ms or median-ulnar palmer sensory latency difference greater than 0.5ms, failed splinting for 2 months

1.patients with evidence of severe CTS: clinical examination showing wastage of the thenar muscles or fibrillation potentials or distal motal latency greater than 6.5ms or unrecordable sensory and motor action potentials, 2.clinical or electrophysiological evidence of accompanying conditions that could mimic CTS such as polyneuropathy, 3.contraindication of steriod use, 4.hx of underlying disorders associated with CTS such as DM, RA, pregnancy, acromegaly or hypothyroidism, 5. patients who have received previous steroid injections

Piravej, et al.2004 18 Ultrasound thermotherapy vs.

Diclofenac

1.) Clinical manifestation of CTS of less than 12 month2.) Electrophysilogic test showed the presence of median nerce sensory and motor responses with SDL 2.8>=4.5, SNAP amplitude exceeding 10uV, median-ulnar mixed nerve latency difference longer than 0.5 msec, MDL 6.5msec> 4.2 msec and CMAP amplitude not lessthan 5.0mv electromyography of the abductor pollicis brevis (APB) muscle shows no spontaneous activity or markedly reduced firing frequency.Patient accepted study and signed consent

Musculoskeletal problems or specifc predisposing factors, such as rheumatic diseases, diabetes mellitus, cervical spondylosis, acute trauma and pregnancy- local corticosteriod injection in the last 3 months- serious co-existing medical condition that may prohibit electrophysiological test during studyallergy or contraindication for-Diclofena and ultrasound therapymuscle atrophy, anesthesia or intractable pain due to CTS




Hui, et al.2004 60 Steroid Injection vs.

Oral Corticosteroid

-Sensory symptoms over median nerve distribution-cofiratory electrophysiologic results: Prolonged median nerve DML > 4ms or median-ulnar palmar sensory latency difference >0/5 msec- Failed splinting for 2 months or more

- Evidence of severe CTS: fibrillation potentials or reinnervation on needle examination of the abductor pollicis brevis muscle or clinical examination showing wastage of the thenar muscles (referred for surgery)- Clinical or electrophysiologic evidence of accompanying conditions that could mimic CTS or interfere with its evaluation, such as proximal median neuropathy, cervical radiculopathy or sighificant polyneuropathy- Contradiction to steriod use- history of underlying disorders associated with CTS such as diabetes mellitus, rheumatiod arthritis, pregnandcy, acromegaly or hypothyroidism�- Patients who have received previous steriod injection or oral steriod therapy for CTS

Bakhtiary, et al.2004 50 Ultrasound thermotherapy vs.

Low Level Laser Therapy

All patients right handedclinicall diagnosed CTSnembness in the Nedian nerve distribution and night waking lasting more than one month1.) postive Phalen's test2.) postive Tinnel's test3.) Standard electrophysiological criteria including prolongation of nerve conduction velocity (ML >4ms or SL >3.5 ms)

-Secondary entrapment neuropathies,- electroneurographic and clinical signs of axonal degeneration of the median nerve- been treated with ultrasound or low level laser therapy for CTS- required regular analgesic or anti-inflammatory drugs- history of steriod injection into the carpal tunnel, thyroid disease, diabetes, or systemic peripheral neuropathy

Girlanda, et al.1993 32 Steroid Injection vs.

Control or PlaceboClinical and electrophysiological evidence of idiopathic CTS Known causes of entrapment neuropathies or systemic diseases

- previous treatment for CTS


Non-Operative/Conservative Treatment with > 20% Bilateral Patient Characteristics - Workers Compensation



Mishra, et al.2006 Splint 20 NR NR NR NR

Oral Steroid 20 NR NR NR NR

Pinar, et al.2005

Nerve gliding + modified activity + splinting 14 NR NR NR NR

Modified activity + splinting 12 NR NR NR NR

Aygul, et al.2005 Steroid Injection 12 NR NR NR NR

Iontophoresis 9 NR NR NR NR

Phonophoresis 10 NR NR NR NR

All Groups 31 NR NR NR NR

Gokoglu, et al.2005 Iontophoresis 15 NR NR NR NR

All Groups 30 NR 25 housewives NR NR


Ly-Pen, et al.2005 OCTR 80

hands NR NR NR NR

Steroid Injection 83 hands NR NR NR NR


Non-Operative/Conservative Treatment with > 20% Bilateral Patient Characteristics - Workers Compensation



Wong, et al.2005 Two Injections 20 NR NR NR NR

Single Injection 20 NR NR NR NR

Piravej, et al.2004 Diclofenac 8 NR NR NR NR

Ultrasound 10 NR NR NR NR

Hui, et al.2004 Steroid Injection 30 NR NR NR NR

Oral Steroid 30 NR NR NR NR

Bakhtiary, et al.2004 Low Level Laser Therapy 40 NR NR NR NR

Ultrasound 45 NR NR NR NR

Girlanda, et al.1993 Steroid Injection 16 NR NR NR NR

Placebo 16 NR NR NR NR


Non-Operative/Conservative Treatment with > 20% BilateralContinuous Data Results


Mishra, et al.2006 40 Functional Status Score (none) 0 baseline Y Y Y Splint Group 20 1.74

± 0.34 SD Oral Steriod 20 1.68 ± 0.31 SD NR NR NR NR 0.46 t test

Mishra, et al.2006 40 Symptom Severity Score (none) 0 baseline Y Y Y Splint Group 20 2.83


Mishra, et al.2006 40 Motor Distal Latency (ms) 0 baseline Unc Unc Unc Splint Group 20 3.94


Mishra, et al.2006 40 CMAP (mV) 0 baseline Unc Unc Unc Splint Group 20 8.36


Mishra, et al.2006 40 Motor Conduction Velocity (m/s) 0 baseline N Unc Unc Splint Group 20 54.13


Mishra, et al.2006 40 SDL (ms) 0 baseline N Unc Unc Splint Group 20 4.23


Mishra, et al.2006 40 SNAP Amplitude (mV) 0 baseline N Unc Unc Splint Group 20 22.86


Mishra, et al.2006 40 SCVL (m/s) 0 baseline N Unc N Splint Group 20 33.04


Mishra, et al.2006 40 Symptom Severity Score (none) 1 Months Y Y Y Splint Group - baseline 20 2.83

± 0.41 SD Splint Group 1 month 20 2.48

± 0.52 SD NR NR 0.34 ± 0.42 SD < 0.001 Paired t test

Mishra, et al.2006 40 Symptom Severity Score (none) 3 Months Y Y Y Splint Group - baseline 20 2.83


± 0.56 SD NR NR 0.39 ± 0.54 SD <0.001 Paired t test

Mishra, et al.2006 40 FSS (none) 1 Months Y Y Y Splint Group - baseline 20 1.74


± 0.41 SD NR NR 0.14 ± 0.13 SD < 0.001 Paired t test

Mishra, et al.2006 40 FSS (none) 3 Months Y Y Y Splint Group - baseline 20 1.74


± 0.43 SD NR NR 0.16 ± 0.17 SD <0.001 Paired t test

Mishra, et al.2006 40 MDL (ms) 1 Months N Unc N Splint Group - baseline 20 3.94


± 0.66 SD NR NR 0.06 ± 0.77 SD 0.607 Paired t test

Mishra, et al.2006 40 MDL (ms) 3 Months N Unc N Splint Group - baseline 20 3.94



Mishra, et al.2006 40 MCV (m/s) 1 Months N Unc N Splint Group - baseline 20 54.13



Mishra, et al.2006 40 MCV (m/s) 3 Months N Unc N Splint Group - baseline 20 54.13



Mishra, et al.2006 40 SDL (ms) 1 Months N Unc N Splint Group - baseline 20 4.23



Mishra, et al.2006 40 SDL (ms) 3 Months N Unc N Splint Group - baseline 20 4.23



Mishra, et al.2006 40 SCV (ms) 1 Months N Unc N Splint Group - baseline 20 33.04


± 9.51 SD NR NR -1.41 ± 7.11 SD 0.24 Paired t test

Mishra, et al.2006 40 SCV (ms) 3 Months N Unc N Splint Group - baseline 20 33.04


± 9.06 SD NR NR -2.83 ± 7.88 SD 0.03 Paired t test

Mishra, et al.2006 40 SSS (none) 1 Months Y Y Y Oral Steroid Group -

baseline 20 2.67 ± 0.37 SD Oral Steroid Group

1 month 20 2.27 ± 0.48 SD NR NR 0.40

± 0.30 SD < 0.001 Paired t test

Mishra, et al.2006 40 SSS (none) 3 Months Y Y Y Oral Steroid Group -


3 month 20 2.18 ± 0.48 SD NR NR 0.49


Mishra, et al.2006 40 FSS (none) 1 Months Y Y Y Oral Steroid Group -


1 month 20 1.48 ± 0.30 SD NR NR 0.20


Mishra, et al.2006 40 FSS (none) 3 Months Y Y Y Oral Steroid Group -


3 month 20 2.18 ± 0.63 SD NR NR 0.49


Mishra, et al.2006 40 MDL (ms) 1 Months N Unc Unc Oral Steroid Group -


1 month 20 3.74 ± 0.73 SD NR NR 0.19

± 0.76 SD 0.143 Paired t test

Mishra, et al.2006 40 MDL (ms) 3 Months N Unc Unc Oral Steroid Group -

baseline 20 3.94 ± .98 SD Oral Steroid Group

3 month 20 3.47 ± 0.77 SD NR NR 0.47


Mishra, et al.2006 40 MCV (ms) 1 Months N Unc N Oral Steroid Group -


1 month 20 52.17 ± 6.19 SD NR NR 1.03


Mishra, et al.2006 40 MCV (ms) 3 Months N Unc N Oral Steroid Group -


3 month 20 54.01 ± 5.64 SD NR NR -0.80


Mishra, et al.2006 40 SDL (ms) 1 Months N Unc Unc Oral Steroid Group -


1 month 20 3.74 ± 0.80 SD NR NR 0.13


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Mishra, et al.2006 40 SDL (ms) 3 Months N Unc Unc Oral Steroid Group -


3 month 20 3.32 ± 0.64 SD NR NR 0.55

± 0.66 SD <0.001 Paired t test

Mishra, et al.2006 40 SCV (m/s) 1 Months N Unc Unc Oral Steroid Group -


1 month 20 33.75 ± 5.89 SD NR NR 2.56


Mishra, et al.2006 40 SCV (m/s) 3 Months N Unc Unc Oral Steroid Group -


3 month 20 39.82 ± 6.47 SD NR NR -3.51


Mishra, et al.2006 40 Change in Mean - SSS (none) 1 Months Y Y N Splint 20 0.34

± 0.42 SD Oral Steroid 20 0.40 ± 0.30 SD NR NR NR NR 0.52 t test

Mishra, et al.2006 40 Change in Mean - SSS (none) 3 Months Y Y N Splint 20 0.39


Mishra, et al.2006 40 Change in Mean - FSS (none) 1 Months Y Y Y Splint 20 0.14


Mishra, et al.2006 40 Change in Mean - FSS (none) 3 Months Y Y Y Splint 20 0.16


Mishra, et al.2006 40 Change in Mean - MDL (ms) 1 Months N Unc Unc Splint 20 0.06


Mishra, et al.2006 40 Change in Mean - MDL (ms) 3 Months N Unc Unc Splint 20 0.20


Mishra, et al.2006 40 Change in Mean - MCV (m/s) 1 Months N Unc Unc Splint 20 2.09


Mishra, et al.2006 40 Change in Mean - MCV (m/s) 3 Months N Unc Unc Splint 20 3.40

± 16.22 SD Oral Steroid 20 -0.80 ± 8.72 SD NR NR NR NR 0.16 t test

Mishra, et al.2006 40 Change in Mean - SDL (ms) 1 Months N Unc Unc Splint 20 0.16


Mishra, et al.2006 40 Change in Mean - SDL (ms) 3 Months N Unc Unc Splint 20 0.35


Mishra, et al.2006 40 Change in Mean - SCV (ms) 1 Months N Unc Unc Splint 20 -1.41


Mishra, et al.2006 40 Change in Mean - SCV (ms) 3 Months N Unc Unc Splint 20 -2.88

± 7.88 SD Oral Steroid 20 -3.51 ± 8.48 SD NR NR NR NR 0.72 t test

Pinar, et al.2005 26 VAS (none) 0 baseline Y Y Y Exercise + act

modification + splint19

(hands)6.9

± 1.4 SD Acticity modification + splint

16 (hands)

6.9 ± 1.5 SD NR NR NR NR NR NR

Pinar, et al.2005 26 VAS (none) 10 Weeks Y Y Y Exercise + act


(hands)1.0


16 (hands)

1.6 ± 1.8 SD NR NR NR NR < 0.05 Mann - Whitney U

TestPinar, et al.

2005 26 Grip Strength 0 baseline Y Unc Y Exercise + act modification + splint

19 (hands)

17.8 ± 6.1 SD Acticity modification +

splint16

(hands)20.4


Pinar, et al.2005 26 Grip Strength (lb / in^2) 10 Weeks Unc Y Y Exercise + act


(hands)22.0


16 (hands)

21.7 ± 4.3 SD NR NR NR NR < 0.05 Mann - Whitney U

TestPinar, et al.

2005 26 Pinch Strength (lb / in^2) 0 baseline Unc Y Y Exercise + act modification + splint

19 (hands)


splint16

(hands)4.3


Pinar, et al.2005 26 Pinch Strength (lb / in^2) 10 Weeks Unc Y Y Exercise + act


(hands)5.4


16 (hands)

4.9 ± 1.1 SD NR NR NR NR <0.05 Mann - Whitney U

TestPinar, et al.

2005 26 Semmes-Weinstein monofilament 0 baseline N Y N Exercise + act modification + splint

19 (hands)


splint16

(hands)3.1


Pinar, et al.2005 26 Semmes-Weinstein monofilament 10 Weeks N Y N Exercise + act


(hands)2.9


16 (hands)

2.8 ± 0.0 SD NR NR NR NR <0.05 Mann - Whitney U

TestPinar, et al.

2005 26 Semmes-Weinstein monofilament 10 Weeks N Y N Exercise + act modification + splint BEFORE

19 (hands)

3.2 ± 0.5 SD Exercise + Activity modification

+ splint AFTER19

(hands)2.9

± 0.2 SD NR NR 03 ± 0.4 SD >0.05 Wilcoxon Test

Pinar, et al.2005 26 Pinch Strength (lb / in^2) 10 Weeks Unc Y Y Exercise + act modification +

splint BEFORE19

(hands)4.1

± 1.7 SD Exercise + Activity modification + splint AFTER

19 (hands)

5.4 ± 1.8 SD NR NR 1.3

± 1.4 SD >0.05 Wilcoxon Test

Pinar, et al.2005 26 Grip Strength (lb / in^2) 10 Weeks Unc Y Y Exercise + act modification +

splint BEFORE19

(hands)17.8


19 (hands)

22.0 ± 6.8 SD NR NR 4.2


Pinar, et al.2005 26 VAS (none) 10 Weeks Y Y Y Exercise + act modification +

splint BEFORE19

(hands)6.9


19 (hands)

1.0 ± 1.6 SD NR NR 5.9

± 1.8 SD NR NR

Pinar, et al.2005 26 VAS (none) 10 Weeks Y Y Y Activity modification +

splint BEFORE16

(hands)6.9


16 (hands)

1.6 ± 1.8 SD NR NR 5.4


Pinar, et al.2005 26 Grip Strength (lb / in^2) 10 Weeks Unc Y Y Activity modification +

splint BEFORE16

(hands)20.4


16 (hands)

21.7 ± 4.3 SD NR NR 1.3

± 1.4 SD <0.05 Wilcoxon Test




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Pinar, et al.2005 26 Pinch Strength (lb / in^2) 10 Weeks Unc Y Y Activity modification +

splint BEFORE16

(hands)4.3


16 (hands)

4.9 ± 1.1 SD NR NR 0.6


Pinar, et al.2005 26 Semmes-Weinstein monofilament (none) 10 Weeks Unc Y N Activity modification +

splint BEFORE16

(hands)3.1


16 (hands)

2.8 ± 0.0 SD NR NR 0.2


Aygul, et al.2005 33 SSS (none) 0 baseline Y Y Y Steroid Injection 20

(hands)2.32

± 0.73 SD Iontophoresis 18 (hands)


Aygul, et al.2005 33 SSS (none) 2 Months Y Y Y Steroid Injection 20

(hands)1.37



Aygul, et al.2005 33 SSS (none) 4 Months Y Y Y Steroid Injection 20

(hands)1.47



Aygul, et al.2005 33 SSS (none) 0 baseline Y Y Y Phonophoresis 18

(hands)2.58

± 0.66 SD NR NR NR NR NR NR NR NR NR

Aygul, et al.2005 33 SSS (none) 2 Months Y Y Y Phonophoresis 18

(hands)1.67


Aygul, et al.2005 33 SSS (none) 4 Months Y Y Y Phonophoresis 18

(hands)1.87


Aygul, et al.2005 33 FSS (none) 0 baseline Y Y Y Phonophoresis 18

(hands)1.89


Aygul, et al.2005 33 FSS (none) 2 Months Y Y Y Phonophoresis 18

(hands)1.24


Aygul, et al.2005 33 FSS (none) 4 Months Y Y Y Phonophoresis 18

(hands)1.44


Aygul, et al.2005 33 FSS (none) 0 baseline Y Y Y Steroid Injection 20

(hands)1.70



Aygul, et al.2005 33 FSS (none) 2 Months Y Y Y Steroid Injection 20

(hands)1.24



Aygul, et al.2005 33 FSS (none) 4 Months Y Y Y Steroid Injection 20

(hands)1.27



Aygul, et al.2005 33 D4M-D4U (msec) NR N Unc N Healthy Control NR

0.16 ± 0.14 SD NR NR NR NR NR NR NR NR NR NR

Aygul, et al.2005 33 d2M-D5U (msec) NR N Unc N Healthy Control NR


Aygul, et al.2005 33 D2M/D5U SNAPa Ratio (mu V) NR N Unc N Healthy Control NR


Aygul, et al.2005 33 mSDL (msec) NR N Unc N Healthy Control NR


Aygul, et al.2005 33 mSNCV (m/s) NR N Unc N Healthy Control NR


Aygul, et al.2005 33 SNAPa (mu V) NR N Unc N Healthy Control NR

26 ± 9 SD NR NR NR NR NR NR NR NR NR NR

Aygul, et al.2005 33 mMDL (msec) NR N Unc Unc Healthy Control NR


Aygul, et al.2005 33 mMNCV (m/s) NR N Unc Unc Healthy Control NR


Aygul, et al.2005 33 mMTLI (none) NR N Unc Unc Healthy Control NR


Aygul, et al.2005 33 D4M-D4U (msec) 0 baseline N Unc Unc Steroid Injection 20

(hands)1.66



Aygul, et al.2005 33 D4M-D4U (msec) 2 Months N Unc Unc Steroid Injection 20

(hands)1.31



Aygul, et al.2005 33 D4M-D4U (msec) 4 Months N Unc Unc Steroid Injection 20

(hands)1.30



Aygul, et al.2005 33 D4M-D4U (msec) 0 baseline N Unc Unc Phonophoresis

18 (Hands

)


Aygul, et al.2005 33 D4M-D4U (msec) 2 Months N Unc Unc Phonophoresis

18 (Hands

)

1.53 ± 0.50 SD NR NR NR NR NR NR NR NR <0.05 Wilcoxon Test

Aygul, et al.2005 33 D4M-D4U (msec) 4 Months N Unc Unc Phonophoresis

18 (Hands

)





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?

Aygul, et al.2005 33 d2M-D5U (msec) 0 baseline N Unc Unc Phonophoresis

18 (Hands

)


Aygul, et al.2005 33 d2M-D5U (msec) 2 Months N Unc Unc Phonophoresis

18 (Hands

)


Aygul, et al.2005 33 d2M-D5U (msec) 4 Months N Unc Unc Phonophoresis

18 (Hands

)


Aygul, et al.2005 33 d2M-D5U (msec) 0 baseline N Unc Unc Steroid Injection 20

(hands)1.09



Aygul, et al.2005 33 d2M-D5U (msec) 2 Months N Unc Unc Steroid Injection 20

(hands)0.68



Aygul, et al.2005 33 d2M-D5U (msec) 4 Months N Unc Unc Steroid Injection 20

(hands)0.61



Aygul, et al.2005 33 D2M/D5U SNAPa Ratio (mu V) 0 baseline N Unc N Steroid Injection 20

(hands)0.76



Aygul, et al.2005 33 D2M/D5U SNAPa Ratio (mu V) 2 Months N Unc N Steroid Injection 20

(hands)0.89


0.69 ± 0.21 SD NR NR NR NR NS Wilcoxon Test

Aygul, et al.2005 33 D2M/D5U SNAPa Ratio (mu V) 4 Months N Unc N Steroid Injection 20

(hands)1.06



Aygul, et al.2005 33 D2M/D5U SNAPa Ratio (mu V) 0 baseline N Unc N Phonophoresis 18

(hands)0.64


Aygul, et al.2005 33 D2M/D5U SNAPa Ratio (mu V) 2 Months N Unc N Phonophoresis 18

(hands)0.79

± 0.35 SD NR NR NR NR NR NR NR NR NS Wilcoxon Test

Aygul, et al.2005 33 D2M/D5U SNAPa Ratio (mu V) 4 Months N Unc N Phonophoresis 18

(hands)0.71


Aygul, et al.2005 33 mSDL (msec) 0 baseline N Unc N Phonophoresis 18

(hands)4.17


Aygul, et al.2005 33 mSDL (msec) 2 Months N Unc N Phonophoresis 18

(hands)4.08


Aygul, et al.2005 33 mSDL (msec) 4 Months N Unc N Phonophoresis 18

(hands)4.05


Aygul, et al.2005 33 mSDL (msec) 0 baseline N Unc N Steroid Injection 20

(hands)4.08



Aygul, et al.2005 33 mSDL (msec) 2 Months N Unc N Steroid Injection 20

(hands)3.87



Aygul, et al.2005 33 mSDL (msec) 4 Months N Unc N Steroid Injection 20

(hands)3.66



Aygul, et al.2005 33 mSNCV (m/s) 0 baseline N Unc Unc Steroid Injection 20

(hands)34.55



Aygul, et al.2005 33 mSNCV (m/s) 2 Months N Unc Unc Steroid Injection 20

(hands)36.33



Aygul, et al.2005 33 mSNCV (m/s) 4 Months N Unc Unc Steroid Injection 20

(hands)38.45



Aygul, et al.2005 33 mSNCV (m/s) 0 baseline N Unc Unc Phonophoresis 18

(hands)33.98


Aygul, et al.2005 33 mSNCV (m/s) 2 Months N Unc Unc Phonophoresis 18

(hands)34.66


Aygul, et al.2005 33 mSNCV (m/s) 4 Months N Unc Unc Phonophoresis 18

(hands)34.90


Aygul, et al.2005 33 SNAP (mu V) 0 baseline N Unc Unc Phonophoresis 18

(hands)13.5


Aygul, et al.2005 33 SNAP (mu V) 2 Months N Unc Unc Phonophoresis 18

(hands)13.5


Aygul, et al.2005 33 SNAP (mu V) 4 Months N Unc Unc Phonophoresis 18

(hands)14.0


Aygul, et al.2005 33 SNAP (mu V) 0 baseline N Unc Unc Steroid Injection 20

(hands)13.3



Aygul, et al.2005 33 SNAP (mu V) 2 Months N Unc Unc Steroid Injection 20

(hands)15.0


16.0 ± 5.24 SD NR NR NR NR NS Wilcoxon Test




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Is th

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valid

ated

?

Aygul, et al.2005 33 SNAP (mu V) 4 Months N Unc Unc Steroid Injection 20

(hands)17.9



Aygul, et al.2005 33 mMDL (msec) 0 baseline N Unc Unc Steroid Injection 20

(hands)4.18



Aygul, et al.2005 33 mMDL (msec) 2 Months N Unc Unc Steroid Injection 20

(hands)4.07



Aygul, et al.2005 33 mMDL (msec) 4 Months N Unc Unc Steroid Injection 20

(hands)3.96



Aygul, et al.2005 33 mMDL (msec) 0 baseline N Unc Unc Phonophoresis 18

(hands)4.20


Aygul, et al.2005 33 mMDL (msec) 2 Months N Unc Unc Phonophoresis 18

(hands)4.07


Aygul, et al.2005 33 mMDL (msec) 4 Months N Unc Unc Phonophoresis 18

(hands)4.4


Aygul, et al.2005 33 mMNCV (m/s) 0 baseline N Unc Unc Phonophoresis 18

(hands)57.13


Aygul, et al.2005 33 mMNCV (m/s) 2 Months N Unc Unc Phonophoresis 18

(hands)55.30


Aygul, et al.2005 33 mMNCV (m/s) 4 Months N Unc Unc Phonophoresis 18

(hands)56.22


Aygul, et al.2005 33 mMNCV (m/s) 0 baseline N Unc Unc Steroid Injection

20 (Hands

)

55.87 ± 4.53 SD Iontophoresis 18

(hands)56.23


Aygul, et al.2005 33 mMNCV (m/s) 2 Months N Unc Unc Steroid Injection

20 (Hands

)


(hands)53.81


Aygul, et al.2005 33 mMNCV (m/s) 4 Months N Unc Unc Steroid Injection

20 (Hands

)


(hands)55.31

± 4.21 SD NR NR NR NR NS Wilcoxon Test

Aygul, et al.2005 33 mMTLI (none) 0 baseline N Unc Unc Steroid Injection

20 (Hands

)


(hands)0.30


Aygul, et al.2005 33 mMTLI (none) 2 Months N Unc Unc Steroid Injection

20 (Hands

)


(hands)0.32


Aygul, et al.2005 33 mMTLI (none) 4 Months N Unc Unc Steroid Injection

20 (Hands

)


(hands)0.31

± 0.03 SD NR NR NR NR NS Wilcoxon Test

Aygul, et al.2005 33 D4M-D4U (ms) 0 Months N Y N Steroid Injection 20 1.66

± 0.65 SD Iontophoresis 18 1.82 ± 0.73 SD NR NR NR NR 0.482 Mann-Whitney

WilcoxonAygul, et al.

2005 33 D2M-D5U SNAPa Ratio 0 Months N Y N Steroid Injection 20 0.76 ± 0.46 SD Phonophoresis 18 0.64

± 0.22 SD NR NR NR NR 0.884 Mann-Whitney Wilcoxon

Aygul, et al.2005 33 D2M-D5U SNAPa Ratio (ms) 0 Months N Y N Iontophoresis 18 0.72

± 0.28 SD Phonophoresis 18 0.64 ± 0.22 SD NR NR NR NR 0.526 Mann-Whitney


2005 33 D2M-D5U SNAPa Ratio 2 Months N Y N Steroid Injection 20 0.89 ± 0.32 SD Iontophoresis 18 0.69


Aygul, et al.2005 33 D2M-D5U SNAPa Ratio 2 Months N Y N Steroid Injection 20 0.89



2005 33 D2M-D5U SNAPa Ratio (ms) 2 Months N Y N Iontophoresis 18 0.69 ± 0.21 SD Phonophoresis 18 0.79





2005 33 D2M-D5U SNAPa Ratio 4 Months N Y N Steroid Injection 20 1.06 ± 0.34 SD Phonophoresis 18 0.71


Aygul, et al.2005 33 D2M-D5U SNAPa Ratio (ms) 4 Months N Y N Iontophoresis 18 0.78



2005 33 mSDL 0 Months N Y N Steroid Injection 20 4.08 ± 0.42 SD Iontophoresis 18 3.96


Aygul, et al.2005 33 mSDL 0 Months N Y N Steroid Injection 20 4.08



2005 33 mSDL (ms) 0 Months N Y N Iontophoresis 18 3.96 ± 0.27 SD Phonophoresis 18 4.17




Wilcoxon




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?

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valid

ated

?




2005 33 mSDL (ms) 2 Months N Y N Iontophoresis 18 4.02 ± 0.3 SD Phonophoresis 18 4.08





2005 33 mSDL 4 Months N Y N Steroid Injection 20 3.66 ± 0.31 SD Phonophoresis 18 4.05


Aygul, et al.2005 33 mSDL (ms) 4 Months N Y N Iontophoresis 18 3.95



2005 33 mSNCV (m/s) 0 Months N Y N Steroid Injection 20 34.55 ± 3.31 SD Iontophoresis 18 35.44


Aygul, et al.2005 33 mSNCV (m/s) 0 Months N Y N Steroid Injection 20 34.55



2005 33 mSNCV (m/s) 0 Months N Y N Iontophoresis 18 35.44 ± 2.21 SD Phonophoresis 18 33.98





2005 33 mSNCV (m/s) 2 Months N Y N Steroid Injection 20 36.33 ± 2.38 SD Phonophoresis 18 34.66


Aygul, et al.2005 33 mSNCV (m/s) 2 Months N Y N Iontophoresis 18 35.04



2005 33 mSNCV (m/s) 4 Months N Y N Steroid Injection 20 38.45 ± 2.96 SD Iontophoresis 18 35.71





2005 33 mSNCV (m/s) 4 Months N Y N Iontophoresis 18 35.71 ± 3.54 SD Phonophoresis 18 34.9


Aygul, et al.2005 33 SNAPa (μv) 0 Months N Y N Steroid Injection 20 13.3



2005 33 SNAPa (m/s) 0 Months N Y N Steroid Injection 20 13.3 ± 6.78 SD Phonophoresis 18 13.5

± 2.42 SD NR NR NR NR 1 Mann-Whitney Wilcoxon

Aygul, et al.2005 33 SNAPa (m/s) 0 Months N Y N Iontophoresis 18 14.1



2005 33 SNAPa (μv) 2 Months N Y N Steroid Injection 20 15 ± 7.58 SD Iontophoresis 18 16


Aygul, et al.2005 33 SNAPa (m/s) 2 Months N Y N Steroid Injection 20 15



2005 33 SNAPa (m/s) 2 Months N Y N Iontophoresis 18 16 ± 5.24 SD Phonophoresis 18 13.5


Aygul, et al.2005 33 SNAPa (μv) 4 Months N Y N Steroid Injection 20 17.9



2005 33 SNAPa (m/s) 4 Months N Y N Steroid Injection 20 17.9 ± 9.85 SD Phonophoresis 18 14


Aygul, et al.2005 33 SNAPa (m/s) 4 Months N Y N Iontophoresis 18 14.4

± 4.71 SD Phonophoresis 18 14 ± 3.82 SD NR NR NR NR 0.485 Mann-Whitney


2005 33 Median MDL (ms) 0 Months N Y N Steroid Injection 20 4.18 ± 0.66 SD Iontophoresis 18 4.18


Aygul, et al.2005 33 Median MDL (m/s) 0 Months N Y N Steroid Injection 20 4.18



2005 33 Median MDL (m/s) 0 Months N Y N Iontophoresis 18 4.18 ± 0.49 SD Phonophoresis 18 4.2


Aygul, et al.2005 33 Median MDL (ms) 2 Months N Y N Steroid Injection 20 4.07



2005 33 Median MDL (m/s) 2 Months N Y N Steroid Injection 20 4.07 ± 0.43 SD Phonophoresis 18 4.07




Wilcoxon




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Aygul, et al.2005 33 D4M-D4U (ms) 0 Months N Y N Iontophoresis 18 1.82



2005 33 D4M-D4U (ms) 2 Months N Y N Iontophoresis 18 1.56 ± 0.47 SD Phonophoresis 18 1.53





2005 33 D4M-D4U (ms) 2 Months N Y N Steroid Injection 20 1.31 ± 0.41 SD Phonophoresis 18 1.53



± 0.48 SD Iontophoresis 18 1.61 ± 0.55 SD NR NR NR NR 0 Mann-Whitney







2005 33 D2M-D5U (ms) 0 Months N Y N Steroid Injection 20 1.09 ± 0.43 SD Iontophoresis 18 0.9















2005 33 D2M-D5U (ms) 4 Months N Y N Steroid Injection 20 0.61 ± 0.26 SD Iontophoresis 18 0.91



± 0.26 SD Phonophoresis 18 1.02 ± 0.38 SD NR NR NR NR 0 Mann-Whitney







2005 33 Median MDL (m/s) 2 Months N Y N Iontophoresis 18 4.1 ± 0.42 SD Phonophoresis 18 4.07


Aygul, et al.2005 33 Median MDL (ms) 4 Months N Y N Steroid Injection 20 3.96



2005 33 Median MDL (m/s) 4 Months N Y N Steroid Injection 20 3.96 ± 0.35 SD Phonophoresis 18 4.04


Aygul, et al.2005 33 Median MDL (m/s) 4 Months N Y N Iontophoresis 18 4.19



2005 33 mMNCV (m/s) 0 Months N Y N Steroid Injection 20 55.87 ± 4.53 SD Iontophoresis 18 56.23


Aygul, et al.2005 33 mMNCV (m/s) 0 Months N Y N Steroid Injection 20 55.87



2005 33 mMNCV (m/s) 0 Months N Y N Iontophoresis 18 56.23 ± 4.27 SD Phonophoresis 18 57.13





2005 33 mMNCV (m/s) 2 Months N Y N Steroid Injection 20 55.83 ± 4.64 SD Phonophoresis 18 55.3


Aygul, et al.2005 33 mMNCV (m/s) 2 Months N Y N Iontophoresis 18 53.81



2005 33 mMNCV (m/s) 4 Months N Y N Steroid Injection 20 57.62 ± 4.69 SD Iontophoresis 18 55.31




Wilcoxon




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Aygul, et al.2005 33 mMNCV (m/s) 4 Months N Y N Iontophoresis 18 55.31



2005 33 mMTLI (m/s) 0 Months N Y N Steroid Injection 20 0.31 ± 0.06 SD Iontophoresis 18 0.3


Aygul, et al.2005 33 mMTLI 0 Months N Y N Steroid Injection 20 0.31



2005 33 mMTLI (m/s) 0 Months N Y N Iontophoresis 18 0.3 ± 0.04 SD Phonophoresis 18 0.3


Aygul, et al.2005 33 mMTLI (m/s) 2 Months N Y N Steroid Injection 20 0.32



2005 33 mMTLI 2 Months N Y N Steroid Injection 20 0.32 ± 0.04 SD Phonophoresis 18 0.31


Aygul, et al.2005 33 mMTLI (m/s) 2 Months N Y N Iontophoresis 18 0.32



2005 33 mMTLI (m/s) 4 Months N Y N Steroid Injection 20 0.32 ± 0.08 SD Iontophoresis 18 0.31


Aygul, et al.2005 33 mMTLI 4 Months N Y N Steroid Injection 20 0.32



2005 33 mMTLI (m/s) 4 Months N Y N Iontophoresis 18 0.31 ± 0.03 SD Phonophoresis 18 0.32


Aygul, et al.2005 33 SSS 4 Months Y Y Y Steroid Injection

0 months 20 2.32 ± 0.73 SD Steroid Injection

4 months 20 1.47 ± 0.52 SD NR NR NR NR <0.001 Unclear

Aygul, et al.2005 33 SSS 2 Months Y Y Y Steroid Injection



Aygul, et al.2005 33 SSS 2 Months Y Y Y Iontophoresis

0 months 20 2.39 ± 0.58 SD Iontophoresis


Aygul, et al.2005 33 SSS 4 Months Y Y Y Iontophoresis


4 months 20 2.07 ± 0.91 SD NR NR NR NR NS Unclear

Aygul, et al.2005 33 SSS 2 Months Y Y Y Phonophoresis

0 months 20 2.58 ± 0.66 SD Phonophoresis


Aygul, et al.2005 33 SSS 4 Months Y Y Y Phonophoresis



Aygul, et al.2005 33 FSS 2 Months Y Y Y Steroid Injection



Aygul, et al.2005 33 FSS 4 Months Y Y Y Steroid Injection



Aygul, et al.2005 33 FSS 2 Months Y Y Y Iontophoresis



Aygul, et al.2005 33 FSS 4 Months Y Y Y Iontophoresis



Aygul, et al.2005 33 FSS 2 Months Y Y Y Phonophoresis



Aygul, et al.2005 33 FSS 4 Months Y Y Y Phonophoresis



Gokoglu, et al.2005 30 Motor Distal Latency 0 Weeks N Y N Steroid Injection 15 4.6

± 0.9 SD Iontophoresis 15 4.6 ± 1.3 SD NR NR NR NR NS Unclear

Gokoglu, et al.2005 30 Sensory Distal Latency 0 Weeks N Y N Steroid Injection 15 3.7

± 0.9 SD Iontophoresis 15 3.3 ± 0.9 SD NR NR NR NR NS Unclear

Gokoglu, et al.2005 30 SSS 0 Weeks Y Y Y Steroid Injection 15 2.7

± 0.8 SD Iontophoresis 15 3.1 ± 0.8 SD NR NR NR NR >0.05 Mann-Whitney

WilcoxonGokoglu, et al.

2005 30 SSS 2 Weeks Y Y Y Steroid Injection 15 1.9 ± 0.7 SD Iontophoresis 15 2.5

± 0.9 SD NR NR NR NR <0.05 Mann-Whitney Wilcoxon

Gokoglu, et al.2005 30 SSS 8 Weeks Y Y Y Steroid Injection 15 1.6

± 0.6 SD Iontophoresis 15 2.2 ± 1 SD NR NR NR NR <0.05 Mann-Whitney


2005 30 FSS 0 Weeks Y Y Y Steroid Injection 15 2.6 ± 1 SD Iontophoresis 15 2.6

± 1 SD NR NR NR NR >0.05 Mann-Whitney Wilcoxon

Gokoglu, et al.2005 30 FSS 2 Weeks Y Y Y Steroid Injection 15 1.8

± 0.9 SD Iontophoresis 15 2.4 ± 0.9 SD NR NR NR NR <0.05 Mann-Whitney

Wilcoxon




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Gokoglu, et al.2005 30 FSS 8 Weeks Y Y Y Steroid Injection 15 1.5

± 0.9 SD Iontophoresis 15 2.2 ± 1 SD NR NR NR NR <0.05 Mann-Whitney


2005 30 VAS pain 0 Weeks Y Y Y Steroid Injection 15 6.2 ± 1.2 SD Iontophoresis 15 7.2

± 0.9 SD NR NR NR NR >0.05 Mann-Whitney Wilcoxon

Gokoglu, et al.2005 30 VAS pain 2 Weeks Y Y Y Steroid Injection 15 4.5

± 1.1 SD Iontophoresis 15 5.1 ± 0.6 SD NR NR NR NR <0.001 Mann-Whitney


2005 30 VAS pain 8 Weeks Y Y Y Steroid Injection 15 1.8 ± 1.2 SD Iontophoresis 15 3.5

± 0.6 SD NR NR NR NR <0.002 Mann-Whitney Wilcoxon

Ly-Pen, et al.2005 101 VAS Nocturnal Paresthesias (mm) 0 Months Y Y Y Steroid Injection 83 58.13

± 28.9 SD OCTR 80 55.63 ± 29.44 SD NR NR NR NR 0.584 t-test

Ly-Pen, et al.2005 101 VAS Diurnal Pain 0 Months Y Y Y Steroid Injection 83 42.2


Ly-Pen, et al.2005 101 VAS Functional Impairment (mm) 0 Months Y Y Y Steroid Injection 83 37.9


Ly-Pen, et al.2005 101 VAS Nocturnal Paresthesias of Study Completers 12 Months Y Y Y Steroid Injection 66 11.99

± 19.06 SD OCTR 57 2.84 ± 10.84 SD NR NR NR NR <0.001 ANOVA


± 17.38 SD OCTR 57 15.55 ± 25.37 SD NR NR NR NR 0.041 ANOVA





Ly-Pen, et al.2005 101 VAS Nocturnal Paresthesias (mm) 0 Months Y Y Y Steroid Injection 83 58.13


Ly-Pen, et al.2005 101 VAS Diurnal Pain 0 Months Y Y Y Steroid Injection 83 42.2


Ly-Pen, et al.2005 101 VAS Functional Impairment (mm) 0 Months Y Y Y Steroid Injection 83 37.9



± 19.06 SD OCTR 57 2.84 ± 10.84 SD NR NR NR NR <0.001 ANOVA


± 17.38 SD OCTR 57 15.55 ± 25.37 SD NR NR NR NR 0.041 ANOVA





Wong, et al.2005 40 GSS 0 Weeks Y Y Y Double Injection 20 26.7

± 10.1 SD Single Injection 20 25.6 ± 11.6 SD NR NR NR NR 0.75 ANOVA


± 9.9 SD Single Injection 20 11.4 ± 7.6 SD NR NR NR NR 0.19 ANOVA


± 10.6 SD Single Injection 20 13 ± 9.7 SD NR NR NR NR 0.37 ANOVA


± 9.1 SD Single Injection 20 14.1 ± 11 SD NR NR NR NR 0.64 ANOVA

Wong, et al.2005 40 GSS 40 Weeks Y Y Y Double Injection

0 weeks 20 26.7 ± 10.1 SD Double Injection

40 weeks 20 12.6 ± 9.1 SD NR NR NR NR <0.001 ANOVA

Wong, et al.2005 40 GSS 40 Weeks Y Y Y Single Injection

0 weeks 20 25.6 ± 11.6 SD Single Injection

40 weeks 20 14.1 ± 11 SD NR NR NR NR <0.001 ANOVA

Wong, et al.2005 40 Grip Strength (kg) 0 Weeks N Y N Left Single Injection 17 20.9

± 4.7 SD Left Double Injection 18 22 ± 7 SD NR NR NR NR 0.55 ANOVA


± 5.1 SD Left Double Injection 18 20.6 ± 6.2 SD NR NR NR NR 0.97 ANOVA



Wong, et al.2005 40 Grip Strength (kg) 0 Weeks N Y N Right Single Injection 18 22

± 5.3 SD Right Double Injection 18 22.5 ± 7.3 SD NR NR NR NR 0.86 ANOVA

Wong, et al.2005 40 Grip Strength (kg) 8 Weeks N Y N Right Single Injection 18 20.9

± 6.2 SD Right Double Injection 18 21.9 ± 7.2 SD NR NR NR NR 0.68 ANOVA




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Wong, et al.2005 40 Grip Strength (kg) 40 Weeks N Y N Right Single Injection 18 21.4

± 6.6 SD Right Double Injection 18 20 ± 7 SD NR NR NR NR 0.5 ANOVA

Wong, et al.2005 40 Grip Strength (kg) 40 Weeks N Y N Left Single Injection

0 weeks 17 20.9 ± 4.7 SD Left Single Injection

40 weeks 17 20.2 ± 6.6 SD NR NR NR NR 0.91 ANOVA

Wong, et al.2005 40 Grip Strength (kg) 40 Weeks N Y N Left Double Injection

0 weeks 18 22 ± 7 SD Left Double Injection


Wong, et al.2005 40 Grip Strength (kg) 40 Weeks N Y N Right Double Injection

0 weeks 18 22.5 ± 7.3 SD Right Double Injection

40 weeks 18 20 ± 7 SD NR NR NR NR 0.21 ANOVA

Wong, et al.2005 40 Grip Strength (kg) 40 Weeks N Y N Right Single Injection

0 weeks 18 22 ± 5.3 SD Right Single Injection


Wong, et al.2005 40 Distal Motor Latency (ms) 8 Weeks N Y N Left Single Injection 17 4.4





± 1.1 SD Left Double Injection 18 4.5 ± 1 SD NR NR NR NR 0.42 ANOVA

Wong, et al.2005 40 Distal Motor Latency (ms) 0 Weeks N Y N Right Single Injection 18 4.5

± 1 SD Right Double Injection 18 5.4 ± 1.9 SD NR NR NR NR 0.08 ANOVA


± 1 SD Right Double Injection 18 5 ± 1.5 SD NR NR NR NR 0.24 ANOVA


± 1 SD Right Double Injection 18 5.2 ± 1.5 SD NR NR NR NR 0.03 ANOVA

Wong, et al.2005 40 Distal Motor Latency (ms) 40 Weeks N Y N Left Single Injection

0 weeks 17 4.5 ± 1.1 SD Left Single Injection


Wong, et al.2005 40 Distal Motor Latency (ms) 40 Weeks N Y N Left Double Injection

0 weeks 18 4.6 ± 1.1 SD Left Double Injection

40 weeks 18 4.5 ± 1 SD NR NR NR NR 0.39 ANOVA

Wong, et al.2005 40 Distal Motor Latency (ms) 40 Weeks N Y N Right Single Injection

0 weeks 18 4.5 ± 1 SD Right Single Injection

40 weeks 18 4.3 ± 1 SD NR NR NR NR 0.39 ANOVA

Wong, et al.2005 40 Distal Motor Latency (ms) 40 Weeks N Y N Right Double Injection

0 weeks 18 5.4 ± 1.9 SD Right Double Injection


Piravej, et al.2004 18 Pain VAS (none) NR Y Y Y Ultrasound 2.93

± 3.45 SD Diclofenac 2.31 ± 2.37 SD NR 95% CI NR NR 0.57 NR

Piravej, et al.2004 18 Night pain/paresthesia (none) NR Y Y Y Ultrasound 15 1.47

± 0.83 SD Diclofenac 15 1.53 ± 0.92 SD NR NR NR NR 0.82 NR

Piravej, et al.2004 18 Frequency of awakening (none) NR Y Y Y Ultrasound 15 0.80


Piravej, et al.2004 18 SDL (msec) NR N Y N Ultrasound 15 3.17

± 0.46 SD Diclofenac 15 3.58 ± 0.42 SD NR 95% CI NR NR 0.05 NR

Piravej, et al.2004 18 SNAP (uV) NR N Y N Ultrasound 15 46.12


Piravej, et al.2004 18 MDL (msec) NR N Y N Ultrasound 15 4.26


Piravej, et al.2004 18 CMAP (mV) NR N Y N Ultrasound 15 11.31

± 2.88 SD Diclofenac 15 10.39 ± 3.05 SD NR 95% CI NR NR 0.73 NR

Piravej, et al.2004 18 Pain VAS - Before Treatment (none) NR Y Y Y Ultrasound 15 2.93

± 3.45 SD Diclofenac 15 2.31 ± 2.37 SD NR SD NR NR NR NR

Piravej, et al.2004 18 Pain VAS - After Treatment (none) 6 Weeks Y Y N Ultrasound 15 1.03

± 1.53 SD Diclofenac 15 1.23 ± 2.14 SD NR NR NR NR NR NR

Piravej, et al.2004 18 Pain VAS Ultrasound (none) 6 Weeks Y Y N Before Treatment 15 2.93

± 3.45 SD After Treatment 15 1.03 ± 1.53 SD NR 95% CI NR NR 0.01 NR

Piravej, et al.2004 18 Pain VAS - Diclofenac (none) 6 Weeks Y Y N Before Treatment 15 2.31

± 2.37 SD After Treatment 15 1.23 ± 2.14 SD NR 95% CI NR NR 0.002 NR

Piravej, et al.2004 18 Mean difference in Pain VAS BT & AT 6 Weeks Y Y Y Ultrasound 15 1.90


Piravej, et al.2004 18 Night pain/paresthesia Ultrasound (none) 6 Weeks Y N Unc Before Treatment 15 1.47

± 0.83 SD After Treatment 15 0.53 ± 0.64 SD NR NR NR NR 0.00 NR

Piravej, et al.2004 18 Night pain/paresthesia - Diclofenac (none) 6 Weeks Y Unc Y Before Treatment 15 1.53





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Piravej, et al.2004 18 Mean difference in Night pain/paresthesia BT & AT

(none) 6 Y Unc Y Ultrasound 15 0.93 ± 0.97 SD Diclofenac 15 0.93

± 0.88 SD NR NR NR NR 0.89 NR

Piravej, et al.2004 18 Difference in Change of Means BT & AT in

Frequency of awakening (none) 6 Weeks Y Unc Y Ultrasound 15 0.53 ± 1.06 SD Diclofenac 15 0.87

± 1.12 SD NR NR NR NR 0.36 NR

Piravej, et al.2004 18 Frequency of awakening - Ultrasound (none) 6 Weeks Y N Unc Before Treatment 15 0.80


Piravej, et al.2004 18 Frequency of awakening - Dicolfenac (none) 6 Weeks Y N Unc Before Treatment 15 1.07


Piravej, et al.2004 18 SDL - Ultrasound (msec) 6 Weeks N Y N Before Treatment 15 3.17

± 0.46 SD After Treatment 15 3.24 ± 1.57 SD -0.07

± 0.22 SD NR NR 0.21 NR

Piravej, et al.2004 18 SDL - Diclofenac (msec) 6 Weeks N Unc N Before Treatment 15 3.58


± 0.41 SD NR NR 0.94 NR

Piravej, et al.2004 18 SNAP Amplitude Ultrasound (mV) 6 Weeks N Unc N Before Treatment 15 46.12


± 20.04 SD NR NR 0.01 NR

Piravej, et al.2004 18 SNAP Amplitude Diclofenac (mV) 6 Weeks N Unc N Before Treatment 15 52.29

± 22.94 SD After Treatment 15 48.22 ± 25.67 SD 4.06

± 22.08 SD NR NR 0.49 NR

Piravej, et al.2004 18 MDL - BT & AT Ultrasound (ms) 6 Weeks N Unc N Before Treatment 15 4.26


± 0.40 SD NR NR 0.06 NR

Piravej, et al.2004 18 MDL - BT & AT - Diclofenac (ms) 6 Weeks N Unc N Before Treatment 15 4.85

± 0.69 SD After Treatment 15 447 ± 0.69 SD 0.11

± 0.70 SD NR NR 0.56 NR

Piravej, et al.2004 18 CMAP amplitude - Ultrasound (mV) 6 Weeks N Unc N Before Treatment 15 11.31


± 1.81 SD NR NR 0.19 NR

Piravej, et al.2004 18 CMAP amplitude - Diclofenac (mV) 6 Seconds N Unc N Before Treatment 15 10.93

± 3.05 SD After Treatment 15 10.59 ± 3.19 SD 0.34

± 2.0 SD NR NR 0.52 NR

Piravej, et al.2004 18 CMAP amplitude - Mean difference BT & AT (mV) 6 Weeks N Unc N Ultrasound 15 -0.65


Piravej, et al.2004 18 MDL Mean Diff BT & AT (mV) 6 Weeks N Unc N Ultrasound 15 -0.21


Piravej, et al.2004 18 SNAP Amplitude - Mean DifferenceBT & AT (ms) 6 Weeks N Unc N Ultrasound 15 -15.21


Piravej, et al.2004 18 SDL - Difference in Means BT & AT (ms) 6 Weeks N Unc N Ultrasound 15 -0.07

± 0.22 SD Diclofenac 15 -0.01 ± 0.41 SD NR NR NR NR 0.58 NR

Bakhtiary, et al.2004 50 VAS-Pain End of therapy mean change (none) 3 Weeks Y Y N Ultrasound 45 -5.6

± 1.5 SD Laser Therapy 45 -2.4 ± 1.2 SD 3.1

{-3.7 - -2.5} 95% CI NR NR 0.001 Two-tailed T-test

Bakhtiary, et al.2004 50 Finger Pinch - End of therapy change in Mean 3 Weeks N Y Y Ultrasound 45 9.1

± 4.1 SD Laser Therapy 45 2.6 ± 1.0 SD 6.7

{5.0 - 8.2} 95% CI NR NR <0.001 Two-tailed T-test

Bakhtiary, et al.2004 50 Motor Distal Latency- End of therapy- Change in

Means from Baseline (msec) 3 Weeks N Y N Ultrasound 45 -1.0 ± 0.6 SD Laser Therapy 45 -0.3

± 0.3 SD -0.8 {-1.0 - -0.6} 95% CI NR NR <0.001 Two-tailed T-test

Bakhtiary, et al.2004 50 Thumb Sensory Latency - Change in Means from

Baseline (ms) 3 Weeks N Y Y Ultrasound 45 -0.7 ± 0.5 SD Laser Therapy 45 -0.2


Bakhtiary, et al.2004 50 CMAP amplitude Change from Baseline (mV) 3 Weeks N N N Ultrasound 45 3.0


{0.9 - 3.1} 95% CI NR NR 0.001 Two-tailed T-test

Bakhtiary, et al.2004 50 Thumb SAP amplitude - Change in mean from

baseline (mV) 3 Weeks N Y N Ultrasound 45 9.5 ± 7.3 SD Laser Therapy 45 4.5

± 7.5 SD 5.0 {1.6 - 8.3} 95% CI NR NR 0.004 Two-tailed T-test

Bakhtiary, et al.2004 50 Pain VAS Change in Means 4 weeks follow-up

(none) 7 Weeks Y Y Y Ultrasound 45 -6.3 ± 1.6 SD Laser Therapy 45 -2.0


Bakhtiary, et al.2004 50 Index SAP amplitude - Mean Change from

Baseline (mu V) 3 Weeks N Y N Ultrasound 45 16.1 ± 16.4 SD Laser Therapy 45 7.0


Bakhtiary, et al.2004 50 Handgrip Strength - Change in Mean - 4 week

follow-up (lb / in^2) 7 Weeks N Y N Ultrasound 45 36.6 ± 19.1 SD Laser Therapy 45 19.4


Bakhtiary, et al.2004 50 Finger Pinch - 4 week follow up- Change in Means

from Baseline (lb / in^2) 7 Weeks N Y N Ultrasound 45 9.9 ± 5.5 SD Laser Therapy 45 2.9


Bakhtiary, et al.2004 50 Motor Distal Latency- 4 week follow-up- Change in

Means from Baseline (msec) 7 Weeks N Y N Ultrasound 45 -1.1 ± 0.5 SD Laser Therapy 45 -0.2

± 0.2 SD -0.9 {-1.0 - -0.8} 95% CI NR NR 0.001 Two-tailed T-test

Bakhtiary, et al.2004 50 CMAP amplitude - 4 week follow-up - Change in

Mean from Baseline (none) 7 Weeks N Y N Ultrasound 45 3.6 ± 1.5 SD Laser Therapy 45 1.1

± 2.9 SD 2.5 {1.2 - 3.3} 95% CI NR NR <0.001 Two-tailed T-test

Bakhtiary, et al.2004 50 Thumb sensory latency - 4 week follow-up -

change in mean from baseline (ms) 7 Weeks N Y N Ultrasound 45 -0.8 ± 1.0 SD Laser Therapy 45 0.1

± 1.1 SD -0.9 {-1.4 - -0.3} 95% CI NR NR 0.004 Two-tailed T-test




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Bakhtiary, et al.2004 50 Thumb SAP amplitude - Change in mean from

baseline - 4 week followup (mu V) 7 Weeks N Y N Ultrasound 45 10.1 ± 6.9 SD Laser Therapy 45 4.4

± 7.4 SD 5.7 {2.0 - 8.5} 95% CI NR NR <0.001 Two-tailed T-test

Bakhtiary, et al.2004 50 Index SAP amplitude - Mean Change from

Baseline - 4 week follow-up (mu V) 7 Weeks N Y N Ultrasound 45 16.8 ± 15.2 SD Laser Therapy 45 6.5


Bakhtiary, et al.2004 50 Handgrip Strength 3 Weeks N Y N Ultrasound 45 36.6


{4.5 - 29.9} 95% CI NR NR 0.008 Two-tailed T-test

Girlanda, et al.1993 32 Median Symptoms (none) 0 baseline Y Unc Y Steroid Injection 16 8

{1 - 15} Min/Max Placebo 16 9 ± Min/Max NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Signs (none) 0 baseline Y Unc Y Steroid Injection 16 2

{0 - 9} Min/Max Placebo 16 2.5 ± Min/Max NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Symptoms (none) 0 baseline Y Y Y Steroid Injection 16 8 NR Placebo 16 9 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Symptoms (none) 1 Weeks Y Y Y Steroid Injection 16 3 NR Placebo 16 7 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Symptoms (none) 2 Weeks Y Y Y Steroid Injection 16 2 NR Placebo 16 8 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Symptoms (none) 1 Months Y Y Y Steroid Injection 16 0 NR Placebo 16 8 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Symptoms (none) 2 Months Y Y Y Steroid Injection 16 2 NR Placebo 16 8 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Signs (none) 0 baseline Y Y Y Steroid Injection 16 2.0 NR Placebo 16 2.5 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Signs (none) 1 Weeks Y Y Y Steroid Injection 16 1.0 NR Placebo 16 3.0 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Signs (none) 2 Weeks Y Y Y Steroid Injection 16 2.0 NR Placebo 16 3.5 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Signs (none) 1 Months Y Y Y Steroid Injection 16 1.0 NR Placebo 16 3.0 NR NR NR NR NR NR NR

Girlanda, et al.1993 32 Median Clinical Score for Signs (none) 2 Months Y Y Y Steroid Injection 16 1.0 NR Placebo 16 3.0 NR NR NR NR NR NR NR


Non-Operative/Conservative Treatment with > 20% Bilateral Dichotomous Data Results


Mishra, et al.2006 40 Tinel Sign 0 days Unc Unc Unc Percentage Splint 20 36.11 NR Oral Steriod 20 40 NR NR NR NR 0.56 t-test

Mishra, et al.2006 40 Phalens sign 0 days Unc Unc Unc Percentage Splint 20 63.88 NR Oral Steriod 20 60 NR NR NR NR 0.73 t test

Pinar, et al.2005 26 Electrophysiologic pathologic tests of CTS

(percentage) 10 Weeks Y Y Y Number Positive Nerve gliding + modified activity + splinting 19 7 NR Modified activity +

splinting 16 8 NR NR NR NR NR NR

Pinar, et al.2005 26 Electrophysiologic pathologic tests of CTS

(percentage) 10 Weeks Y Y Y Number Negative Nerve gliding + modified activity + splinting 19 12 NR Modified activity +

splinting 16 8 NR NR NR NR NR NR

Pinar, et al.2005 26 Tinel Test 10 Weeks Unc Y N Number Positive Nerve gliding + modified

activity + splinting 19 10 NR Modified activity + splinting 16 9 NR NR NR NR NR NR

Pinar, et al.2005 26 Tinel Test 10 Weeks Unc Y N Number Negative Nerve gliding + modified


Pinar, et al.2005 26 Phalen Test 10 Weeks Unc Y N Number Positive Nerve gliding + modified

activity + splinting 19 4/ NR Modified activity + splinting 16 16 NR NR NR NR NR NR

Pinar, et al.2005 26 Phalen Test 10 Weeks Y Y N Number Negative Nerve gliding + modified


Aygul, et al.2005 33 D4M-D4U (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Steroid Injection 20 13 NR Iontophoresis 18 7 NR NR NR NR NR NR

Aygul, et al.2005 33 D4M-D4U (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Steroid Injection 20 13 NR Phonophoresis 18 6 NR NR NR NR NR NR

Aygul, et al.2005 33 D4M-D4U (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Iontophoresis 18 7 NR Phonophoresis 18 6 NR NR NR NR NR NR










Aygul, et al.2005 33 D2M-D5U SNAPa Ratio (improved by more than 2

SD) (μv) 2 Months N Y N Number Wrists Steroid Injection 20 8 NR Iontophoresis 18 3 NR NR NR NR NR NR


SD) (ms) 2 Months N Y N Number Wrists Steroid Injection 20 8 NR Phonophoresis 18 4 NR NR NR NR NR NR


SD) (ms) 2 Months N Y N Number Wrists Iontophoresis 18 3 NR Phonophoresis 18 4 NR NR NR NR NR NR


SD) (μv) 4 Months N Y N Number Wrists Steroid Injection 20 12 NR Iontophoresis 18 4 NR NR NR NR NR NR


SD) (ms) 4 Months N Y N Number Wrists Steroid Injection 20 12 NR Phonophoresis 18 4 NR NR NR NR NR NR


SD) (ms) 4 Months N Y N Number Wrists Iontophoresis 18 4 NR Phonophoresis 18 4 NR NR NR NR NR NR

Aygul, et al.2005 33 mSDL (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Steroid Injection 20 7 NR Iontophoresis 18 4 NR NR NR NR NR NR

Aygul, et al.2005 33 mSDL (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Steroid Injection 20 7 NR Phonophoresis 18 5 NR NR NR NR NR NR

Aygul, et al.2005 33 mSDL (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Iontophoresis 18 4 NR Phonophoresis 18 5 NR NR NR NR NR NR

Aygul, et al.2005 33 mSDL (improved by more than 2 SD) (ms) 4 Months N Y N Number Wrists Steroid Injection 20 10 NR Iontophoresis 18 5 NR NR NR NR NR NR

Aygul, et al.2005 33 mSDL (improved by more than 2 SD) (ms) 4 Months N Y N Number Wrists Steroid Injection 20 10 NR Phonophoresis 18 6 NR NR NR NR NR NR

Aygul, et al.2005 33 mSDL (improved by more than 2 SD) (ms) 4 Months N Y N Number Wrists Iontophoresis 18 5 NR Phonophoresis 18 6 NR NR NR NR NR NR

Aygul, et al.2005 33 mSNCV (improved by more than 2 SD) (m/s) 2 Months N Y N Number Wrists Steroid Injection 20 4 NR Iontophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 mSNCV (improved by more than 2 SD) (m/s) 2 Months N Y N Number Wrists Steroid Injection 20 4 NR Phonophoresis 18 2 NR NR NR NR NR NR

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Aygul, et al.2005 33 mSNCV (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Iontophoresis 18 2 NR Phonophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 mSNCV (improved by more than 2 SD) (m/s) 4 Months N Y N Number Wrists Steroid Injection 20 8 NR Iontophoresis 18 3 NR NR NR NR NR NR

Aygul, et al.2005 33 mSNCV (improved by more than 2 SD) (m/s) 4 Months N Y N Number Wrists Steroid Injection 20 8 NR Phonophoresis 18 4 NR NR NR NR NR NR

Aygul, et al.2005 33 mSNCV (improved by more than 2 SD) (ms) 4 Months N Y N Number Wrists Iontophoresis 18 3 NR Phonophoresis 18 4 NR NR NR NR NR NR

Aygul, et al.2005 33 SNAPa (improved by more than 2 SD) (μv) 2 Months N Y N Number Wrists Steroid Injection 20 5 NR Iontophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 SNAPa (improved by more than 2 SD) (μv) 2 Months N Y N Number Wrists Steroid Injection 20 5 NR Phonophoresis 18 1 NR NR NR NR NR NR

Aygul, et al.2005 33 SNAPa (improved by more than 2 SD) (μv) 2 Months N Y N Number Wrists Iontophoresis 18 2 NR Phonophoresis 18 1 NR NR NR NR NR NR

Aygul, et al.2005 33 SNAPa (improved by more than 2 SD) (μv) 4 Months N Y N Number Wrists Steroid Injection 20 6 NR Iontophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 SNAPa (improved by more than 2 SD) (μv) 4 Months N Y N Number Wrists Steroid Injection 20 6 NR Phonophoresis 18 0 NR NR NR NR NR NR

Aygul, et al.2005 33 SNAPa (improved by more than 2 SD) (μv) 4 Months N Y N Number Wrists Iontophoresis 18 2 NR Phonophoresis 18 0 NR NR NR NR NR NR

Aygul, et al.2005 33 Median MDL (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Steroid Injection 20 6 NR Iontophoresis 18 5 NR NR NR NR NR NR

Aygul, et al.2005 33 Median MDL (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Steroid Injection 20 6 NR Phonophoresis 18 5 NR NR NR NR NR NR

Aygul, et al.2005 33 Median MDL (improved by more than 2 SD) (ms) 2 Months N Y N Number Wrists Iontophoresis 18 5 NR Phonophoresis 18 5 NR NR NR NR NR NR

Aygul, et al.2005 33 Median MDL (improved by more than 2 SD) (ms) 4 Months N Y N Number Wrists Steroid Injection 20 7 NR Iontophoresis 18 1 NR NR NR NR NR NR

Aygul, et al.2005 33 Median MDL (improved by more than 2 SD) (ms) 4 Months N Y N Number Wrists Steroid Injection 20 7 NR Phonophoresis 18 6 NR NR NR NR NR NR

Aygul, et al.2005 33 Median MDL (improved by more than 2 SD) (ms) 4 Months N Y N Number Wrists Iontophoresis 18 1 NR Phonophoresis 18 6 NR NR NR NR NR NR

Aygul, et al.2005 33 mMNCV (improved by more than 2 SD) (m/s) 2 Months N Y N Number Wrists Steroid Injection 20 2 NR Iontophoresis 18 0 NR NR NR NR NR NR

Aygul, et al.2005 33 mMNCV (improved by more than 2 SD) (m/s) 2 Months N Y N Number Wrists Steroid Injection 20 2 NR Phonophoresis 18 0 NR NR NR NR NR NR

Aygul, et al.2005 33 mMNCV (improved by more than 2 SD) (m/s) 2 Months N Y N Number Wrists Iontophoresis 18 0 NR Phonophoresis 18 0 NR NR NR NR NR NR

Aygul, et al.2005 33 mMNCV (improved by more than 2 SD) (m/s) 4 Months N Y N Number Wrists Steroid Injection 20 3 NR Iontophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 mMNCV (improved by more than 2 SD) (m/s) 4 Months N Y N Number Wrists Steroid Injection 20 3 NR Phonophoresis 18 0 NR NR NR NR NR NR

Aygul, et al.2005 33 mMNCV (improved by more than 2 SD) (m/s) 4 Months N Y N Number Wrists Iontophoresis 18 2 NR Phonophoresis 18 0 NR NR NR NR NR NR

Aygul, et al.2005 33 mMTLI (improved by more than 2 SD) 2 Months N Y N Number Wrists Steroid Injection 20 5 NR Iontophoresis 18 4 NR NR NR NR NR NR

Aygul, et al.2005 33 mMTLI (improved by more than 2 SD) 2 Months N Y N Number Wrists Steroid Injection 20 5 NR Phonophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 mMTLI (improved by more than 2 SD) 2 Months N Y N Number Wrists Iontophoresis 18 4 NR Phonophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 mMTLI (improved by more than 2 SD) 4 Months N Y N Number Wrists Steroid Injection 20 5 NR Iontophoresis 18 2 NR NR NR NR NR NR

Aygul, et al.2005 33 mMTLI (improved by more than 2 SD) 4 Months N Y N Number Wrists Steroid Injection 20 5 NR Phonophoresis 18 3 NR NR NR NR NR NR

Aygul, et al.2005 33 mMTLI (improved by more than 2 SD) 4 Months N Y N Number Wrists Iontophoresis 18 2 NR Phonophoresis 18 3 NR NR NR NR NR NR

Gokoglu, et al.2005 30 Tinels Sign 8 Weeks N Y N Number Wrists Steroid Injection

0 weeks 20 15 NR Steroid Injection 8 weeks 20 3 NR NR NR NR NR NR

Gokoglu, et al.2005 30 Tinels Sign 8 Weeks N Y N Number Wrists Iontophoresis

0 weeks 28 19 NR Iontophoresis 8 weeks 28 9 NR NR NR NR NR NR

Gokoglu, et al.2005 30 Phalens Test 8 Weeks N Y N Number Wrists Steroid Injection


Gokoglu, et al.2005 30 Phalens Test 8 Weeks N Y N Number Wrists Iontophoresis


Gokoglu, et al.2005 30 Reverse Phalens Test 8 Weeks N Y N Number Wrists Steroid Injection


Gokoglu, et al.2005 30 Reverse Phalens Test 8 Weeks N Y N Number Wrists Iontophoresis





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Gokoglu, et al.2005 30 Paresthesias 8 Weeks Y N Y Number Wrists Iontophoresis


Gokoglu, et al.2005 30 Paresthesias 8 Weeks Y N Y Number Wrists Steroid Injection


Gokoglu, et al.2005 30 Numbness 8 Weeks Y N Y Number Wrists Steroid Injection


Gokoglu, et al.2005 30 Numbness 8 Weeks Y N Y Number Wrists Iontophoresis


Ly-Pen, et al.2005 101 VAS 20% Improvement of Nocturnal Paresthesias 3 Months Y Y Y Percent Wrists Steroid Injection 83 94 NR OCTR 80 75 NR Relative Risk 0.798

{0.7 - 0.916} 95% CI 0.001 Unclear

Ly-Pen, et al.2005 101 VAS 20% Improvement of Diurnal Pain 3 Months Y Y Y Percent Wrists Steroid Injection 83 89.2 NR OCTR 80 68.8 NR Relative Risk 0.771

{0.65 - 0.91} 95% CI 0.002 Unclear

Ly-Pen, et al.2005 101 VAS 20% Improvement of Functional Impairment 3 Months Y Y Y Percent Wrists Steroid Injection 83 88 NR OCTR 80 67.5 NR Relative Risk 0.767

{0.65 - 0.911} 95% CI 0.002 Unclear

Ly-Pen, et al.2005 101 VAS 20% Improvement of Nocturnal Paresthesias 6 Months Y Y Y Percent Wrists Steroid Injection 83 85.5 NR OCTR 80 76.3 NR Relative Risk 0.891

{0.77 - 1.037} 95% CI 0.163 Unclear


{0.78 - 1.104} 95% CI 0.467 Unclear

Ly-Pen, et al.2005 101 VAS 20% Improvement of Functional Impairment 6 Months Y Y Y Percent Wrists Steroid Injection 83 78.3 NR OCTR 80 73.8 NR Relative Risk 0.942

{0.79 - 1.12} 95% CI 0.583 Unclear

Ly-Pen, et al.2005 101 VAS 20% Improvement of Nocturnal Paresthesias 12 Months Y Y Y Percent Wrists Steroid Injection 83 69.9 NR OCTR 80 75 NR Relative Risk 1.073

{0.89 - 1.297} 95% CI 0.488 Unclear


{0.88 - 1.314} 95% CI 0.5 Unclear


{0.85 - 1.261} 95% CI 0.733 Unclear


{0.68 - 0.936} 95% CI 0.005 Unclear


{0.66 - 0.958} 95% CI 0.018 Unclear


{0.57 - 0.869} 95% CI NR Unclear


{0.79 - 1.124} 95% CI 0.589 Unclear


{0.78 - 1.129} 95% CI 0.594 Unclear


{0.75 - 1.125} 95% CI 0.497 Unclear


{0.93 - 1.381} 95% CI 0.234 Unclear


{0.84 - 1.284} 95% CI 0.742 Unclear


{0.96 - 1.514} 95% CI 0.139 Unclear


{0.58 - 0.857} 95% CI 0.001 Unclear


{0.52 - 0.848} 95% CI 0.001 Unclear

Ly-Pen, et al.2005 101 VAS 70% Improvement of Functional Impairment 3 Months Y Y Y Percent Wrists Steroid Injection 83 73.5 NR OCTR 80 40 NR Relative Risk 0.544

{0.4 - 0.733} 95% CI 0.001 Unclear


{0.8 - 1.207} 95% CI 1 Unclear

Ly-Pen, et al.2005 101 VAS 70% Improvement of Diurnal Pain 6 Months Y Y Y Percent Wrists Steroid Injection 83 71.1 NR OCTR 80 70 NR Relative Risk 0.985

{0.81 - 1.201} 95% CI 1 Unclear


{0.71 - 1.15} 95% CI 0.424 Unclear


{0.97 - 1.488} 95% CI 0.098 Unclear


{0.87 - 1.38} 95% CI 0.513 Unclear


{1.03 - 1.776} 95% CI 0.04 Unclear

Ly-Pen, et al.2005 101 VAS 70% Improvement of Nocturnal Paresthesias 3 Months Y Y Y Percent Wrists Steroid Injection 33 87.9 NR OCTR 36 58.3 NR NR NR NR 0.006 Unclear

Ly-Pen, et al.2005 101 VAS 70% Improvement of Diurnal Pain 3 Months Y Y Y Percent Wrists Steroid Injection 33 75.8 NR OCTR 36 44.4 NR NR NR NR 0.008 Unclear

Ly-Pen, et al.2005 101 VAS 70% Improvement of Functional Impairment 3 Months Y Y Y Percent Wrists Steroid Injection 33 69.7 NR OCTR 36 44.4 NR NR NR NR 0.035 Unclear




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Ly-Pen, et al.2005 101 VAS 20% Improvement of Nocturnal Paresthesias 3 Minutes Y Y Y Percent Wrists Steroid Injection 83 94 NR OCTR 80 75 NR Relative Risk 0.798

{0.7 - 0.916} 95% CI 0.001 Unclear


{0.65 - 0.91} 95% CI 0.002 Unclear


{0.65 - 0.911} 95% CI 0.002 Unclear


{0.77 - 1.037} 95% CI 0.163 Unclear


{0.78 - 1.104} 95% CI 0.467 Unclear


{0.79 - 1.12} 95% CI 0.583 Unclear


{0.89 - 1.297} 95% CI 0.488 Unclear


{0.88 - 1.314} 95% CI 0.5 Unclear


{0.85 - 1.261} 95% CI 0.733 Unclear


{0.68 - 0.936} 95% CI 0.005 Unclear


{0.66 - 0.958} 95% CI 0.018 Unclear


{0.57 - 0.869} 95% CI NR Unclear


{0.79 - 1.124} 95% CI 0.589 Unclear


{0.78 - 1.129} 95% CI 0.594 Unclear


{0.75 - 1.125} 95% CI 0.497 Unclear


{0.93 - 1.381} 95% CI 0.234 Unclear


{0.84 - 1.284} 95% CI 0.742 Unclear


{0.96 - 1.514} 95% CI 0.139 Unclear


{0.58 - 0.857} 95% CI 0.001 Unclear


{0.52 - 0.848} 95% CI 0.001 Unclear


{0.4 - 0.733} 95% CI 0.001 Unclear


{0.8 - 1.207} 95% CI 1 Unclear

Ly-Pen, et al.2005 101 VAS 70% Improvement of Diurnal Pain 6 Months Y Y Y Percent Wrists Steroid Injection 83 71.1 NR OCTR 80 70 NR Relative Risk 0.985

{0.81 - 1.201} 95% CI 1 Unclear


{0.71 - 1.15} 95% CI 0.424 Unclear


{0.97 - 1.488} 95% CI 0.098 Unclear


{0.87 - 1.38} 95% CI 0.513 Unclear


{1.03 - 1.776} 95% CI 0.04 Unclear





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Hui, et al.2004 60 Needed Surgery 80 Weeks Y Unc N Number Steroid Injection 30 5 NR Oral Steroid 30 9 NR NR NR NR NR NR

Hui, et al.2004 60 GSS (of those not needing surgery) 80 Weeks Y Y Y Percent Improved Steroid Injection 25 69.5 NR Oral Steroid 21 51.9 NR NR NR NR NS t-test


Comparison Outcome Measure Duration Measure of ES Favors Effect size (CI) Number of Studies/LOE

No Treatment FSS 2 weeks SMD ● 0.85 (0.40, 1.31)

No Treatment FSS 4 weeks SMD ● 1.10 (0.49, 1.71)

No Treatment FSS 3 months SMD ● 0.68 (0.10, 1.25)

No Treatment FSS 6 months SMD ● 0.40 (-0.16, 0.97)

No Treatment SSS 2 weeks SMD ● 2.57 (1.98, 3.17)

No Treatment SSS 4 weeks SMD ● 2.10 (1.55, 2.65)

No Treatment SSS 3 months SMD ● 3.35 (2.47, 4.22)

No Treatment SSS 6 months SMD ? N/A

No Treatment Patient Satisfaction withTreatment 4 weeks OR ● 235.29 (6.94, 7977.9

Nocturnal Splinting Symptoms 6 weeks SMD ● 0.26 (-0.55, 1.07)

Nocturnal Splinting Hand Function 6 weeks SMD ● 0.25 (-0.55, 1.06)

Yoga Pain 8 weeks SMD ○ 0.64 (0.01, 1.26)1 Level II Systematic

Review

Nerve and Tendo Exercises plus Splinting Hand Function 3 months SMD ? N/A

Nerve and Tendo Exercises plus Splinting Symptoms 3 months SMD ? N/A

Nerve and Tendo Exercises plus Splinting Grip Strength 3 months OR ? N/A

Nerve and Tendo Exercises plus Splinting Patient Satisfaction withTreatment 3 months OR ? N/A

Nerve and Tendo Exercises plus Splinting Imrprovement in Nocturnal Symptoms 3 months OR ? N/A

Proximal Steroid Injection NSS 11 months SMD ? N/A

Distal Injection NSS 11 months SMD ? N/A

Splinting plus Steroid Injection FSS 3 months SMD ○ 1.03 (0.29, 1.76)

Splinting plus Steroid Injection FSS 6 months SMD ? N/A

Splinting plus Steroid Injection SSS 3 months SMD ? N/A

Splinting plus Steroid Injection SSS 6 months SMD ? N/A

Open Carpal Tunnel Release FSS 3 months SMD ? N/A

Open Carpal Tunnel Release FSS 6 months SMD ? N/A

Open Carpal Tunnel Release SSS 3 months SMD ● -1.03 (-1.94, -0.13)

Open Carpal Tunnel Release SSS 6 months SMD ? N/A

● Favors Splinting

○ Favors Comparison

? Underpowered for outcome Non-significant Results

N/A - Not applicable, non-significant results

1 Level II Trial

1 Level II Trial

1 Level II Trial

Splinting vs Treatment

2 studies, 1 Level II, 1 level II systematic review

1 Level II Systematic Review

1 Level II Trial


Comparison Outcome Measure Duration Measure of ES Effect size (CI) Favors Number of Studies/LOE

Yoga Pain 8 weeks SMD 0.64 (0.01, 1.26) ● 1 Level II Systematic Review

● Favors Yoga ○ Favors Comparison



Yoga vs Treatment



Sham Treatment VAS Pain 6 weeks SMD ? N/A 1 Level 2 Systematic Review

● Favors Therapeautic Touch





Clinician Hands FSS 7 weeks SMD ? N/A

Clinician Hands FSS 5 months SMD ? N/A

Clinician Hands VAS 7 weeks SMD ? N/A

Clinician Hands VAS 5 months SMD ● -1.17 (-2.08, -0.25)

● Favors Graston Instrument




Therapeautic Touch vs Treatment

Graston Instrument vs Treatment

1 Level 2 RCT



Steroid Injection SSS 2 weeks SMD ○ 0.74 (0.00, 1.49)

Steroid Injection SSS 8 weeks SMD ? N/A

Steroid Injection FSS 2 weeks SMD ? N/A

Steroid Injection FSS 8 weeks SMD ? N/A

Steroid Injection VAS Pain 2 weeks SMD ? N/A

Steroid Injection VAS Pain 8 weeks SMD ○ 1.79 (0.94, 2.65)

Steroid Injection FSS 2 months SMD ? 0.00 (-0.76, 0.76)

Steroid Injection FSS 4 months SMD ? N/A

Steroid Injection SSS 2 months SMD ? N/A

Steroid Injection SSS 4 months SMD ○ 0.82 (0.03, 1.61)

Phonophoresis FSS 2 months SMD ? 0.00 (-0.78, 0.78)

Phonophoresis FSS 4 months SMD ? N/A

Phonophoresis SSS 2 months SMD ? N/A


● Favors




Iontophoresis vs Treatment

1 Level 2 RCT

1 Level 2 RCT

1 Level 2 RCT



PlaceboPatient Satisfaction with Treatment 2 weeks OR ● 4.44 (1.74, 11.29) 1 Level 1 RCT

Placebo Clinical Improvement 1 months OR ● 13.14 (3.84, 45.02) 1 Level 2 Systematic Review

Oral Steroid GSS 2 weeks SMD ? N/A

Oral Steroid GSS 8 weeks SMD ● 0.84 (0.31, 1.37)

Oral Steroid GSS 12 weeks SMD ● 0.77 (0.25, 1.30)Splinting plus NSAID Symptoms 2 weeks SMD ? N/ASplinting plus NSAID Symptoms 8 weeks SMD ? N/ASplinting plus NSAID VAS- Pain 2 weeks SMD ? N/ASplinting plus NSAID VAS- Pain 8 weeks SMD ? N/A

Systemic Injection Clinical Improvement 1 months OR ● 5.33 (1.14, 24.90) 1 Level 2 Systematic Review

Iontophoresis SSS 2 weeks SMD ● 0.74 (0.00, 1.49)

Iontophoresis SSS 8 weeks SMD ? N/A

Iontophoresis FSS 2 weeks SMD ? N/A

Iontophoresis FSS 8 weeks SMD ? N/A

Iontophoresis VAS Pain 2 weeks SMD ? N/A

Iontophoresis VAS Pain 8 weeks SMD ● 1.79 (0.94, 2.65)

Iontophoresis FSS 2 months SMD ? 0.00 (-0.76, 0.76)

Iontophoresis FSS 4 months SMD ? N/A

Iontophoresis SSS 2 months SMD ? N/A

Iontophoresis SSS 4 months SMD ● 0.82 (0.03, 1.61)





He-Ne Laser Symptoms Improvement 20 days OR ● 6.93 (1.53, 31.38)

He-Ne Laser Symptoms Improvement 6 months OR ? N/A

OCTRImprovement in Clinical Symptoms 3 months OR ○ 3.45 (1.89, 6.28)

OCTRImprovement in Clinical Symptoms 6 months OR ○ 6.23 (3.24, 11.99)

OCTRImprovement in Clinical Symptoms 1 year OR ○ 3.85 (2.10, 7.07)

OCTRImprovement in Clinical Symptoms 1 year OR ○ 79.80 (3.38, 1882.16)

OCTR FSS 3 months SMD ? N/A

OCTR FSS 6 months SMD ○ 0.55 (0.13, 0.97)

OCTR SSS 3 months SMD ○ 0.48 (0.06, 0.90)

OCTR SSS 6 months SMD ○ 0.66 (0.23, 1.08)

OCTR GSS 6 weeks SMD ○ 0.78 (0.20, 1.35)

OCTR GSS 20 weeks SMD ○ 1.25 (0.64, 1.85)

● Favors Local Steroid Injection




1 Level 2 RCT

1 Level 2 Systematic Review

1 Level 2 RCT


Local Steroid Injection vs Treatment


1 Level 2 RCT

1 Level 2 RCT




Placebo Symptoms 2 weeks SMD ? NA

Placebo Symptoms 7 weeks SMD ● 0.61 (0.12, 1.09)

Placebo Symptoms 6 months SMD ● 1.17 (0.65, 1.68)Placebo (vs 1.5 W/cm2) Pain 2 weeks SMD ? NAPlacebo (vs 1.5 W/cm2) Symptoms 2 weeks SMD ? NAPlacebo (vs 1.5 W/cm2) Nocturnal Waking 2 weeks SMD ? NA

Placebo (vs 0.8 W/cm2) Pain 2 weeks SMD ? NA

Placebo (vs 0.8 W/cm2) Symptoms 2 weeks SMD

?NA

Placebo (vs 0.8 W/cm2) Nocturnal Waking 2 weeks SMD ? NA

Laser Therapy Change in VAS Pain Score 3 weeks SMD ● 1.31 (0.86, 1.77)

Laser Therapy Change in VAS Pain Score 7 weeks SMD ● 2.95 (2.35, 3.55)

NSAIDS VAS Pain 6 weeks SMD ? NA 1 level 1 RCT

● Favors Ultrasound




Ultrasound vs Treatment

1 level 2 Systematic Review

1 level 2 Systematic Review

1 level 2 RCT



Placebo Improved Night Pain 3 weeks OR ? N/A 1 Level 2 Systematic Review

Steroid Injection Symptom Improvement 20 days OR ○ 6.93 (1.53, 31.38)

Steroid Injection Symptom Improvement 6 months OR ? N/A

● Favors He-Ne Laser




Laser Acupuncture (He-Ne Laser) vs Treatment




UltrasoundChange in VAS Pain Score 3 weeks SMD ○ 1.31 (0.86, 1.77)

UltrasoundChange in VAS Pain Score 7 weeks SMD ○ 2.95 (2.35, 3.55)

● Favors Low Level Laser





Splint plus Placebo Laser Handgrip Strength 4 weeks SMD ? N/A

Splint plus Placebo Laser Handgrip Strength 12 weeks SMD ● 0.45 (0.01, 0.89)

● Favors Low Level Laser Plus Splinting




Low Level Laser vs Treatment

1 level 2 RCT

Low Level Laser plus Splinting vs Treatment

1 level 1 RCT



Placebo GSS 2 weeks SMD ? NA

Placebo GSS 4 weeks SMD ? NA

Oral Steroids Symptoms 2 weeks SMD ○ 1.27 (0.38, 2.16)

Oral Steroids Symptoms 4 weeks SMD ○ 1.64 (0.70, 2.58)

Diuretics Symptoms 2 weeks SMD ? NA

Diuretics Symptoms 4 weeks SMD ? NA

Ultrasound VAS Pain 6 weeks SMD ? NA 1 level 1 RCT

● Favors NSAIDS





NSAIDS vs Treatment



Placebo Nocturnal Discom 12 weeks SMD ? N/A

Placebo Movement Discom 12 weeks SMD ● 0.74( 0.02, 1.46)

● Favors Vitamin B




Vitamin B vs Treatment




Placebo Symptom Improvement 4 weeks OR ? N/A

Placebo Symptom Improvement 8 weeks OR ? N/A

Placebo Symptoms - GSS 2 weeks SMD ? N/A

Placebo Symptoms - GSS 4 weeks SMD ? N/A

Oral Steroids Symptoms- GSS 2 weeks SMD ○ 1.16 (0.25, 2.07)

Oral Steroids Symptoms- GSS 4 weeks SMD ○ 1.65 (0.67, 2.62)

NSAIDS Symptoms 2 weeks SMD ? NA

NSAIDS Symptoms 4 weeks SMD ? NA

● Favors Diuretic




Diuretics vs Treatment





Placebo Symptoms - GSS 2 weeks SMD ● 0.90 (0.22, 1.59)

Placebo Symptoms- GSS 8 weeks SMD ● 0.88 (0.20, 1.57)

Placebo Symptoms - GSS 2 weeks SMD ● 0.99 (0.10, 1.88)

Placebo Symptoms- GSS 4 weeks SMD ● 1.51 (0.56, 2.46)

NSAIDS Symptoms- GSS 2 weeks SMD ● 1.27 (0.38, 2.16)

NSAIDS Symptoms- GSS 4 weeks SMD ● 1.64 (0.70, 2.58)

Diuretics Symptoms- GSS 2 weeks SMD ● 1.15 (0.25, 2.07)

Diuretics Symptoms- GSS 4 weeks SMD ● 1.65 (0.67, 2.62)

Steroid Injection GSS 2 weeks SMD ? N/A

Steroid Injection GSS 8 weeks SMD ○ 0.84 (0.31, 1.37)

Steroid Injection GSS 12 weeks SMD ○ 0.77 (0.25, 1.30)

● Favors Oral Steroid





Oral Steroid vs Treatment





Oral Placebo FSS 3 days SMD ○ -3.44 (-4.79, -2.08)

Oral Placebo FSS 5 days SMD ○ -2.15 (-3.22, -1.08)

Oral Placebo SSS 3 days SMD ○ -5.38 (-7.25, -3.52)

Oral Placebo SSS 5 days SMD ○ -5.56 (-7.47, -3.64)

Oral Placebo PRWE 3 days SMD ○ -4.90 (-6.63, -3.16)

Oral Placebo PRWE 5 days SMD ○ -3.45 (-4.81, -2.09)

● Favors Heat Therapy




Heat Therapy vs Treatment

1 Level 2 RCT



Medical Treatment Hand Function 13 Weeks SMD ? N/A

Medical Treatment SF-35 13 Weeks SMD ? N/A

● Favors Chiropractic Treatment




Chiropractic Treatment vs Treatment




Iontophoresis FSS 2 months SMD ? 0.00 (-0.78, 0.78)

Iontophoresis FSS 4 months SMD ? N/A







● Favors Phonophoresis




Phonophoresis vs Treatment

1 Level 2 RCT

1 Level 2 RCT



No relevant articles meeting inclusion criteria retrieved for this treatment


No relevant articles meeting inclusion criteria retrieved for this exercise alone













Manipulations vs Treatment

Physical Therapy vs Treatment

Occupational Therapy vs Treatment

Magnet Therapy vs Treatment

Activity Modification vs Treatment

Nerve and Tendon Exercise vs Treatment

Stretching vs Treatment

Restrictions at Work vs Treatment














Cold Laser vs Treatment

Electric Stimulation vs Treatment

Fitness vs Treatment

Weight Reduction vs Treatment

Smoking Cessation vs Treatment

Cognitive Behavioral Therapy vs Treatment


Benefits and Harms

Outcome Measure Study Duration Favors Level of Evidence

Functional Status Manente, et al. 2 weeks ● Level II

Functional Status Manente, et al. 4 weeks ● Level II

Functional Status Premoselli, et al. 3 months ● Level II

Functional Status Premoselli, et al. 6 months ? Level II

Symptom Severity Manente, et al. 2 weeks ● Level II

Symptom Severity Manente, et al. 4 weeks ● Level II

Symptom Severity Premoselli, et al. 3 months ● Level II

Symptom Severity Premoselli, et al. 6 months ? Level II

Patient Satisfaction with treatment Manente, et al. 4 weeks ● Level II

Symptom Severity Walker, et al. 6 weeks ? Level II

Functional Status Walker, et al. 6 weeks ? Level II

Pain Garfinkel, et al. 8 weeks ● Level II

Functional Status Akalin, et al. 3 months ? Level II

Symptom Severity Akalin, et al. 3 months ? Level II

High Satisfaction with Treatment Akalin, et al. 3 months ? Level II

Improved Nocturnal Symptoms Akalin, et al. 3 months ? Level II

Full time Splinting vs. Nocturnal

Nerve and Tendon Exercises plus Splinting vs.Splinting

Conservative Treatments

Splinting vs. No Treatment

Yoga vs. Splinting

● = Significant in favor of Treatment○ = Significant in favor of Control◐ = Treatments "equal" in appropriately powered studies? = Underpowered study for outcome


Benefits and Harms



Symptom Severity Ebenbichler, et al. 2 weeks ? Level II

Symptom Severity Ebenbichler, et al. 7 weeks ● Level II

Symptom Severity Ebenbichler, et al. 6 months ● Level II

(1.5 W/cm2) Pain Oztas, et al. 2 weeks ? Level II

(1.5 W/cm2) Symptoms Oztas, et al. 2 weeks ? Level II

(1.5 W/cm2) Nocturnal Waking Oztas, et al. 2 weeks ? Level II


(0.8 W/cm2) Symptoms Oztas, et al. 2 weeks ? Level II


Pain Oztas, et al. 2 weeks ? Level II

Symptoms Oztas, et al. 2 weeks ? Level II

Nocturnal Waking Oztas, et al. 2 weeks ? Level II

Handgrip Strength Evcik, et al. 4 weeks ? Level I

Handgrip Strength Evcik, et al. 12 weeks ● Level I

Improved Night Pain Aigner, et al. n/a ? Level II

Symptom Improvement Lucantoni, et al. 20 days ● Level II

Symptom Improvement Lucantoni , et al. 6 months ? Level II

Change in Pain Score Bakhtiary, et al. 3 weeks ● Level II

Change in Pain Score Bakhtiary, et al. 7 weeks ● Level II

Ultrasound vs. Placebo

Ultrasound- 1.5 W/cm2 vs. 0.8 W/cm2

Laser Therapy & Splint vs. Splint & Placebo Laser

Laser Acupuncture vs. Placebo Laser

Steroid Injection vs. Laser Acupuncture

Ultrasound vs. Laser

? = Underpowered study for outcome

● = Significant in favor of Treatment○ = Significant in favor of Control◐ = Treatments "equal" in appropriately powered studies


Benefits and Harms



Symptoms Hui, et al. 2 weeks ● Level II

Symptoms Hui, et al. 8 weeks ● Level II

Symptoms Chang, et al. 2 weeks ● Level II


Symptom Improvement Pal, et al. 4 weeks ? Level II

Symptom Improvement Pal, et al. 6 months ? Level II

Symptoms Chang, et al. 2 weeks ? Level II




Function Michlovitz, et al. 3 days ○ Level II

Function Michlovitz, et al. 5 days ○ Level II

Symptoms Michlovitz, et al. 3 days ○ Level II

Symptoms Michlovitz, et al. 5 days ○ Level II

PWRE Michlovitz, et al. 3 days ○ Level II

PWRE Michlovitz, et al. 5 days ○ Level II



Oral Steroids vs. Placebo

Diuretics vs. Placebo

NSAIDS vs. Placebo

Heat Therapy vs. Oral Placebo

Oral Steroids vs. Diuretics



Benefits and Harms





Nocturnal Discomfort Spooner, et al. 12 weeks ? Level II

Movement Discomfort Spooner, et al. 12 weeks ● Level II

VAS Pain Blankfield, et al. 6 weeks ? Level II

Function Davis, et al. 13 weeks ? Level II

SF-36 Davis, et al. 13 weeks ? Level II

Function Burke, et al. 7 weeks ? Level II

Function Burke, et al. 5 months ? Level II

VAS Pain Burke, et al. 7 weeks ? Level II

VAS Pain Burke, et al. 5 months ● Level II

Patient Satisfaction with Treatment Armstrong, et al. 2 weeks ● Level I

Clinical Improvement Dammers, et al. 1 months ● Level II

Clinical Improvement Wong, et al. 2 weeks ? Level II

Clinical Improvement Wong, et al. 8 weeks ● Level II

Clinical Improvement Wong, et al. 12 weeks ● Level II

Clinical Improvement Ozdogan, et al. 1 months ● Level II

NSAIDS vs. Diuretics

? = Underpowered study for outcome

Vitamin B vs. Placebo

Therapeutic Touch vs. Sham Treatment

Chiropractic vs. Medical Treatment

Graston Instrument vs. Clinician Hands

Steroid Injection vs. Placebo

Steroid Injection vs. Oral Steroid

Steroid Injection vs. Systemic Steroid Injection

● = Significant in favor of Treatment○ = Significant in favor of Control◐ = Treatments "equal" in appropriately powered studies


Benefits and Harms



Symptoms Gokoglu, et al. 2 weeks ● Level II

Symptoms Gokoglu, et al. 8 weeks ? Level II

Function Gokoglu, et al. 2 weeks ? Level II

Function Gokoglu, et al. 8 weeks ? Level II

Pain Gokoglu, et al. 2 weeks ? Level II

Pain Gokoglu, et al. 8 weeks ● Level II

Function Aygul, et al. 2 months ? Level II


Symptoms Aygul, et al. 2 months ? Level II

Symptoms Aygul, et al. 4 months ● Level II





Symptoms Celiker, et al. 2 weeks ? Level II

Symptoms Celiker, et al. 8 weeks ? Level II

VAS Pain Celiker, et al. 2 weeks ? Level II

VAS Pain Celiker, et al. 8 weeks ? Level II

Steroid Injection vs. Phonophoresis

Steroid Injection vs. Splinting & NSAIDS


Steroid Injection vs. Iontophoresis


Benefits and Harms



Neurologic Symptom Score Sevim, et al. 11 months ○ Level II

Neurologic Symptom Score Sevim, et al. 11 months ? Level II

Function Ucan, et al. 3 months ● Level II

Function Ucan, et al. 6 months ? Level II

Symptoms Ucan, et al. 3 months ? Level II

Symptoms Ucan, et al. 6 months ● Level II

Neurologic Symptom Score Sevim, et al. 11 months ? Level II





Clinical Improvement Gerritsen, et al. 3 months ● Level II

Clinical Improvement Gerritsen, et al. 6 months ● Level II

Clinical Improvement Gerritsen, et al. 1 year ● Level II

Clinical Improvement Garland, et al. 1 year ● Level II



Symptoms Ucan, et al. 3 months ○ Level II

Symptoms Ucan, et al. 6 months ? Level II

● = Significant in favor of Treatment

Iontophoresis vs. Phonophoresis

Open Carpal Tunnel Release vs. Splinting

Proximal Steroid Injection vs. Splinting

Distal Steroid Injection vs. Splinting

Steroid Injection plus Splinting vs. Splinting Alone

Proximal Steroid Injection vs. Distal Steroid Injection

○ = Significant in favor of Control◐ = Treatments "equal" in appropriately powered studies? = Underpowered study for outcome


Benefits and Harms



Function Demirci, et al. 3 months ? Level II

Function Demirci, et al. 6 months ● Level II

Symptoms Demirci, et al. 3 months ● Level II

Symptoms Demirci, et al. 6 months ● Level II

GSS- Symptoms Hui, et al. 6 weeks ● Level I

GSS- Symptoms Hui, et al. 20 weeks ● Level I

Function Ucan, et al. 3 months ○ Level II


Symptoms Ucan, et al. 3 months ○ Level II

Symptoms Ucan, et al. 6 months ● Level II

◐ = Treatments "equal" in appropriately powered studies? = Underpowered study for outcome

Open Carpal Tunnel Release vs. Local Steroid Injection

Open Carpal Tunnel Release vs. Local Steroid Injection & Splinting

● = Significant in favor of Treatment○ = Significant in favor of Control


Minimal Detectable Effect Size

Author Outcome Measure Duration Name of Effect Size

Value of Effect Size*

Minimal Detectable Effect Size*†

Manente, et al. Functional Status 2 weeks SMD Significant n/a

Manente, et al. Functional Status 4 weeks SMD Significant n/a

Premoselli, et al. Functional Status 3 months SMD Significant n/a

Premoselli, et al. Functional Status 6 months SMD 0.4 0.63

Manente, et al. Symptom Severity 2 weeks SMD Significant n/a

Manente, et al. Symptom Severity 4 weeks SMD Significant n/a

Premoselli, et al. Symptom Severity 3 months SMD Significant n/a

Premoselli, et al. Symptom Severity 6 months SMD 0.53 0.83

Manente, et al. Patient Satisfaction with treatment 4 weeks OR Significant n/a

Walker, et al. Symptom Severity 6 weeks SMD 0.26 1.20

Walker, et al. Functional Status 6 weeks SMD 0.25 1.20

Garfinkel, et al. Pain 8 weeks SMD Significant n/a

Akalin, et al. Functional Status 3 months SMD 0.18 0.96

Akalin, et al. Symptom Severity 3 months SMD 0.49 0.96

Akalin, et al. High Satisfaction with Treatment 3 months OR 6.54 ( 0.14 - 7.01 )

Akalin, et al. Improved Nocturnal Symptoms 3 months OR 2.29 ( 0.14 - 7.18 )


Splinting vs. No Treatment

OR = Odds Ratio ; SMD = Standardized Mean Differrence (Hedges d) ; n/a = not applicable* If the value of the effect size was statistically significant (p < 0.05) the minimal detectable effect size is not calculated

Nerve and Tendon Exercises plus Splinting vs.Splinting

Yoga vs. Splinting

Full time Splinting vs. Nocturnal

† For OR: underpowered studies will have an effect size within the listed range







Ebenbichler, et al. Symptom Severity 2 weeks SMD 0.16 0.69

Ebenbichler, et al. Symptom Severity 7 weeks SMD Significant n/a

Ebenbichler, et al. Symptom Severity 6 months SMD Significant n/a

Oztas, et al. (1.5 W/cm2) Pain 2 weeks SMD 0.53 1.32

Oztas, et al. (1.5 W/cm2) Symptoms 2 weeks SMD 0 1.32

Oztas, et al. (1.5 W/cm2) Nocturnal Waking 2 weeks SMD 0 1.32


Oztas, et al. (0.8 W/cm2) Symptoms 2 weeks SMD 0.33 1.32


Oztas, et al. Pain 2 weeks SMD 0.39 1.32

Oztas, et al. Symptoms 2 weeks SMD 0.44 1.32

Oztas, et al. Nocturnal Waking 2 weeks SMD 0.43 1.32

Evcik, et al. Handgrip Strength 4 weeks SMD 0.41 0.63

Evcik, et al. Handgrip Strength 12 weeks SMD Significant n/a

Aigner, et al. Improved Night Pain n/a OR 12.79 ( 0.23 - 4.42 )

Laser Acupuncture vs. Placebo Laser

Laser Therapy & Splint vs. Splint & Placebo Laser

Ultrasound- 1.5 W/cm2 vs. 0.8 W/cm2

OR = Odds Ratio ; SMD = Standardized Mean Differrence (Hedges d) ; n/a = not applicable* If the value of the effect size was statistically significant (p < 0.05) the minimal detectable effect size is not calculated† For OR: underpowered studies will have an effect size within the listed range

Ultrasound vs. Placebo







Lucantoni, et al. Symptom Improvement 20 days OR Significant n/a

Lucantoni , et al. Symptom Improvement 6 months OR 2.36 ( 0.13 - 7.45 )

Bakhtiary, et al. Change in Pain Score 3 weeks SMD Significant n/a

Bakhtiary, et al. Change in Pain Score 7 weeks SMD Significant n/a

Hui, et al. Symptoms 2 weeks SMD Significant n/a

Hui, et al. Symptoms 8 weeks SMD Significant n/a

Chang, et al. Symptoms 2 weeks SMD Significant n/a


Pal, et al. Symptom Improvement 4 weeks OR 0.86 ( 0.32 - 3.10 )

Pal, et al. Symptom Improvement 6 months OR 0.93 ( 0.03 - 35.36 )

Chang, et al. Symptoms 2 weeks SMD 0.12 1.02





NSAIDS vs. Placebo

Diuretics vs. Placebo

Oral Steroids vs. Placebo

Ultrasound vs. Laser

Steroid Injection vs. Laser Acupuncture







Michlovitz, et al. Function 3 days SMD Significant n/a

Michlovitz, et al. Function 5 days SMD Significant n/a

Michlovitz, et al. Symptoms 3 days SMD Significant n/a

Michlovitz, et al. Symptoms 5 days SMD Significant n/a

Michlovitz, et al. PWRE 3 days SMD Significant n/a

Michlovitz, et al. PWRE 5 days SMD Significant n/a





Spooner, et al. Nocturnal Discomfort 12 weeks SMD 0.4 1.02

Spooner, et al. Movement Discomfort 12 weeks SMD Significant n/a

Blankfield, et al. VAS Pain 6 weeks SMD 0.04 1.29

Therapeutic Touch vs. Sham Treatment


Vitamin B vs. Placebo

NSAIDS vs. Diuretics

Oral Steroids vs. Diuretics

Heat Therapy vs. Oral Placebo







Davis, et al. Function 13 weeks SMD 0.27 0.68

Davis, et al. SF-36 13 weeks SMD 0.07 0.68

Burke, et al. Function 7 weeks SMD 0.15 1.19

Burke, et al. Function 5 months SMD 0.14 1.19

Burke, et al. VAS Pain 7 weeks SMD 0.35 1.19

Burke, et al. VAS Pain 5 months SMD Significant n/a

Armstrong, et al. Patient Satisfaction with Treatment 2 weeks OR Significant n/a

Dammers, et al. Clinical Improvement 1 months OR Significant n/a

Wong, et al. Clinical Improvement 2 weeks SMD 0.47 0.67

Wong, et al. Clinical Improvement 8 weeks SMD Significant n/a

Wong, et al. Clinical Improvement 12 weeks SMD Significant n/a

Ozdogan, et al. Clinical Improvement 1 months OR Significant n/a

Steriod Injection vs. Systemic Steroid Injection

Steriod Injection vs. Oral Steroid


Steriod Injection vs. Placebo

Graston Instrument vs. Clinician Hands

Chiropractic vs. Medical Treatment







Gokoglu, et al. Symptoms 2 weeks SMD Significant n/a

Gokoglu, et al. Symptoms 8 weeks SMD 0.73 1.05

Gokoglu, et al. Function 2 weeks SMD 0.67 1.05

Gokoglu, et al. Function 8 weeks SMD 0.74 1.05

Gokoglu, et al. Pain 2 weeks SMD 0.68 1.05

Gokoglu, et al. Pain 8 weeks SMD Significant n/a

Aygul, et al. Function 2 months SMD 0 0.96

Aygul, et al. Function 4 months SMD 0.5 0.96

Aygul, et al. Symptoms 2 months SMD 0.29 0.96

Aygul, et al. Symptoms 4 months SMD Significant n/a





Celiker, et al. Symptoms 2 weeks SMD 0 1.23

Celiker, et al. Symptoms 8 weeks SMD 0.18 1.23

Celiker, et al. VAS Pain 2 weeks SMD 0.63 1.23

Celiker, et al. VAS Pain 8 weeks SMD 0.35 1.23

Steriod Injection vs. Splinting & NSAIDS

Steriod Injection vs. Phonophoresis

Steriod Injection vs. Iontophoresis








Sevim, et al. Neurologic Symptom Score 11 months SMD Significant n/a

Sevim, et al. Neurologic Symptom Score 11 months SMD 0.52 0.76

Ucan, et al. Function 3 months SMD Significant n/a

Ucan, et al. Function 6 months SMD 0.21 0.45

Ucan, et al. Symptoms 3 months SMD 0.06 0.45

Ucan, et al. Symptoms 6 months SMD Significant n/a

Sevim, et al. Neurologic Symptom Score 11 months SMD 0.35 0.47





Iontophoresis vs. Phonophoresis

Proximal Steroid Injection vs. Distal Steroid Injection

Steroid Injection plus Splinting vs. Splinting Alone

Distal Steroid Injection vs. Splinting

Proximal Steroid Injection vs. Splinting








Gerritsen, et al. Clinical Improvement 3 months OR Significant n/a

Gerritsen, et al. Clinical Improvement 6 months OR Significant n/a

Gerritsen, et al. Clinical Improvement 1 year OR Significant n/a

Garland, et al. Clinical Improvement 1 year OR Significant n/a




Ucan, et al. Symptoms 6 months SMD 0.42 1.21

Demirci, et al. Function 3 months SMD 0.22 0.24

Demirci, et al. Function 6 months SMD Significant n/a

Demirci, et al. Symptoms 3 months SMD Significant n/a

Demirci, et al. Symptoms 6 months SMD Significant n/a

Hui, et al. GSS- Symptoms 6 weeks SMD Significant n/a

Hui, et al. GSS- Symptoms 20 weeks SMD Significant n/a

Ucan, et al. Function 3 months SMD Significant n/a




Open Carpal Tunnel Release vs. Local Steroid Injection & Splinting

Open Carpal Tunnel Release vs. Local Steroid Injection

Open Carpal Tunnel Release vs. Splinting

† For OR: underpowered studies will have an effect size within the listed range

OR = Odds Ratio ; SMD = Standardized Mean Differrence (Hedges d) ; n/a = not applicable* If the value of the effect size was statistically significant (p < 0.05) the minimal detectable effect size is not calculated


Work-Related CTSExcluded Articles


Abasolo, et al.2007

Musculoskeletal work disability for clinicians: time course and effectiveness of a specialized intervention program by diagnosis Arthritis Rheum Not Relevant - Treatments Not Reported

Burke, et al.2007

Primary care management of patients with carpal tunnel syndrome referred to surgeons: are non-operative interventions effectively utilised? Postgrad Med J Not Relevant - No patient oriented

outcome measures to analyze treatment

Bonfiglioli, et al.2007

Relationship between repetitive work and the prevalence of carpal tunnel syndrome in part-time and full-time female supermarket cashiers: a quasi-

experimental studyInt Arch Occup Environ Health Not Relevant - Prevalence Analysis

Palmer, et al.2007

Carpal tunnel syndrome and its relation to occupation: a systematic literature review Occup Med (Lond) Not Relevant - Risk Analysis

Staal, et al.2007 Aetiology and management of work-related upper extremity disorders Best Pract Res Clin Rheumatol No Data

Rempel, et al.2006

A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders

among computer operatorsOccup Environ Med Not Relevant - Not CTS specific

Werner, et al.2006 Evaluation of work-related carpal tunnel syndrome J Occup Rehabil Not Relevant - Diagnostic study

Greening, et al.2006

Workshop: clinical implications for clinicians treating patients with non-specific arm pain, whiplash and carpal tunnel syndrome Man Ther No Data


Ergonomic and physiotherapeutic interventions for treating work-related complaints of the arm, neck or shoulder in adults Cochrane Database Syst Rev Relevant studies did not use

electrodiagnostic testing for diagnosis

Gimeno, et al.2005 The role of job strain on return to work after carpal tunnel surgery Occup Environ Med Not Relevant - Post Operative

Gell, et al.2005

A longitudinal study of industrial and clerical workers: incidence of carpal tunnel syndrome and assessment of risk factors J Occup Rehabil Not Relevant - Risk Analysis

Gerr, et al.2005

A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users Occup Environ Med Not Relevant - Not CTS specific

Werner, et al.2005

Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome Arch Phys Med Rehabil Did not use electrodiagnostic testing for

diagnosis




Sato, et al.2005

Amelioration by mecobalamin of subclinical carpal tunnel syndrome involving unaffected limbs in stroke patients J Neurol Sci Not Relevant

Turner, et al.2004

Prediction of chronic disability in work-related musculoskeletal disorders: a prospective, population-based study BMC Musculoskelet Disord Not Relevant - Risk/Prevalence Analysis

Wellman, et al.2004

Work-related carpal tunnel syndrome (WR-CTS) in Massachusetts, 1992-1997: source of WR-CTS, outcomes, and employer intervention practices Am J Ind Med Not Relevant - No patient oriented

outcome measures to analyze treatment

Chaise, et al.2004

Return-to-work interval and surgery for carpal tunnel syndrome. Results of a prospective series of 233 patients J Hand Surg [Br ] Not Relevant - Post Operative

Thomsen, et al.2002 Carpal tunnel syndrome in repetitive work: a follow-up study Am J Ind Med Not Relevant - Risk Analysis

Lincoln, et al.2002

Impact of case manager training on worksite accommodations in workers' compensation claimants with upper extremity disorders J Occup Environ Med Not Relevant - Not CTS specific

Silverstein, et al.2002

Use of a prevention index to identify industries at high risk for work-related musculoskeletal disorders of the neck, back, and upper extremity in

Washington state, 1990-1998Am J Ind Med Not Relevant - Risk Analysis

Nathan, et al.2002 Predictors of carpal tunnel syndrome: an 11-year study of industrial workers J Hand Surg [Am ] Not Relevant - Risk Analysis

Cosgrove, et al.2002 Carpal tunnel syndrome in railroad workers Am J Phys Med Rehabil Not Relevant - Risk/Prevalence Analysis

Bitar, et al.2002

Carpal tunnel release in the United States and Sweden: reimbursement patterns, cost for treatment, and return to work Plast Reconstr Surg Retrospective

Davis, et al.2001

Surveillance of work-related carpal tunnel syndrome in Massachusetts, 1992-1997: a report from the Massachusetts Sentinel Event Notification System for

Occupational Risks (SENSOR)Am J Ind Med Not Relevant - Risk Analysis

Leclerc, et al.2001 Upper-limb disorders in repetitive work Scand J Work Environ Health Not Relevant - Risk Analysis

Giele, et al.2001 Evidence-based treatment of carpal tunnel syndrome Curr Orthop Not Relevant - Descriptive




Giersiepen, et al.2000

Gender differences in carpal tunnel syndrome? occupational and non-occupational risk factors in a population-based case-control study Ann Epidemiol Not Relevant - Risk Analysis

Keogh, et al.2000

Patterns and predictors of employer risk-reduction activities (ERRAs) in response to a work-related upper extremity cumulative trauma disorder

(UECTD): reports from workers' compensation claimantsAm J Ind Med Not Relevant - Predictability Analysis

Herbert, et al.2000 Clinical evaluation and management of work-related carpal tunnel syndrome Am J Ind Med Not Relevant - Descriptive

Kearns, et al.2000

Pre- and post-employment median nerve latency in pork processing employees J Occup Environ Med Not Relevant Risk/Prevalence Analysis

Roquelaure, et al.2000 Occupational risk factors for radial tunnel syndrome in industrial workers Scand J Work Environ Health Not Relevant - No treatment

Tittiranonda, et al.1999

Effect of four computer keyboards in computer users with upper extremity musculoskeletal disorders Am J Ind Med Did not use electrodiagnostic testing for

diagnosis

Rempel, et al.1999 Effect of keyboard keyswitch design on hand pain J Occup Environ Med Did not use electrodiagnostic testing for

diagnosis

Feuerstein, et al.1998

Occupational upper extremity disorders in the federal workforce. Prevalence, health care expenditures, and patterns of work disability J Occup Environ Med Not Relevant - Prevalence/Risk Analysis

Fish, et al.1998 Musculoskeletal disorders in dentists N Y State Dent J Not Relevant - Descriptive

Sheon, et al.1997

Repetitive strain injury. 2. Diagnostic and treatment tips on six common problems. The Goff Group Postgrad Med Not Relevant - Descriptive

Tanaka, et al.1997

Association of occupational and non-occupational risk factors with the prevalence of self-reported carpal tunnel syndrome in a national survey of the

working populationAm J Ind Med Not Relevant - Risk/Prevalence Analysis

Bonzani, et al.1997 Factors prolonging disability in work-related cumulative trauma disorders J Hand Surg [Am ] Retrospective

Raffi, et al.1996

Cumulative trauma disorders of the upper limbs in workers on an agricultural farm Arh Hig Rada Toksikol Not Relevant - Risk Analysis




Franklin, et al.1996 Outcomes research in Washington state workers' compensation Am J Ind Med Not Relevant - Post Operative

English, et al.1995

Relations between upper limb soft tissue disorders and repetitive movements at work Am J Ind Med Not Relevant - Risk Analysis

Monsivais, et al.1994 Nonsurgically treated carpal tunnel syndrome in the manual worker Plast Reconstr Surg Not a controlled trial

Bovenzi, et al.1991

Occupational musculoskeletal disorders in the neck and upper limbs of forestry workers exposed to hand-arm vibration Ergonomics Not Relevant - Risk Analysis

Gerr, et al.1991 Upper-extremity musculoskeletal disorders of occupational origin Annu Rev Public Health Not Relevant - Risk Analysis

Morgenstern, et al.1991 A cross-sectional study of hand/wrist symptoms in female grocery checkers Am J Ind Med Gender restricted

Eversmann, et al.1990

Reduction of cumulative trauma disorders by a comprehensive ergonomic program in a major commercial bakery. ASSH Could not retrieve

Morse, et al.1986 Repetitive motion musculoskeletal problems in the microelectronics industry Occup Med Not Relevant - Descriptive

Birkbeck, et al.1975 Occupation in relation to the carpal tunnel syndrome Rheumatol Rehabil Not Relevant - Risk Analysis


Surgical TreatmentExcluded Articles


Bigat, et al.2006

Does dexamethasone improve the quality of intravenous regional anesthesia and analgesia? A randomized, controlled clinical study Anesth Analg Study of anaesthesia/analgesia

Patil, et al.2006

Local anaesthesia for carpal tunnel decompression: a comparison of two techniques J Hand Surg [Br ] Study of anaesthesia/analgesia

Pretto, et al.2005

Endoscopic carpal tunnel release: A comparative study to the conventional open technique Arquivos de Neuro-Psiquiatria Foreign Language

Lorgelly, et al.2005

Carpal tunnel syndrome, the search for a cost-effective surgical intervention: arandomised controlled trial Ann R Coll Surg Engl Retrospective

Kharwadkar, et al.2005

Prospective randomized trial comparing absorbable and non-absorbable sutures in open carpal tunnel release J Hand Surg [Br ] Study of suture type

Menovsky, et al.2004

Skin closure in carpal tunnel surgery: a prospective comparative study between nylon, polyglactin 910 and stainless steel sutures Hand Surg Study of suture type

Mondelli, et al.2004 Outcome of surgical release among diabetics with carpal tunnel syndrome Arch Phys Med Rehabil Not a controlled trial

Alayurt, et al.2004

The addition of sufentanil, tramadol or clonidine to lignocaine for intravenous regional anaesthesia Anaesth Intensive Care Not CTS specific

Zhao, et al.2004

[Comparison of endoscopic versus open surgical treatment of carpal tunnel syndrome]

Zhongguo Yi Xue Ke Xue Yuan Xue Bao Foreign Language

Vossinakis, et al.2004

Reducing the pain associated with local anaesthetic infiltration for open carpal tunnel decompression J Hand Surg [Br ] Study of anaesthesia/analgesia

Edgell, et al.2003 Predicting the outcome of carpal tunnel release J Hand Surg [Am ] Not a controlled trial

Lawrence, et al.2002 Topical anaesthesia to reduce pain associated with carpal tunnel surgery J Hand Surg [Br ] Study of anaesthesia/analgesia

Erel, et al.2001 Absorbable versus non-absorbable suture in carpal tunnel decompression J Hand Surg [Br ] Study of suture type

Concannon, et al.1997 The predictive value of electrodiagnostic studies in carpal tunnel syndrome Plast Reconstr Surg Retrospective


Surgical TreatmentRelevant articles from Scholten, et al. Systematic Review and Thoma, et al. Meta - Analysis


Helm, et al.2003 Evaluation of carpal tunnel release using the Knifelight instrument J Hand Surg [Br]

Ferdinand, et al.2002

Endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome. A prospective, randomised, blinded assessment J Bone Joint Surg Br

Trumble, et al.2001 Endoscopic versus open surgical treatment of carpal tunnel syndrome Neurosurg Clin N Am

Hoefnagels, et al.1997

[Surgical treatment of carpal tunnel syndrome: endoscopic or classical (open)? A prospective randomized trial] Ned Tijdschr Geneeskd

Benedetti, et al.1996

[Agee endoscopic decompression of the median nerve: prospective study with comparison to open decompression] Handchir Mikrochir Plast Chir

Stark, et al.1996

[Endoscopic operation or conventional open surgical technique in carpal tunnel syndrome: a prospective comparative study] Handchir Mikrochir Plast Chir

Jacobsen, et al.1996

A prospective, randomized study with an independent observer comparing open carpal tunnel release with endoscopic carpal tunnel release J Hand Surg [Br ]

Dumontier, et al.1995

Early results of conventional versus two-portal endoscopic carpal tunnel release. A prospective study J Hand Surg [Br ]

Sennwald, et al.1995

The value of one-portal endoscopic carpal tunnel release: a prospective randomized study Knee Surg Sports Traumatol Arthrosc

Erdmann, et al.1994 Endoscopic carpal tunnel decompression J Hand Surg [Br ]

Brown, et al.1993

Carpal tunnel release. A prospective, randomized assessment of open and endoscopic methods J Bone Joint Surg Am

Agee, et al.1992

Endoscopic release of the carpal tunnel: a randomized prospective multicenter study J Hand Surg [Am ]


Surgical TreatmentIncluded Articles


Zyluk, et al.2006 A comparison of two limited open techniques for carpal tunnel release J Hand Surg [Br ]

Forward, et al.2006

Preservation of the ulnar bursa within the carpal tunnel: does it improve the outcome of carpal tunnel surgery? A randomized, controlled trial J Bone Joint Surg Am

Siegmeth, et al.2006

Standard open decompression in carpal tunnel syndrome compared with a modified open technique preserving the superficial skin nerves: a prospective

randomized studyJ Hand Surg [Am ]

Atroshi, et al.2006

Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial BMJ

Rab, et al.2006

Intra-individual comparison between open and 2-portal endoscopic release in clinically matched bilateral carpal syndrome J Plast Reconstr Aesthet Surg

Cellocco, et al.2005

Mini-open blind procedure versus limited open technique for carpal tunnel release: a 30-month follow-up study J Hand Surg [Am ]

Thoma, et al.2004


Dias, et al.2004

Carpal tunnel decompression. Is lengthening of the flexor retinaculum better than simple division? J Hand Surg [Br ]

Bhattacharya, et al.2004 A randomized controlled trial of knifelight and open carpal tunnel release J Hand Surg [Br]


Borisch, et al.2003

Neurophysiological recovery after open carpal tunnel decompression: comparison of simple decompression and decompression with epineurotomy J Hand Surg [Br]

Saw, et al.2003

Early outcome and cost-effectiveness of endoscopic versus open carpal tunnel release: a randomized prospective trial J Hand Surg [Br]

Wong, et al.2003

Carpal tunnel release. A prospective, randomised study of endoscopic versus limited-open methods J Bone Joint Surg Br


Surgical TreatmentStudy Design and Quality


Zyluk, et al.2006 76 RCT Two inicision limited OCTR vs.

Single inicision limited OCTR 12 Months ● ● ● ○ ○ ○ ▫ ▫ ● ● ● ● ▫ Level II

Forward, et al.2006 118 RCT OCTR preserving the ulnar bursa vs.

OCTR 8-9 Weeks ● ● ● ● ● ○ ○ ● ● ● ● ● ● Level I

Siegmeth, et al.2006 42 RCT OCTR preserving skin nerves vs.

OCTR 6 Months ● ● ● ● ● ○ ● ● ● ● ● ● ▫ Level I

Atroshi, et al.2006 128 RCT Two-portal ECTR vs.

OCTR 12 Months ● ● ● ● ○ ○ ○ ● ● ● ● ● ● Level I

Rab, et al.2006 10 RCT Two-portal ECTR vs.

OCTR 12 Months ● ● ● ● ○ ○ ▫ ● ● ● ● ● ▫ Level I

Cellocco, et al.2005 185 RCT Knifelight vs.

Limited OCTR 30 Months ● ● ▫ ▫ ▫ ○ ▫ ● ● ○ ● ● ▫ Level I

Dias, et al.2004 26 RCT OCTR with flexor retinaculum lengthening vs.

OCTR 25 Weeks ● ● ● ● ● ○ ● ● ● ● ● ● ▫ Level I

Bhattacharya, et al.2004 32 RCT Knifelight vs.

OCTR 6 Weeks ● ● ● ▫ ○ ○ ▫ ● ● ● ● ● ▫ Level I

Borisch, et al.2003 273 RCT OCTR with epineurotomy vs.

OCTR 3 Months ▫ ● ▫ ○ ○ ○ ○ ● ● ● ● ● ▫ Level II

Saw, et al.2003 123 RCT Single-portal ECTR vs.

OCTR 12 Weeks ▫ ● ● ● ○ ○ ● ● ● ● ● ● ▫ Level II

Wong, et al.2003 30 RCT Minimal Incision vs.

Two-portal ECTR 12 Months ● ● ▫ ● ○ ○ ○ ● ● ● ● ● ▫ Level I


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Surgical TreatmentPatient Characteristics



RangeAge Std.



Zyluk, et al.2006 All Groups 65 73 48 { 41-60 } NR 50 NR NR NR NR 15 NR NR NR NR 5

Months NR NR NR NR NR

Two incision limited OCTR 33 33 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Single incision limited OCTR 35 40 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Forward, et al.2006 OCTR 58 58 57 NR ± 1.8 40 40 NR NR NR 18 18 NR NR NR NR NR NR NR NR NR

OCTR preserving ulnar bursa 53 53 57 NR ± 2.0 37 37 NR NR NR 16 16 NR NR NR NR NR NR NR NR NR

Siegmeth, et al.2006 OCTR 42 42 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

OCTR preserving skin nerves 42 42 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Atroshi, et al.2006 OCTR 65 65 44 { 25-59 } NR 52 52 NR NR NR 13 13 NR NR NR 36

Months4-240

Months NR 26.7 NR 4.4

Two-portal ECTR 63 63 44 { 26-59 } NR 44 44 NR NR NR 19 19 NR NR NR 36Months

3-240Months NR 27.5 NR 4.5

Rab, et al.2006 OCTR 10 10 56.2 NR ± 8.2 4 4 NR NR NR 6 6 NR NR NR NR NR NR NR NR NR

Two-portal ECTR 10 10 56.2 NR ± 8.2 4 4 NR NR NR 6 6 NR NR NR NR NR NR NR NR NR

Cellocco, et al.2005 Knifelight 82 99 60 { 29-82 } NR 63 NR NR NR NR 19 NR NR NR NR NR NR NR NR NR NR

Limited OCTR 103 123 59 { 31-85 } NR 72 NR NR NR NR 31 NR NR NR NR NR NR NR NR NR NR

All groups 185 222 59 { 29-85 } NR 135 NR NR NR NR 50 NR NR NR NR NR NR NR NR NR NR

Dias, et al.2004 OCTR 26 26 56 { 23-84 } NR 19 19 NR NR NR 7 7 NR NR NR NR NR NR NR NR NR

OCTR with flexor retinaculum lengthening 26 26 56 { 23-84 } NR 19 19 NR NR NR 7 7 NR NR NR NR NR NR NR NR NR

Bhattacharya, et al.2004 Knifelight 26 26 48 NR NR 18 18 NR NR NR 8 8 NR NR NR 1.5

Years0.3-10Years NR NR NR NR

OCTR 26 26 48 NR NR 18 18 NR NR NR 8 8 NR NR NR 1.5Years

0.5-10Years NR NR NR NR

Borisch, et al.2003 OCTR with epineurotomy 147 147 58 NR ± 15 119 119 NR NR NR 28 28 NR NR NR NR NR NR NR NR NR

OCTR 160 160 58 NR ± 15 123 123 NR NR NR 37 37 NR NR NR NR NR NR NR NR NR

Saw, et al.2003 Single-portal ECTR 74 74 54 NR ± 15 53 NR NR NR NR 21 NR NR NR NR NR NR NR NR NR NR

OCTR 76 76 50 NR ± 15 57 NR NR NR NR 19 NR NR NR NR NR NR NR NR NR NR

All Groups 123 150 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Wong, et al.2003 Minimal Incision 30 30 47 { 35-73 } NR 28 28 NR NR NR 2 2 NR NR NR 5.0

Years NR ± 3.6 NR NR NR

ECTR 30 30 47 { 35-73 } NR 28 28 NR NR NR 2 2 NR NR NR 4.2Years NR ± 3.5 NR NR NR



Surgical TreatmentPatient Characteristics


Right Handed


w/ Thenar Atrophy

w/ Axonal Loss

w/ Spontaneous

Remission

Want Surgery

Want Non-Surgical


by

Zyluk, et al.2006 All Groups 65 NR 3 complaints of tender

scars NR NR NR NR NR NR NR NR NR NR

Two incision limited OCTR 33 NR 1 superficial wound infection, 1 CRPS NR NR NR NR NR NR NR NR NR NR

Single incision limited OCTR 35 NR 1 superficial wound

infection NR NR NR NR NR NR NR NR NR NR

Forward, et al.2006 OCTR 58 NR NR 2 revisions, 7 infections 1 57 NR NR NR NR NR NR NR NR

OCTR preserving ulnar bursa 53 NR NR

1 recurrence of symptoms, 1 scar pain for 17 months, 1 wound infection

5 48 NR NR NR NR NR NR NR NR

Siegmeth, et al.2006 OCTR 42 NR NR NR NR NR NR NR NR NR NR NR NR NR

OCTR preserving skin nerves 42 NR NR NR NR NR NR NR NR NR NR NR NR NR

Atroshi, et al.2006 OCTR 65 NR NR NR NR NR NR NR NR NR NR NR NR

Two-portal ECTR 63 NR NR NR NR NR NR NR NR NR NR NR NR

Rab, et al.2006 OCTR 10 NR NR NR NR NR NR NR NR NR NR NR NR

Two-portal ECTR 10 NR NR NR NR NR NR NR NR NR NR NR NR

Cellocco, et al.2005 Knifelight 82 NR NR NR NR NR NR NR NR NR NR NR NR

Limited OCTR 103 NR NR NR NR NR NR NR NR NR NR NR NR

All groups 185 NR NR NR NR NR NR NR NR NR NR NR NR

Dias, et al.2004 OCTR 26 NR 1 CRPS 2 24 NR NR NR NR NR NR NR NR

OCTR with flexor retinaculum lengthening 26 NR 1 superficial wound

infection 2 24 NR NR NR NR NR NR NR NR

Bhattacharya, et al.2004 Knifelight 26 NR NR 1 numbness over the

thenar eminence NR NR NR NR NR NR NR NR NR NR

OCTR 26 NR NR No complications occurred NR NR NR NR NR NR NR NR NR NR

OCTR with epineurotomy 147 NR NR 19 128 NR NR NR NR NR NR NR NR

OCTR 160 NR NR 19 141 NR NR NR NR NR NR NR NR

Saw, et al.2003 Single-portal ECTR 74 NR NR 1 transient numbness (index

finger), 1 incomplete release NR NR NR NR NR NR NR NR NR NR

OCTR 76 NR NR1 hyperaesthesia over the scar area, 1 superficial haematoma, 1 persistence of symptoms after surgery

NR NR NR NR NR NR NR NR NR NR

All Groups 123 NR NR 2 superficial wound infections NR NR NR NR NR NR NR NR NR NR

Wong, et al.2003 Minimal Incision 30 NR NR NR NR NR NR NR NR NR NR NR NR

ECTR 30 NR NR NR NR NR NR NR NR NR NR NR NR

Number of Patients

No complications occurred

3 trigger finger

Of the entire patient population eight (12%) were diabetics, six (8%) had rheumatoid arthritis and 15 (23%) had a history of recent trauma to the affected hand.

Two patients were diabetic

3 repeat surgery




Surgical TreatmentPatient Characteristics - Inclusion/Exclusion Criteria


Zyluk, et al.2006 76 Two inicision limited OCTR vs.

Single inicision limited OCTR

All patients who underwent carpal tunnel surgery between July and December 2003 with diagnosis confirmed by clinical and electrophysiological findings and did not meet other exclusion criteria.

Refusal of participation in the study and recurrent carpal tunnel syndrome.

Forward, et al.2006 118 OCTR preserving the ulnar bursa vs.

OCTR

All patients scheduled to undergo single-side surgery on a dedicated carpal tunnel decompression operating-room schedule between February and March 2002 and between September and November 2003 were invited to take part in the study.

Bilateral CT release and rheumatoid arthritis.

Siegmeth, et al.2006 42 OCTR preserving skin nerves vs.

OCTR

Inclusion criteria were (1) bilateral painful paresthesia in the hand, (2) loss of sensibility in the median nerve distribution, (3) a positive Tinel sign over the median nerve, and (4) a positive phalen test result.

Exclusion criteria were (1) prveious carpal tunnel surgery, (2) inflammatory arthropathy and/or peripheral neuropathy, (3) spine/shoulder or elbow pathology, (4) previous wrist fracture, and (5) age under 18 years.

Atroshi, et al.2006 128 Two-portal ECTR vs.

OCTR

Primary idiopathic carpal tunnel syndrome, age 25-60, currently employed, duration of symptoms at least three months, inadequate response to six weeks' treatment with wrist spline, symptoms of classic or probable carpal tunnel syndrom according to diagnostic criteria in Katz hand diagram, and nerve conduction test showing median neuropathy at the wrist (distal motor latency >4.5ms, wrist-digit sensory latency >3.5ms, or sensory conduciton velocity at the carpal tunnel segment <40 meters/second).

Inflammatory joint disease, diabetes mellitus, thyroid disorder, pregnancy, trauma to the affected hand during the preceding year, carpal tunnel release surgery in the affected hand, carpal tunnel release surgery in the contralateral hand during the preceding year, symptoms of carpal tunnel syndrom in the contralateral hand not adequately relieved by splint at the time of enrollment, current sick leave because of disorders other than carpal tunnel syndrome, and inability to complete questionnaires because of language problem or cognitive disorder.

Rab, et al.2006 10 Two-portal ECTR vs.

OCTR

Bilateral CTS based upon positive history and examinaiton (night pain, Tinel's sign at the wrist, median nerve sensory disturbances) and positive electrophysiological studies [distal latency (DL) and sensory antidromic conduction velocity (S-CV)].

Diabetes, inflammatory conditions, previous hand trauma, and previous carpal tunnel surgery.

Cellocco, et al.2005 185 Knifelight vs.

Limited OCTR

The CT syndrome diagnosis was based on a clinical evaluation and then was confirmed by electrodiagnostic tests.

Not Reported


Surgical TreatmentPatient Characteristics - Inclusion/Exclusion Criteria


Dias, et al.2004 26

OCTR with flexor retinaculum lengthening vs.

OCTR

Patients presenting between May 1999 and August 2000 with bilateral carpal tunnel syndrome who required bilateral surgical decompressions were included in the study. Inclusion criteria included paraesthesia in the median nerve distribution with positive Phalen’s or Tinel’s tests and all patientshad neurophysiological confirmation of slowing of sensory nerve conduction across the wrist.

Other hand disorders which would have affected the outcome measures, if they had other disabling co-morbidities or if they were considered unable to give informed consent either due to language difficulties or mental impairment.

Bhattacharya, et al.2004 32 Knifelight vs.

OCTRTwenty-six patients with bilateral carpal tunnel syndrome requiring operation were selected for the study. Not Reported.

Borisch, et al.2003 273 OCTR with epineurotomy vs.

OCTR

All patients requiring operative treatment for carpal tunnel syndrome between January 1994 and January 1996 who did not fit any exclusionary criteria.

Preesxiting polyneuropathy, an additional operative procedure in the palm and advanced carpal tunnel syndrome (distal motor latency larger than 11ms).

Saw, et al.2003 123 Single-portal ECTR vs.

OCTR

Patients who presented to Norfolk and Norwich or West Norwich Hospitals with a diagonosis of carpal tunnel syndrome based on clinical grounds (nerve conduction tests were performed only when there was clinical doubt).

Patients with previous wrist fractures and surgery, patients with rheumatoid arthritis and other inflammatory conditions, a suspected mass lesion or any patients requiring additional procedures such as biopsy and those less than 16 years of age.

Wong, et al.2003 30 Minimal Incision vs.

Two-portal ECTR

Between July 1999 and August 2000, 30 patients with bilateral idiopathic carpal tunnel syndrome were included in the study. The syndrome was diagnosed clinically according to symptoms and signs, including nocturnal pain, numbness, weakness and positive provocative tests. Reduced nerve conduction velocity (NCV) was confirmed in every case.

Patients with diabetes mellitus, peripheral neuropathy, cervical radiculopathy, thoracic outlet syndrome or a previous injury or operation to the wrist were excluded as were all workers compensation cases.


Surgical TreatmentPatient Characteristics - Workers Compensation



Zyluk, et al.2006 All Groups 65 NR NR NR NR

Two incision limited OCTR 33 NR NR NR NR

Single incision limited OCTR 35 NR NR NR NR

Forward, et al.2006 OCTR 58 NR NR NR NR

OCTR preserving ulnar bursa 53 NR NR NR NR

Siegmeth, et al.2006 OCTR 42 NR NR NR NR

OCTR preserving skin nerves 42 NR NR NR NR

Atroshi, et al.2006 OCTR 65 NR NR NR

Two-portal ECTR 63 NR NR NR

Rab, et al.2006 OCTR 10 NR NR NR NR

Two-portal ECTR 10 NR NR NR NR

Cellocco, et al.2005 Knifelight 82 NR NR NR NR

Limited OCTR 103 NR NR NR NR

All groups 185 NR No patient received workers compensation. NR NR

Dias, et al.2004 OCTR 26 NR NR NR NR

OCTR with flexor retinaculum lengthening 26 NR NR NR NR

Blue collar - 48 (73.9%)White collar - 14 (21.5%)Self employed - 3 (4.6%)


Surgical TreatmentPatient Characteristics - Workers Compensation



Bhattacharya, et al.2004 Knifelight 26 NR NR NR NR

OCTR 26 NR NR NR NR

Borisch, et al.2003 OCTR with epineurotomy 147 NR NR NR NR

OCTR 160 NR NR NR NR

Saw, et al.2003 Single-portal ECTR 74 NR NR NR NR

OCTR 76 NR NR NR NR

All Groups 123 NR NR NR NR

Wong, et al.2003 Minimal Incision 30 NR NR NR

ECTR 30 NR NR NR

Seventeen were housewives, eight were manual workers, and four were non-manual workers.


Surgical TreatmentContinuous Data Results


Zyluk, et al.2006 76 Grip strength (kg) 0 Days Unc Y N Single incision limited

OCTR 35 16.6 NR Two incision limited OCTR 33 18.1 NR NR NR NR NR NR NR

Zyluk, et al.2006 76 Two-point pinch strength (kg) 0 Days Unc Y N Single incision limited


Zyluk, et al.2006 76 Three-point pinch strength (kg) 0 Days Unc Y N Single incision limited


Zyluk, et al.2006 76 Key pinch (kg) 0 Days Unc Y N Single incision limited


Zyluk, et al.2006 76 2 PD-Sensory Index 0 Days N N N Single incision limited


Zyluk, et al.2006 76 Semmes-Weinstein monofilament-Sensory Index 0 Days N N N Single incision limited


Zyluk, et al.2006 76 Levine I: SSS 0 Days Y Y Y Single incision limited


Zyluk, et al.2006 76 Levine II: FSS 0 Days Y Y Y Single incision limited


Zyluk, et al.2006 76 Grip strength (kg) 1 Month Unc Y N Single incision limited


Zyluk, et al.2006 76 Two-point pinch strength (kg) 1 Month Unc Y N Single incision limited


Zyluk, et al.2006 76 Three-point pinch strength (kg) 1 Month Unc Y N Single incision limited


Zyluk, et al.2006 76 Key pinch (kg) 1 Month Unc Y N Single incision limited


Zyluk, et al.2006 76 2 PD-Sensory Index 1 Month N N N Single incision limited


Zyluk, et al.2006 76 Semmes-Weinstein monofilament-Sensory Index 1 Month N N N Single incision limited


Zyluk, et al.2006 76 Levine I: SSS 1 Month Y Y Y Single incision limited


Zyluk, et al.2006 76 Levine II: FSS 1 Month Y Y Y Single incision limited


Zyluk, et al.2006 76 Grip strength (kg) 3 Months Unc Y N Single incision limited


Zyluk, et al.2006 76 Two-point pinch strength (kg) 3 Months Unc Y N Single incision limited


Zyluk, et al.2006 76 Three-point pinch strength (kg) 3 Months Unc Y N Single incision limited


Zyluk, et al.2006 76 Key pinch (kg) 3 Months Unc Y N Single incision limited


Zyluk, et al.2006 76 2 PD-Sensory Index 3 Months N N N Single incision limited


Zyluk, et al.2006 76 Semmes-Weinstein monofilament-Sensory Index 3 Months N N N Single incision limited


Zyluk, et al.2006 76 Levine I: SSS 3 Months Y Y Y Single incision limited


Zyluk, et al.2006 76 Levine II: FSS 3 Months Y Y Y Single incision limited












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Forward, et al.2006 118 PEM (%) 0 Days Y Y Y Ulnar Bursa Preserved 53 54

± 0.3 SD Ulnar Bursa Divided 58 57 ± 0.3 SD NR NR NR NR 0.417 Two-tailed T-test

Forward, et al.2006 118 Grip strength (kg) 0 Days Unc Y N Ulnar Bursa Preserved 53 18.9

± 1.7 SD Ulnar Bursa Divided 58 20.0 ± 1.7 SD NR NR NR NR 0.628 Two-tailed T-test

Forward, et al.2006 118 Key pinch (kg) 0 Days Unc Y N Ulnar Bursa Preserved 53 4.1


Forward, et al.2006 118 Tip pinch (kg) 0 Days Unc Y N Ulnar Bursa Preserved 53 3.6


Forward, et al.2006 118 PEM (%) 8-9 Weeks Y Y Y Ulnar Bursa Preserved 53 26

{21 - 32} 95% CI Ulnar Bursa Divided 58 25 {20 - 30} 95% CI NR NR NR NR 0.990 Two-tailed T-test

Forward, et al.2006 118 Grip strength (kg) 8-9 Weeks Unc Y N Ulnar Bursa Preserved 53 13.2

{10.7 - 15.7} 95% CI Ulnar Bursa Divided 58 14.7 {11.3 - 18.2} 95% CI NR NR NR NR 0.661 Two-tailed T-test

Forward, et al.2006 118 Key pinch (kg) 8-9 Weeks Unc Y Y Ulnar Bursa Preserved 53 2.9


Forward, et al.2006 118 Tip pinch (kg) 8-9 Weeks Unc Y N Ulnar Bursa Preserved 53 2.8


Forward, et al.2006 118 Scar Pain (VAS) 8-9 Weeks Y Y Y Ulnar Bursa Preserved 53 3.1


Siegmeth, et al.2006 42 PEM-difference from preop (%) 6 Weeks Y Y Y OCTR preserving skin

nerves 42 -20 NR OCTR 42 -20 NR NR NR NR NR 0.93 Wilcoxon

Siegmeth, et al.2006 42 PEM-difference from preop (%) 3 Months Y Y Y OCTR preserving skin


Siegmeth, et al.2006 42 PEM-difference from preop (%) 6 Months Y Y Y OCTR preserving skin


Siegmeth, et al.2006 42 Scar Pain (VAS) 6 Weeks Y Y Y OCTR preserving skin

nerves 42 3 NR OCTR 42 3 NR NR NR NR NR 0.73 Wilcoxon

Siegmeth, et al.2006 42 Scar Pain (VAS) 3 Months Y Y Y OCTR preserving skin


Siegmeth, et al.2006 42 Scar Pain (VAS) 6 Months Y Y Y OCTR preserving skin





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Atroshi, et al.2006 128 Postoperative pain score (SF-36) 3 Weeks Y Y Y OCTR 65 60.5

± 23 SD ECTR 63 52.1 ± 23 SD 8.6

{1.0 - 16.3} 95% CI NR NR 0.028 NR

Atroshi, et al.2006 128 Levine I: SSS 3 Months Y Y Y OCTR 65 1.6

± 0.5 SD ECTR 63 1.5 ± 0.5 SD NR NR 0.07

{-0.11 - 0.24} 95% CI 0.44 NR

Atroshi, et al.2006 128 Levine I: SSS 12 Months Y Y Y OCTR 65 1.5

± 0.5 SD ECTR 61 1.4 ± 0.5 SD NR NR 0.005

{-0.18 - 0.17} 95% CI 0.96 NR

Atroshi, et al.2006 128 Levine II: FSS 0 Days Y Y Y OCTR 65 2.4

± 0.8 SD ECTR 63 2.4 ± 0.8 SD NR NR NR NR NR NR

Atroshi, et al.2006 128 Levine II: FSS 3 Weeks Y Y Y OCTR 65 2.3

± 0.9 SD ECTR 63 2.055 ± 0.8 SD NR NR 0.22

{0.04 - 0.41} 95% CI 0.02 NR

Atroshi, et al.2006 128 Levine II: FSS 6 Weeks Y Y Y OCTR 65 1.6

± 0.5 SD ECTR 63 1.5 ± 0.5 SD NR NR 0.07

{-0.12 - 0.25} 95% CI 0.48 NR

Atroshi, et al.2006 128 Levine II: FSS 3 Months Y Y Y OCTR 65 1.3

± 0.4 SD ECTR 63 1.4 ± 0.4 SD NR NR -0.02

{-0.21 - 0.14} 95% CI 0.82 NR

Atroshi, et al.2006 128 Levine II: FSS 12 Months Y Y Y OCTR 65 1.2

± 0.4 SD ECTR 61 1.24 ± 0.5 SD NR NR -0.08

{-0.27 - 0.11} 95% CI 0.43 NR

Atroshi, et al.2006 128 SF-12 0 Days Y Y Y OCTR 65 42.5

± 9 SD ECTR 63 44.2 ± 8 SD NR NR NR NR NR NR

Atroshi, et al.2006 128 SF-12 3 Months Y Y Y OCTR 65 49.3

± 9 SD ECTR 63 50.7 ± 8 SD NR NR -1.1

{-4.1 - 1.9} 95% CI 0.48 NR

Atroshi, et al.2006 128 SF-12 12 Months Y Y Y OCTR 65 49.8

± 10 SD ECTR 61 50.1 ± 9 SD NR NR 0.43

{-2.6 - 3.5} 95% CI 0.78 NR

Atroshi, et al.2006 128 Postoperative Work Absence (not on leave preop)

(days) NR Y Y Y OCTR 59 33 ± 19 SD ECTR 53 28

± 16 SD NR NR NR NR NR NR

Atroshi, et al.2006 128 Postoperative Work Absence (on leave preop)

(days) NR Y Y Y OCTR 6 76 ± 74 SD ECTR 10 84

± 62 SD NR NR NR NR NR NR

Atroshi, et al.2006 128 Semmes-Weinstein monofilament (median) 0 Days N Y N OCTR 65 2.0


Atroshi, et al.2006 128 Semmes-Weinstein monofilament (median) 3 Weeks N Y N OCTR 65 1.5


Atroshi, et al.2006 128 Semmes-Weinstein monofilament (median) 6 Weeks N Y N OCTR 65 1.4


Atroshi, et al.2006 128 Semmes-Weinstein monofilament (median) 3 Months N Y N OCTR 65 1.5


Atroshi, et al.2006 128 Semmes-Weinstein monofilament (ulnar) 0 Days N Y N OCTR 65 1.5


Atroshi, et al.2006 128 Semmes-Weinstein monofilament (ulnar) 3 Weeks N Y N OCTR 65 1.3


Atroshi, et al.2006 128 Semmes-Weinstein monofilament (ulnar) 6 Weeks N Y N OCTR 65 1.2


Atroshi, et al.2006 128 Semmes-Weinstein monofilament (ulnar) 3 Months N Y N OCTR 65 1.2


Atroshi, et al.2006 128 2 PD-median (mm) 0 Days N Y N OCTR 65 4.5





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Atroshi, et al.2006 128 2 PD-median (mm) 3 Weeks N Y N OCTR 65 4.1


Atroshi, et al.2006 128 2 PD-median (mm) 6 Weeks N Y N OCTR 65 4.1


Atroshi, et al.2006 128 2 PD-median (mm) 3 Months N Y N OCTR 65 4.1


Atroshi, et al.2006 128 2 PD-ulnar (mm) 0 Days N Y N OCTR 65 4.3


Atroshi, et al.2006 128 2 PD-ulnar (mm) 3 Weeks N Y N OCTR 65 4.2


Atroshi, et al.2006 128 2 PD-ulnar (mm) 6 Weeks N Y N OCTR 65 4.2


Atroshi, et al.2006 128 2 PD-ulnar (mm) 3 Months N Y N OCTR 65 4.1


Atroshi, et al.2006 128 Grip strength (lbs) 0 Days Y Y N OCTR 65 31.2

± 11 SD ECTR 63 32.6 ± 14 SD NR NR NR NR NR NR

Atroshi, et al.2006 128 Grip strength (lbs) 3 Weeks Unc Y N OCTR 65 17.4

± 9 SD ECTR 63 20.7 ± 10 SD NR NR -2.1

{-4.4 - 0.2} 95% CI 0.073 NR

Atroshi, et al.2006 128 Grip strength (lbs) 6 Weeks Unc Y N OCTR 65 24.6

± 10 SD ECTR 63 26.8 ± 11 SD NR NR -1.2

{-3.5 - 1.1} 95% CI 0.30 NR

Atroshi, et al.2006 128 Grip strength (lbs) 3 Months Unc Y N OCTR 65 29.9

± 11 SD ECTR 63 31.5 ± 11 SD NR NR -0.5

{-2.8 - 1.8} 95% CI 0.69 NR

Atroshi, et al.2006 128 Pinch Strength (lbs) 0 Days Unc Y N OCTR 65 5.0


Atroshi, et al.2006 128 Pinch Strength (lbs) 3 Weeks Unc Y N OCTR 65 4.3

± 1.9 SD ECTR 63 5.2 ± 2.2 SD NR NR -0.4

{-0.9 - 0.1} 95% CI 0.095 NR

Atroshi, et al.2006 128 Pinch Strength (lbs) 6 Weeks Unc Y N OCTR 65 5.3

± 1.8 SD ECTR 63 6.2 ± 2.1 SD NR NR -0.4

{-0.9 - 0.04} 95% CI 0.070 NR

Atroshi, et al.2006 128 Pinch Strength (lbs) 3 Months Unc Y N OCTR 65 6.0

± 1.8 SD ECTR 63 6.7 ± 2.2 SD NR NR -0.3

{-0.8 - 0.2} 95% CI 0.15 NR

Atroshi, et al.2006 128 Levine I: SSS 3 Weeks Y Y Y OCTR 65 1.9

± 0.5 SD ECTR 63 1.8 ± 0.5 SD NR NR -0.003

{-0.18 - 0.17} 95% CI NR NR

Atroshi, et al.2006 128 Levine I: SSS 6 Weeks Y Y Y OCTR 65 1.8

± 0.5 SD ECTR 63 1.7 ± 0.5 SD NR NR 0.05

{-0.12 - 0.23} 95% CI 0.57 NR

Atroshi, et al.2006 128 Postoperative pain score (SF-36) 6 Weeks Y Y Y OCTR 65 51.3

± 23 SD ECTR 63 43.3 ± 23 SD 8.7

{1.0 - 16.4} 95% CI NR NR 0.030 NR

Atroshi, et al.2006 128 Postoperative pain score (SF-36) 3 Months Y Y Y OCTR 65 36.2

± 20 SD ECTR 63 23.5 ± 26 SD 13.3

{5.3 - 21.3} 95% CI NR NR 0.001 NR

Atroshi, et al.2006 128 Postoperative pain score (SF-36) 12 Months Y Y Y OCTR 65 13.9

± 22 SD ECTR 61 8.7 ± 21 SD 5.8

{1.7 - 13.3} 95% CI NR NR 0.13 NR

Atroshi, et al.2006 128 Levine I: SSS 0 Days Y Y Y OCTR 65 3.1


Atroshi, et al.2006 128 Postoperative Work Absence (Whole) NR Y Y Y OCTR 65 37.0





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Rab, et al.2006 10 VAS 12 Weeks Y Y Y OCTR 10 1.7 NR 2-Portal ECTR 10 0.3 NR NR NR NR NR 0.10 NR

Rab, et al.2006 10 Levine I: SSS 12 Weeks Y Y Y OCTR 10 16.8 NR 2-Portal ECTR 10 14.7 NR NR NR NR NR 0.27 NR

Rab, et al.2006 10 Levine II: FSS 12 Weeks Y Y Y OCTR 10 12.3 NR 2-Portal ECTR 10 10.3 NR NR NR NR NR 0.16 NR

Rab, et al.2006 10 Grip strength (kg) 12 Weeks Unc Y N OCTR 10 12.3 NR 2-Portal ECTR 10 13.5 NR NR NR NR NR 0.67 NR

Rab, et al.2006 10 Pinch Strength (kg) 12 Weeks Unc Y N OCTR 10 2.4 NR 2-Portal ECTR 10 3.0 NR NR NR NR NR 0.23 NR

Rab, et al.2006 10 Key grip (kg) 12 Weeks Unc Y N OCTR 10 3.2 NR 2-Portal ECTR 10 4.3 NR NR NR NR NR 0.16 NR

Rab, et al.2006 10 2 PD-index (mm) 12 Weeks N Y N OCTR 10 3.9 NR 2-Portal ECTR 10 3.9 NR NR NR NR NR 1.00 NR

Rab, et al.2006 10 2 PD-dig. V (mm) 12 Weeks N Y N OCTR 10 3.8 NR 2-Portal ECTR 10 4.6 NR NR NR NR NR 0.31 NR

Rab, et al.2006 10 2P-PSSD-index (g/mm^2) 12 Weeks N Y N OCTR 10 1.5 NR 2-Portal ECTR 10 2.2 NR NR NR NR NR 0.35 NR

Rab, et al.2006 10 2P-PSSD-dig.V (g/mm^2) 12 Weeks N Y N OCTR 10 1.5 NR 2-Portal ECTR 10 1.7 NR NR NR NR NR 0.82 NR

Rab, et al.2006 10 DL (ms) 12 Weeks N Y N OCTR 10 5.3 NR 2-Portal ECTR 10 5.0 NR NR NR NR NR 0.54 NR

Rab, et al.2006 10 S-NV (m/s) 12 Weeks N Y N OCTR 10 40.3 NR 2-Portal ECTR 10 35.8 NR NR NR NR NR 0.36 NR

Rab, et al.2006 10 VAS 12 Months Y Y Y OCTR 10 0.2 NR 2-Portal ECTR 10 0.6 NR NR NR NR NR 0.43 NR

Rab, et al.2006 10 Levine I: SSS 12 Months Y Y Y OCTR 10 12.8 NR 2-Portal ECTR 10 14.0 NR NR NR NR NR 0.49 NR

Rab, et al.2006 10 Levine II: FSS 12 Months Y Y Y OCTR 10 9.9 NR 2-Portal ECTR 10 11.1 NR NR NR NR NR 0.39 NR

Rab, et al.2006 10 Grip strength (kg) 12 Months Unc Y N OCTR 10 18.0 NR 2-Portal ECTR 10 13.8 NR NR NR NR NR 0.21 NR

Rab, et al.2006 10 Pinch Strength (kg) 12 Months Unc Y N OCTR 10 3.1 NR 2-Portal ECTR 10 3.1 NR NR NR NR NR 0.83 NR

Rab, et al.2006 10 Key grip (kg) 12 Months Unc Y N OCTR 10 4.9 NR 2-Portal ECTR 10 4.9 NR NR NR NR NR 1.00 NR

Rab, et al.2006 10 2 PD-index (mm) 12 Months N Y N OCTR 10 4.0 NR 2-Portal ECTR 10 3.3 NR NR NR NR NR 0.26 NR

Rab, et al.2006 10 2 PD-dig. V (mm) 12 Months N Y N OCTR 10 3.7 NR 2-Portal ECTR 10 3.2 NR NR NR NR NR 0.46 NR

Rab, et al.2006 10 2P-PSSD-index (g/mm^2) 12 Months N Y N OCTR 10 2.5 NR 2-Portal ECTR 10 2.3 NR NR NR NR NR 0.84 NR

Rab, et al.2006 10 2P-PSSD-dig.V (g/mm^2) 12 Months N Y N OCTR 10 1.4 NR 2-Portal ECTR 10 1.4 NR NR NR NR NR 0.91 NR

Rab, et al.2006 10 DL (ms) 12 Months N Y N OCTR 10 4.8 NR 2-Portal ECTR 10 4.6 NR NR NR NR NR 0.49 NR

Rab, et al.2006 10 S-NV (m/s) 12 Months N Y N OCTR 10 42.9 NR 2-Portal ECTR 10 41.7 NR NR NR NR NR 0.81 NR




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Cellocco, et al.2005 185 BCTi (modified Italian version) - SSS 0 Days Y Y Y Knifelight 82 3.84 NR Limited OCTR 103 3.66 NR NR NR NR NR NR NR

Cellocco, et al.2005 185 BCTi (modified Italian version) - SSS 19 Months Y Y Y Knifelight 82 1.46 NR Limited OCTR 103 2.04 NR NR NR NR NR <0.001 Two-tailed T-test

Cellocco, et al.2005 185 BCTi (modified Italian version) - SSS 30 Months Y Y Y Knifelight 82 1.28 NR Limited OCTR 103 1.39 NR NR NR NR NR NR NR

Cellocco, et al.2005 185 BCTi (modified Italian version) - FSS 0 Days Y Y Y Knifelight 82 3.86 NR Limited OCTR 103 3.79 NR NR NR NR NR NR NR

Cellocco, et al.2005 185 BCTi (modified Italian version) - FSS 19 Months Y Y Y Knifelight 82 2.02 NR Limited OCTR 103 2.53 NR NR NR NR NR <0.001 Two-tailed T-test

Cellocco, et al.2005 185 BCTi (modified Italian version) - FSS 30 Months Y Y Y Knifelight 82 1.87 NR Limited OCTR 103 1.73 NR NR NR NR NR NR NR

Cellocco, et al.2005 185 Postoperative Work Absence NR Y Y N Knifelight 82 16.6 NR Limited OCTR 103 25.4 NR NR NR NR NR <0.001 Two-tailed T-test

Cellocco, et al.2005 185 2 PD (mm) 30 Months N Y N Knifelight 82 4.7 NR Limited OCTR 103 4.3 NR NR NR NR NR NR NR

Dias, et al.2004 26 Levine I: SSS 0 Days Y Y Y F-R Division 26 3.1

{2.8 - 3.4} 95% CI F-R Lengthening 26 2.8 {2.5 - 3.1} 95% CI NR NR NR NR NR NR

Dias, et al.2004 26 Levine II: FSS 0 Days Y Y Y F-R Division 26 2.7


Dias, et al.2004 26 Jebsons Test (sec) 0 Days N Y N F-R Division 24 81.5


Dias, et al.2004 26 Levine I: SSS 2 Weeks Y Y Y F-R Division 26 1.3


Dias, et al.2004 26 Levine II: FSS 2 Weeks Y Y Y F-R Division 26 1.6


Dias, et al.2004 26 Jebsons Test (sec) 2 Weeks N Y N F-R Division 26 75.0



















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Dias, et al.2004 26 Grip strength (kg) 0 Days Unc Y N F-R Division 26 17.8


Dias, et al.2004 26 Pinch Strength (kg) 0 Days Unc Y N F-R Division 26 4.9


Dias, et al.2004 26 Grip strength (kg) 2 Weeks Unc Y N F-R Division 26 12.7


Dias, et al.2004 26 Pinch Strength (kg) 2 Weeks Unc Y N F-R Division 26 5.2











{17.8 - 24.6} 95% CI F-R Lengthening 2621.5

{18.1 - 25 0}

95% CI NR NR NR NR NR NR



Dias, et al.2004 26 Levine I: SSS NR Y Y Y F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR NR 0.63 ANOVA

Dias, et al.2004 26 Levine II: FSS NR Y Y Y F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR NR 0.90 ANOVA

Dias, et al.2004 26 Grip strength (kg) NR Unc Y N F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR NR 0.45 ANOVA

Dias, et al.2004 26 Jebsons Test (sec) NR N Y N F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR NR 0.33 ANOVA

Dias, et al.2004 26 Pinch Strength (kg) NR Unc Y N F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR NR 0.94 ANOVA

Dias, et al.2004 26 Wrist stiffness (sum of goni measures) (degrees) 0 Weeks Y Unc N F-R Division 26 197

{187 - 207} 95% CI F-R Lengthening 26 197 {187 - 207} 95% CI NR NR NR NR NR NR







Dias, et al.2004 26 Wrist stiffness (sum of goni measures) (degrees) 25 Weeks Y Unc Y F-R Division 26 196


Dias, et al.2004 26 Wrist stiffness (sum of goni measures) (degrees) NR Y Unc Y F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR NR 0.41 ANOVA

Bhattacharya, et al.2004 32 Return to Work (weeks) NR Y Y N Knifelight 26 2.0 NR OCTR 26 2.0 NR NR NR NR NR 0.80 NR

Borisch, et al.2003 273 Distal Motor Latency (mm) 0 Days N Y N OCTR with

epineurotomy 147 6.0 ± 1.6 SD OCTR without

epineurotomy 157 6.3 ± 1.6 SD NR NR NR NR NR NR

Borisch, et al.2003 273 Distal Motor Latency (mm) 3-12 Months N Y N OCTR with


epineurotomy 124 4.8 ± 1.0 SD NR NR NR NR 0.35 Mann-Whitney U-test

Borisch, et al.2003 273 Sensory Conduction Velocity (m/s) 0 Days N Y N OCTR with


epineurotomy 80 37.0 ± 1.0 SD NR NR NR NR NR NR

Borisch, et al.2003 273 Sensory Conduction Velocity (m/s) 3-12 Months N Y N OCTR with


epineurotomy 70 43.3 ± 5.6 SD NR NR NR NR 0.52 Mann-Whitney U-test




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Saw, et al.2003 123 Return to Work (days) NR Unc Y N ECTR 74 18

± 11 SD OCTR 76 26 ± 14 SD -8

{-13 - -2} 95% CI NR NR 0.005 Two-tailed T-test

Saw, et al.2003 123 Grip strength (kg) 0 Days Unc Y N ECTR 74 26

± 12 SD OCTR 76 27 ± 11 SD NR NR NR NR NR NR

Saw, et al.2003 123 Grip strength (kg) 1 Weeks Unc Y N ECTR 74 13 NR OCTR 76 12 NR NR NR NR NR NR NR

Saw, et al.2003 123 Grip strength (kg) 3 Weeks Unc Y N ECTR 74 22 NR OCTR 76 18.5 NR NR NR NR NR NR NR



Saw, et al.2003 123 Anterior Carpal Tenderness (VAS) 0 Days Unc Y Y ECTR 74 0 NR OCTR 76 0 NR NR NR NR NR NR NR

Saw, et al.2003 123 Anterior Carpal Tenderness (VAS) 1 Weeks Unc Y Y ECTR 74 2 NR OCTR 76 3 NR NR NR NR NR NR NR

Saw, et al.2003 123 Anterior Carpal Tenderness (VAS) 3 Weeks Unc Y Y ECTR 74 2 NR OCTR 76 2.1 NR NR NR NR NR NR NR



Saw, et al.2003 123 Operation Time (min) NR N Y N ECTR 74 15.8


Wong, et al.2003 30 2 PD (mm) 12 Weeks N Y N Minimal Incision 30 3.3 NR ECTR 30 3.1 NR NR NR NR NR NR NR

Wong, et al.2003 30 2 PD (mm) 6 Months N Y N Minimal Incision 30 3 NR ECTR 30 2.7 NR NR NR NR NR NR NR

Wong, et al.2003 30 2 PD (mm) 1 Years N Y N Minimal Incision 30 2.8 NR ECTR 30 2.5 NR NR NR NR NR NR NR

Wong, et al.2003 30 Postoperative pain (VAS) 16 Weeks Y Y Y Minimal Incision 30 0.6 NR ECTR 30 0.55 NR NR NR NR NR NR NR

Wong, et al.2003 30 Postoperative pain (VAS) 6-12 Months Y Y Y Minimal Incision 30 0.30 NR ECTR 30 0.22 NR NR NR NR NR NR NR

Wong, et al.2003 30 Postoperative pain (VAS) 8 Weeks Y Y Y Minimal Incision 30 1.37 NR ECTR 30 1.12 NR NR NR NR NR NR NR

Wong, et al.2003 30 Operation Time (min) NR N Unc N Minimal Incision 30 12.9

± 5.1 SD ECTR 30 12.9 ± 4.9 SD NR NR NR NR 0.96 NR

Wong, et al.2003 30 Postoperative pain (VAS) 2 Weeks Y Y Y Minimal Incision 30 2.5 NR ECTR 30 3.3 NR NR NR NR NR 0.004 Two-tailed T-test

Wong, et al.2003 30 Postoperative pain (VAS) 4 Weeks Y Y Y Minimal Incision 30 1.5 NR ECTR 30 2.5 NR NR NR NR NR 0.008 Two-tailed T-test

Wong, et al.2003 30 2 PD (mm) 4 Weeks N Y N Minimal Incision 30 2.9 NR ECTR 30 2.9 NR NR NR NR NR NR NR


Surgical TreatmentDichotomous Data Results


Zyluk, et al.2006 76 Grip strength (kg) 0 Days Unc Y N Percentage of Preop Single incision limited

OCTR 35 100 NR Two incision limited OCTR 33 100 NR NR NR NR NR NR

Zyluk, et al.2006 76 Two-point pinch strength (kg) 0 Days Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Three-point pinch strength (kg) 0 Days Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Key pinch (kg) 0 Days Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 2 PD-Sensory Index 0 Days N N N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Semmes-Weinstein monofilament-Sensory Index 0 Days N N N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Levine I: SSS 0 Days Y Y Y Percentage of Preop Single incision limited


Zyluk, et al.2006 76 FSS 0 Days Y Y Y Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Grip strength (kg) 1 Month Unc Y N Percentage of Preop Single incision limited

OCTR 35 97 NR Two incision limited OCTR 33 82 NR NR NR NR <0.05 Mann-Whitney

Wilcoxon

Zyluk, et al.2006 76 Two-point pinch strength (kg) 1 Month Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Three-point pinch strength (kg) 1 Month Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Key pinch (kg) 1 Month Unc Y N Percentage of Preop Single incision limited

OCTR 35 99 NR Two incision limited OCTR 33 86 NR NR NR NR <0.005 Mann-Whitney

Wilcoxon

Zyluk, et al.2006 76 2 PD-Sensory Index 1 Month N N N Percentage of Preop Single incision limited

OCTR 35 82 NR Two incision limited OCTR 33 85 NR NR NR NR >0.2 Mann-Whitney

Wilcoxon

Zyluk, et al.2006 76 Semmes-Weinstein monofilament-Sensory Index 1 Month N N N Percentage of Preop Single incision limited


Wilcoxon

Zyluk, et al.2006 76 Levine I: SSS 1 Month Y Y Y Percentage of Preop Single incision limited


Wilcoxon

Zyluk, et al.2006 76 FSS 1 Month Y Y Y Percentage of Preop Single incision limited


Wilcoxon

Zyluk, et al.2006 76 Grip strength (kg) 3 Months Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Two-point pinch strength (kg) 3 Months Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Three-point pinch strength (kg) 3 Months Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 Key pinch (kg) 3 Months Unc Y N Percentage of Preop Single incision limited


Zyluk, et al.2006 76 2 PD-Sensory Index 3 Months N N N Percentage of Preop Single incision limited


Wilcoxon

Zyluk, et al.2006 76 Semmes-Weinstein monofilament-Sensory Index 3 Months N N N Percentage of Preop Single incision limited


Wilcoxon

Zyluk, et al.2006 76 Levine I: SSS 3 Months Y Y Y Percentage of Preop Single incision limited


Wilcoxon

Zyluk, et al.2006 76 FSS 3 Months Y Y Y Percentage of Preop Single incision limited


Wilcoxon











Wilcoxon



Wilcoxon



Wilcoxon

Zyluk, et al.2006 76 FSS 6 Months Y Y Y Percentage of Preop Single incision limited


Wilcoxon





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Wilcoxon



Wilcoxon



Wilcoxon

Atroshi, et al.2006 128 2 PD-median-4mm (mm) 0 Days N Y N Number OCTR 63 38 NR ECTR 63 35 NR NR NR NR NR NR

Atroshi, et al.2006 128 2 PD-median (mm) 0 Days N Y N Number at 6mm OCTR 63 18 NR ECTR 63 20 NR NR NR NR NR NR

Atroshi, et al.2006 128 2 PD-median (mm) 0 Days N Y N Number at >8mm OCTR 63 7 NR ECTR 63 8 NR NR NR NR NR NR

Atroshi, et al.2006 128 2 PD-median (mm) 3 Weeks N Y N Number at 4mm OCTR 64 50 NR ECTR 63 49 NR NR NR NR NR NR


Atroshi, et al.2006 128 2 PD-median (mm) 3 Weeks N Y N Number at >8mm OCTR 64 0 NR ECTR 63 2 NR NR NR NR NR NR



Atroshi, et al.2006 128 2 PD-median (mm) 6 Weeks N Y N Number at >8mm OCTR 64 0 NR ECTR 63 0 NR NR NR NR NR NR

Atroshi, et al.2006 128 2 PD-median (mm) 3 Months N Y N Number at 4mm OCTR 61 51 NR ECTR 63 51 NR NR NR NR NR NR

Atroshi, et al.2006 128 2 PD-median (mm) 3 Months N Y N Number at 6mm OCTR 61 10 NR ECTR 63 11 NR NR NR NR NR NR

Atroshi, et al.2006 128 2 PD-median (mm) 3 Months N Y N Number at >8mm OCTR 61 0 NR ECTR 63 1 NR NR NR NR NR NR

Atroshi, et al.2006 128 No Postoperative Pain (SF-36) 3 Weeks Y Y Y Percentage OCTR 63 12 NR ECTR 65 6 NR NR NR NR NR NR

Atroshi, et al.2006 128 Mild postoperative pain (SF-36) 3 Weeks Y Y Y Percentage OCTR 63 42 NR ECTR 65 28 NR NR NR NR NR NR

Atroshi, et al.2006 128 Moderate or severe postoperative pain (SF-36) 3 Weeks Y Y Y Percentage OCTR 63 46 NR ECTR 65 66 NR NR NR NR NR NR

Atroshi, et al.2006 128 No Postoperative Pain (SF-36) 6 Weeks Y Y Y Percentage OCTR 63 15 NR ECTR 65 6 NR NR NR NR NR NR

Atroshi, et al.2006 128 Mild postoperative pain (SF-36) 6 Weeks Y Y Y Percentage OCTR 63 53 NR ECTR 65 47 NR NR NR NR NR NR

Atroshi, et al.2006 128 Moderate or severe postoperative pain (SF-36) 6 Weeks Y Y Y Percentage OCTR 63 32 NR ECTR 65 47 NR NR NR NR NR NR

Atroshi, et al.2006 128 No Postoperative Pain (SF-36) 3 Months Y Y Y Percentage OCTR 63 48 NR ECTR 65 19 NR NR NR NR NR NR

Atroshi, et al.2006 128 Mild postoperative pain (SF-36) 3 Months Y Y Y Percentage OCTR 63 39 NR ECTR 65 66 NR NR NR NR NR NR

Atroshi, et al.2006 128 Moderate or severe postoperative pain (SF-36) 3 Months Y Y Y Percentage OCTR 63 13 NR ECTR 65 15 NR NR NR NR NR NR

Atroshi, et al.2006 128 No Postoperative Pain (SF-36) 12 Months Y Y Y Percentage OCTR 63 84 NR ECTR 65 66 NR NR NR NR NR NR

Atroshi, et al.2006 128 Mild postoperative pain (SF-36) 12 Months Y Y Y Percentage OCTR 63 8 NR ECTR 65 31 NR NR NR NR NR NR

Atroshi, et al.2006 128 Moderate or severe postoperative pain (SF-36) 12 Months Y Y Y Percentage OCTR 63 6 NR ECTR 65 3 NR NR NR NR NR NR

Cellocco, et al.2005 185 Recurrent Disease 30 Months Y Y Y Number Knifelight 82 1 NR Limited OCTR 103 7 NR NR NR NR <0.01 Two-tailed T-test

Cellocco, et al.2005 185 Subjective satisfaction-good/excellent 30 Months Y N Y Number of Hands Knifelight 82 99 NR Limited OCTR 103 96 NR NR NR NR NR NR

Cellocco, et al.2005 185 Subjective satisfaction-fair 30 Months Y N Y Number of Hands Knifelight 82 0 NR Limited OCTR 103 23 NR NR NR NR NR NR

Cellocco, et al.2005 185 Subjective satisfaction-poor 30 Months Y N Y Number of Hands Knifelight 82 0 NR Limited OCTR 103 4 NR NR NR NR NR NR

Dias, et al.2004 26 Positive Phalens Test 0 Days N Y N Number F-R Division 26 25 NR F-R Lengthening 26 24 NR NR NR NR 0.51 Chi Square




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Dias, et al.2004 26 Positive Phalens Test 2 Weeks N Y N Number F-R Division 26 4 NR F-R Lengthening 26 4 NR NR NR NR 0.76 Chi Square

Dias, et al.2004 26 Positive Phalens Test 6 Weeks N Y N Number F-R Division 26 1 NR F-R Lengthening 26 1 NR NR NR NR 1 Chi Square

Dias, et al.2004 26 Positive Phalens Test 12 Weeks N Y N Number F-R Division 26 1 NR F-R Lengthening 26 0 NR NR NR NR 1 Chi Square

Dias, et al.2004 26 Positive Phalens Test 25 Weeks N Y N Number F-R Division 26 1 NR F-R Lengthening 26 1 NR NR NR NR 0.37 Chi Square

Dias, et al.2004 26 No ulnar pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 20 NR F-R Lengthening 26 21 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Mild ulnar pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 6 NR F-R Lengthening 26 4 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Moderate ulnar pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 0 NR F-R Lengthening 26 1 NR NR NR NR NR Chi Square










Dias, et al.2004 26 Ulnar pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR 0.49 Chi Square




Dias, et al.2004 26 No radial pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 16 NR F-R Lengthening 26 20 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Mild radial pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 7 NR F-R Lengthening 26 2 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Moderate radial pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 3 NR F-R Lengthening 26 4 NR NR NR NR NR Chi Square










Dias, et al.2004 26 Radial pillar tenderness 2 Weeks Y Unc Y Number F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR 0.19 Chi Square

Dias, et al.2004 26 Radial pillar tenderness 6 Weeks Y Unc Y Number F-R Division 26 0.71 NR F-R Lengthening 26 NR NR NR NR NR NR Chi Square




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Dias, et al.2004 26 No scar tenderness 2 Weeks Y Unc Y Number F-R Division 26 8 NR F-R Lengthening 26 7 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Mild scar tenderness 2 Weeks Y Unc Y Number F-R Division 26 13 NR F-R Lengthening 26 16 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Moderate scar tenderness 2 Weeks Y Unc Y Number F-R Division 26 4 NR F-R Lengthening 26 2 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Severe Scar Tenderness 2 Weeks Y Unc Y Number F-R Division 26 1 NR F-R Lengthening 26 1 NR NR NR NR NR Chi Square














Dias, et al.2004 26 Scar Tenderness 2 Weeks Y Unc Y Number F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR 0.19 Chi Square




Dias, et al.2004 26 Hypersensitivity 2 Weeks Y Unc Y Number F-R Division 26 2 NR F-R Lengthening 26 1 NR NR NR NR 0.84 Chi Square


Dias, et al.2004 26 Hypersensitivity 12 Weeks Y Unc Y Number F-R Division 25 1 NR F-R Lengthening 25 0 NR NR NR NR NR Chi Square


Dias, et al.2004 26 No wrist stiffness 2 Weeks Y Unc Y Number F-R Division 26 13 NR F-R Lengthening 26 12 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Mild wrist stiffness 2 Weeks Y Unc Y Number F-R Division 26 10 NR F-R Lengthening 26 9 NR NR NR NR NR Chi Square

Dias, et al.2004 26 Moderate wrist stiffness 2 Weeks Y Unc Y Number F-R Division 26 3 NR F-R Lengthening 26 5 NR NR NR NR NR Chi Square








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Dias, et al.2004 26 Wrist stiffness 2 Weeks Y Unc Y Number F-R Division 26 NR NR F-R Lengthening 26 NR NR NR NR NR 0.74 Chi Square


Dias, et al.2004 26 Wrist stiffness 12 Weeks Y Unc Y Number F-R Division 25 NR NR F-R Lengthening 25 NR NR NR NR NR NR Chi Square


Bhattacharya, et al.2004 32 Grip strength (%) 6 Weeks Y Y N Percent of Preop (%) Knifelight 26 89 NR OCTR 26 84 NR NR NR NR 0.25 NR

Bhattacharya, et al.2004 32 Complications NR Y Y Unc Number Knifelight 26 1 NR OCTR 26 0 NR NR NR NR NR NR

Bhattacharya, et al.2004 32 Scar tenderness NR Y Unc Unc Number Knifelight 26 8 NR OCTR 26 17 NR NR NR NR 0.01 NR

Bhattacharya, et al.2004 32 Pillar Pain NR Y Unc Unc Number Knifelight 26 7 NR OCTR 26 8 NR NR NR NR NR NR

Bhattacharya, et al.2004 32 Symptom Relief 2 Weeks Y Unc Y Number Knifelight 26 17 NR OCTR 26 18 NR NR NR NR NR NR

Bhattacharya, et al.2004 32 Symptom Relief 6 Weeks Y Unc Y Number Knifelight 26 17 NR OCTR 26 19 NR NR NR NR NR NR

Borisch, et al.2003 273 Brachial Nocturnal Pain 0 Days Y Y Y Number OCTR with epineurotomy 146 95 NR OCTR without

epineurotomy 159 111 NR NR NR NR NR NR

Borisch, et al.2003 273 Brachial Nocturnal Pain 3 Months Y Y Y Number OCTR with epineurotomy 93 8 NR OCTR without


Borisch, et al.2003 273 Paraesthesia 0 Days Y Y Y Number OCTR with epineurotomy 146 136 NR OCTR without


Borisch, et al.2003 273 Paraesthesia 3 Months Y Y Y Number OCTR with epineurotomy 93 16 NR OCTR without


Borisch, et al.2003 273 Hypaesthesia 0 Days Y Y Y Number OCTR with epineurotomy 145 104 NR OCTR without


Borisch, et al.2003 273 Hypaesthesia 3 Months Y Y Y Number OCTR with epineurotomy 82 19 NR OCTR without


Borisch, et al.2003 273 Tinels Sign 0 Days Unc Y N Number OCTR with epineurotomy 144 115 NR OCTR without


Borisch, et al.2003 273 Tinels Sign 3 Months Unc Y N Number OCTR with epineurotomy 93 32 NR OCTR without


Borisch, et al.2003 273 Thenar Atrophy 0 Days Unc Unc Unc Number OCTR with epineurotomy 148 57 NR OCTR without


Borisch, et al.2003 273 Thenar Atrophy 3 Months Unc Unc Unc Number OCTR with epineurotomy 92 35 NR OCTR without


Borisch, et al.2003 273 Tilt Sign 0 Days Unc Unc Unc Number OCTR with epineurotomy 147 90 NR OCTR without


Borisch, et al.2003 273 Tilt Sign 3 Months Unc Unc Unc Number OCTR with epineurotomy 92 36 NR OCTR without


Saw, et al.2003 123 Reversible Nerve Damage NR Y Y Unc Number ECTR 74 1 NR OCTR 76 1 NR NR NR NR NR NR

Saw, et al.2003 123 Wound infection NR Y Y Unc Number ECTR 74 1 NR OCTR 76 1 NR NR NR NR NR NR

Saw, et al.2003 123 Superficial haematoma NR Y Y Unc Number ECTR 74 0 NR OCTR 76 1 NR NR NR NR NR NR




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Wong, et al.2003 30 Radial pillar tenderness 2 Weeks Y Unc Y Number Minimal Incision 30 13 NR ECTR 30 15 NR NR NR NR NR NR

Wong, et al.2003 30 Surgical Preference 8 Weeks Y Unc Y Number Minimal Incision 30 16 NR ECTR 30 5 NR NR NR NR 0.04 Chi Square

Wong, et al.2003 30 Surgical Preference 6-12 Months Y Unc Y Number Minimal Incision 30 13 NR ECTR 30 6 NR NR NR NR NR NR

Wong, et al.2003 30 Grip strength (%) 4 Weeks Unc Y N Percent of Preop (%) Minimal Incision 30 65 NR ECTR 30 65 NR NR NR NR NR NR

Wong, et al.2003 30 Grip strength (%) 12 Weeks Unc Y N Percent of Preop (%) Minimal Incision 30 100 NR ECTR 30 85 NR NR NR NR NR NR

Wong, et al.2003 30 Grip strength (%) 6 Months Unc Y N Percent of Preop (%) Minimal Incision 30 120 NR ECTR 30 100 NR NR NR NR NR NR

Wong, et al.2003 30 Grip strength (%) 1 Years Unc Y N Percent of Preop (%) Minimal Incision 30 165 NR ECTR 30 125 NR NR NR NR NR NR

Wong, et al.2003 30 Pinch Strength (%) 4 Weeks Unc Y N Percent of Preop (%) Minimal Incision 30 90 NR ECTR 30 85 NR NR NR NR NR NR

Wong, et al.2003 30 Pinch Strength (%) 12 Weeks Unc Y N Percent of Preop (%) Minimal Incision 30 105 NR ECTR 30 105 NR NR NR NR NR NR

Wong, et al.2003 30 Pinch Strength (%) 6 Months Unc Y N Percent of Preop (%) Minimal Incision 30 112 NR ECTR 30 99 NR NR NR NR NR NR

Wong, et al.2003 30 Pinch Strength (%) 1 Years Unc Y N Percent of Preop (%) Minimal Incision 30 112 NR ECTR 30 100 NR NR NR NR NR NR

Wong, et al.2003 30 Radial pillar tenderness 8 Weeks Y Unc Y Number Minimal Incision 30 8 NR ECTR 30 15 NR NR NR NR NR NR

Wong, et al.2003 30 Radial pillar tenderness 6 Months Y Unc Y Number Minimal Incision 30 3 NR ECTR 30 7 NR NR NR NR NR NR

Wong, et al.2003 30 Radial pillar tenderness 1 Years Y Unc Y Number Minimal Incision 30 2 NR ECTR 30 5 NR NR NR NR NR NR

Wong, et al.2003 30 Ulnar pillar tenderness 2 Weeks Y Unc Y Number Minimal Incision 30 11 NR ECTR 30 15 NR NR NR NR NR NR

Wong, et al.2003 30 Ulnar pillar tenderness 8 Weeks Y Unc Y Number Minimal Incision 30 10 NR ECTR 30 16 NR NR NR NR 0.03 Chi Square

Wong, et al.2003 30 Ulnar pillar tenderness 6 Months Y Unc Y Number Minimal Incision 30 1 NR ECTR 30 5 NR NR NR NR NR NR

Wong, et al.2003 30 Ulnar pillar tenderness 1 Years Y Unc Y Number Minimal Incision 30 1 NR ECTR 30 2 NR NR NR NR NR NR

Wong, et al.2003 30 Symptom Relief (full) 1 Years Y Unc Y Number Minimal Incision 30 19 NR ECTR 30 17 NR NR NR NR 0.65 Chi Square

Wong, et al.2003 30 Symptom Relief (partial) 1 Years Y Unc Y Number Minimal Incision 30 8 NR ECTR 30 10 NR NR NR NR 0.83 Chi Square

Wong, et al.2003 30 Symptom Relief (little) 1 Years Y Unc Y Number Minimal Incision 30 2 NR ECTR 30 3 NR NR NR NR 1 Chi Square


Benefits and Harms

Benefits Study Duration Favors Level of Evidence

SSS Cellocco, et al. 19 months ● Level I

FSS Cellocco, et al. 19 months ● Level I

Symptom Relief Bhattacharya, et al. 2 weeks ? Level I

Symptom Relief Bhattacharya, et al. 6 weeks ? Level I

Overall Improvement Scholten, et al. 6 weeks ? Level I

Harms Study Duration Favors Level of Evidence

Complications Bhattacharya, et al. 6 weeks ? Level I

Scar Tenderness Bhattacharya, et al. 6 weeks ● Level I

Pillar Pain Bhattacharya, et al. 6 weeks ? Level I

? = Underpowered for this outcome

Minimal Incision vs. OCTR

● = Significant in favor of Minimal Incision○ = Significant in favor of OCTR◐ = Treatments "equal" in appropriately powered studies






Cellocco, et al. SSS 19 months SMD Significant n/a

Cellocco, et al. FSS 19 months SMD Significant n/a

Bhattacharya, et al. Symptom Relief 2 weeks OR 0.84 ( 0.09 - 11.26 )

Bhattacharya, et al. Symptom Relief 6 weeks OR 0.70 ( 0.09 - 11.26 )

Bhattacharya, et al. Complications 6 weeks OR 0.32 ( 0.08 - 12.55 )

Bhattacharya, et al. Scar Tenderness 6 weeks OR Significant n/a

Bhattacharya, et al. Pillar Pain 6 weeks OR 1.21 ( 0.20 - 4.99 )

Scholten, et al. Overall Improvement 6 weeks OR 1.95 ( 0.12 - 8.03)

Minimal Incision vs. OCTR



Benefits and Harms


Pain Wong, et al. 2 weeks ● Level I

Pain Wong, et al. 4 weeks ● Level I


Radial Pillar Pain Wong, et al. 8 weeks ? Level I

Ulnar Pillar Pain Wong, et al. 8 weeks ? Level I


Minimal Incision vs. ECTR

● = Significant in favor of Minimal Incision○ = Significant in favor of ECTR◐ = Treatments "equal" in appropriately powered studies






Wong, et al. Pain 2 weeks SMD Significant n/a

Wong, et al. Pain 4 weeks SMD Significant n/a

Wong, et al. Radial Pillar Pain 8 weeks OR 2.75 ( 0.22 - 4.47 )

Wong, et al. Ulnar Pillar Pain 8 weeks OR 2.29 ( 0.23 - 4.41 )

Minimal Incision vs. ECTR



Benefits and Harms


SSS Scholten, et al. 12 months ? Level I

FSS Scholten, et al. 12 months ? Level I

Overall Improvement Scholten, et al. 3 months ? Level I



Nocturnal Pain Borisch, et al. 3 months ○ Level II

Paraesthesia Borisch, et al. 3 months ? Level II

PEM Forward, et al. 8 weeks ? Level I

PEM Siegmeth, et al. 6 weeks ? Level I

PEM Siegmeth, et al. 3 months ? Level I

PEM Siegmeth, et al. 6 months ○ Level I

SSS Dias, et al. 2 weeks ? Level I

FSS Dias, et al. 2 weeks ? Level I








Scar Pain Forward, et al. 8 weeks ? Level I

Scar Pain Siegmeth, et al. 6 weeks ? Level I

Scar Pain Siegmeth, et al. 3 months ? Level I

Scar Pain Siegmeth, et al. 6 months ? Level I

● = Significant in favor of Adjuvant Method○ = Significant in favor of Standard◐ = Treatments "equal" in appropriately ? = Underpowered for this outcome

Epineurotomy

Skin Nerve Preservation

Flexor Retinaculum Lengthening

Ulnar Bursa Preservation



Adjuvant Methods vs. OCTR

Tenosynovectomy

Internal Neurolysis






Scholten, et al. SSS 12 months SMD 0 0.6

Scholten, et al. FSS 12 months SMD 0.15 0.6

Scholten, et al. Overall Improvement 3 months OR 1.07 ( 0.07 - 13.79 )


Borisch, et al. Nocturnal Pain 3 months OR Significant n/a

Borisch, et al. Paraesthesia 3 months OR 0.44 ( 0.31 - 3.19 )


Forward, et al. Scar Pain 8 weeks SMD 0.06 0.54

Forward, et al. PEM 8 weeks SMD 0.05 0.54


Tenosynovectomy

Internal Neurolysis

Epineurotomy









Siegmeth, et al. Scar Pain 6 weeks SMD 0 0.62

Siegmeth, et al. Scar Pain 3 months SMD 0 0.62

Siegmeth, et al. Scar Pain 6 months SMD 0 0.62

Siegmeth, et al. PEM 6 weeks SMD 0 0.62

Siegmeth, et al. PEM 3 months SMD 0.2 0.62

Siegmeth, et al. PEM 6 months SMD Significant n/a

Dias, et al. SSS 2 weeks SMD 0.38 0.79

Dias, et al. FSS 2 weeks SMD 0 0.79

Dias, et al. SSS 6 weeks SMD 0.24 0.79


Dias, et al. SSS 12 weeks SMD 0 0.79


Dias, et al. SSS 25 weeks SMD 0 0.79

Dias, et al. FSS 25 weeks SMD 0.24 0.79

* If the value of the effect size was statistically significant (p < 0.05) the minimal detectable effect size is not calculated† For OR: underpowered studies will have an effect size within the listed range

OR = Odds Ratio ; SMD = Standardized Mean Differrence (Hedges d) ; n/a = not applicable


Flexor Retinaculum Lengthening


Pre-operative AntibioticsExcluded Articles


Heuser, et al.2007

Telerehabilitation using the Rutgers Master II glove following carpal tunnel release surgery: proof-of-concept

IEEE Trans Neural Syst Rehabil Eng Less than 10 patients

Siegmeth, et al.2006

Standard open decompression in carpal tunnel syndrome compared with a modified open technique preserving the superficial skin nerves: a prospective randomized study J Hand Surg [Am ] Did not report infections

Bekerom, et al.2006

Outcome of open versus endoscopic approach for the surgical treatment of carpal tunnel syndrome Acta Orthop Belg Retrospective

Bigat, et al.2006

Does dexamethasone improve the quality of intravenous regional anesthesia and analgesia? A randomized, controlled clinical study Anesth Analg Did not report infections

Patil, et al.2006 Local anaesthesia for carpal tunnel decompression: a comparison of two techniques J Hand Surg [Br ] Did not report infections

Oertel, et al.2006

Dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome: results of 411 procedures with special reference to technique, efficacy, and complications Neurosurgery Did not report infections

Pretto, et al.2005 Endoscopic carpal tunnel release: A comparative study to the conventional open technique Arquivos de Neuro-Psiquiatria Foreign Language

Gimeno, et al.2005 The role of job strain on return to work after carpal tunnel surgery Occup Environ Med Did not report infections

Macaire, et al.2005

Nerve blocks at the wrist for carpal tunnel release revisited: the use of sensory-nerve and motor-nerve stimulation techniques Reg Anesth Pain Med Did not report infections

Eskandari, et al.2005

Effect of patient age and symptom duration on subjective and objective outcomes of carpal tunnel surgery Orthopedics Gender Restricted

Lorgelly, et al.2005

Carpal tunnel syndrome, the search for a cost-effective surgical intervention: a randomised controlled trial Ann R Coll Surg Engl Did not report infections

Katz, et al.2005 Determinants of work absence following surgery for carpal tunnel syndrome Am J Ind Med Did not report infections

Kharwadkar, et al.2005

Prospective randomized trial comparing absorbable and non-absorbable sutures in open carpal tunnel release J Hand Surg [Br ] Did not report infections

Ozer, et al.2005

Alkalinisation of local anaesthetics prescribed for pain relief after surgical decompression of carpal tunnel syndrome J Orthop Surg (Hong Kong ) Did not report infections

Tuzuner, et al.2004 Endoscopic carpal tunnel release: modification of Menon's technique and data from 191 cases Arthroscopy Did not report infections

Park, et al.2004

Surgical outcome of endoscopic carpal tunnel release in 100 patients with carpal tunnel syndrome Minim Invasive Neurosurg Retrospective

Ketchum, et al.2004

A comparison of flexor tenosynovectomy, open carpal tunnel release, and open carpal tunnel release with flexor tenosynovectomy in the treatment of carpal tunnel syndrome Plast Reconstr Surg Retrospective

Mondelli, et al.2004 Outcome of surgical release among diabetics with carpal tunnel syndrome Arch Phys Med Rehabil Did not report infections

Alayurt, et al.2004

The addition of sufentanil, tramadol or clonidine to lignocaine for intravenous regional anaesthesia Anaesth Intensive Care Not CTS specific




Chaise, et al.2004

Return-to-work interval and surgery for carpal tunnel syndrome. Results of a prospective series of 233 patients J Hand Surg [Br ] Did not report infections

Yoshida, et al.2004

Results of endoscopic management of primary versus recurrent carpal tunnel syndrome in long-term haemodialysis patients Hand Surg Did not report infections

Zhao, et al.2004 [Comparison of endoscopic versus open surgical treatment of carpal tunnel syndrome] Zhongguo Yi Xue Ke Xue Yuan

Xue Bao Foreign Language

Vossinakis, et al.2004

Reducing the pain associated with local anaesthetic infiltration for open carpal tunnel decompression J Hand Surg [Br ] Did not report infections

McNally, et al.2003 Results of 1245 endoscopic carpal tunnel decompressions Hand Surg Did not report infections

Cavallo, et al.2003 Endoscopic carpal tunnel release and congenital anomalies of the median nerve Hand Surg Did not report infections

Schonauer, et al.2003 Endoscopic carpal tunnel release: practice in evolution Scand J Plast Reconstr Surg

Hand Surg Retrospective

Ahcan, et al.2002 Surgical technique to reduce scar discomfort after carpal tunnel surgery J Hand Surg [Am ] Did not report infections

Lawrence, et al.2002 Topical anaesthesia to reduce pain associated with carpal tunnel surgery J Hand Surg [Br ] Did not report infections

Chow, et al.2002 Endoscopic carpal tunnel release: thirteen years' experience with the Chow technique J Hand Surg [Am ] Did not report infections

Makowiec, et al.2002 Outcome of first-time endoscopic carpal tunnel release in a teaching environment Arthroscopy Cadaver study

Ferdinand, et al.2002

Endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome. A prospective,randomised, blinded assessment J Bone Joint Surg Br Did not report infections

Katz, et al.2001 Predictors of outcomes of carpal tunnel release Arthritis Rheum Did not report infections

Bland, et al.2001 Do nerve conduction studies predict the outcome of carpal tunnel decompression? Muscle Nerve Did not report infections


A randomized prospective study to assess the efficacy of two cold-therapy treatments following carpal tunnel release J Hand Ther Did not report infections

Huracek, et al.2001

Recovery after carpal tunnel syndrome operation: the influence of the opposite hand, if operated on in the same session Arch Orthop Trauma Surg Retrospective

Trumble, et al.2001 Endoscopic versus open surgical treatment of carpal tunnel syndrome Neurosurg Clin N Am Did not report infections

Gunetti, et al.2000 Peri- and postoperative pain valutation in carpal tunnel release of median nerve compression J Neurosurg Sci Did not report infections




Mackenzie, et al.2000 Early recovery after endoscopic vs. short-incision open carpal tunnel release Ann Plast Surg Did not report infections

Provinciali, et al.2000 Usefulness of hand rehabilitation after carpal tunnel surgery Muscle Nerve Did not report infections

Bhatia, et al.2000 Does splintage help pain after carpal tunnel release? J Hand Surg [Br ] Did not report infections

Concannon, et al.2000 The incidence of recurrence after endoscopic carpal tunnel release Plast Reconstr Surg Retrospective

Chen, et al.1999 Endoscopic carpal tunnel release Changgeng Yi Xue Za Zhi Did not report infections

Vasen, et al.1999 Open versus endoscopic carpal tunnel release: a decision analysis J Hand Surg [Am ] Did not report infections

Atherton, et al.1999

Follow-up after carpal tunnel decompression - general practitioner surgery or hand clinic? A randomized prospective study J Hand Surg [Br ] Did not use electrodiagnostic

testing for diagnosis

Braun, et al.1999

The effect of legal representation on functional recovery of the hand in injured workers following carpal tunnel release J Hand Surg [Am ] Retrospective

Schonauer, et al.1999 Anthropometry and endoscopic carpal tunnel release J Hand Surg [Br ] Did not use electrodiagnostic


Olney, et al.1999 Contested claims in carpal tunnel surgery: outcome study of worker's compensation factors Iowa Orthop J Retrospective

Jimenez, et al.1998 Endoscopic treatment of carpal tunnel syndrome: a critical review J Neurosurg Did not report infections

Katz, et al.1998

Maine Carpal Tunnel Study: outcomes of operative and nonoperative therapy for carpal tunnel syndrome in a community-based cohort J Hand Surg [Am ] Did not report infections

Atroshi, et al.1998 Patient satisfaction and return to work after endoscopic carpal tunnel surgery J Hand Surg [Am ] Did not report infections

Netscher, et al.1998

Temporal changes in grip and pinch strength after open carpal tunnel release and the effect of ligament reconstruction J Hand Surg [Am ] Did not report infections

Hoefnagels, et al.1997

[Surgical treatment of carpal tunnel syndrome: endoscopic or classical (open)? A prospective randomized trial] Ned Tijdschr Geneeskd Foreign Language

Bessette, et al.1997 Patients' preferences and their relationship with satisfaction following carpal tunnel release J Hand Surg [Am ] Did not report infections

Serra, et al.1997 Carpal tunnel release with short incision Plast Reconstr Surg Cadaver study

Drapela, et al.1997 Carpal tunnel syndrome. Revision of the thenar motor branch? Acta Chir Plast Did not report infections




Nygaard, et al.1996 Recovery of sensory function after surgical decompression in carpal tunnel syndrome Acta Neurol Scand Did not report infections

Benedetti, et al.1996

[Agee endoscopic decompression of the median nerve: prospective study with comparison to open decompression] Handchir Mikrochir Plast Chir Foreign Language

Schafer, et al.1996

[Agee endoscopic operation of carpal tunnel syndrome in comparison with open surgical technique] Handchir Mikrochir Plast Chir Foreign Language

Stark, et al.1996

[Endoscopic operation or conventional open surgical technique in carpal tunnel syndrome: a prospective comparative study] Handchir Mikrochir Plast Chir Foreign Language

Lee, et al.1996

Carpal tunnel release through a limited skin incision under direct visualization using a new instrument, the carposcope Plast Reconstr Surg Retrospective

Braga-Silva, et al.1996

Postoperative strength after surgical release of the carpal tunnel: A randomized prospective study. Rev Bras Ortop Foreign Language

Abdullah, et al.1995 Sequelae of carpal tunnel surgery: rationale for the design of a surgical approach Neurosurgery Did not use electrodiagnostic


Higgs, et al.1995 Carpal tunnel surgery outcomes in workers: effect of workers' compensation status J Hand Surg [Am ] Did not report infections

Dawson, et al.1995 Elective hand surgery in the breast cancer patient with prior ipsilateral axillary dissection Ann Surg Oncol Retrospective

Mirza, et al.1995 Palmar uniportal extrabursal endoscopic carpal tunnel release Arthroscopy Did not report infections

Adams, et al.1994 Outcome of carpal tunnel surgery in Washington State workers' compensation Am J Ind Med Retrospective

Brown, et al.1993 Results of 1236 endoscopic carpal tunnel release procedures using the Brown technique Contemp Orthop Did not report infections

Nathan, et al.1993

Rehabilitation of carpal tunnel surgery patients using a short surgical incision and an early program of physical therapy J Hand Surg [Am ] Did not report infections

Schlenker, et al.1993

Synovialectomy and reconstruction of the retinaculum flexorum in median nerve decompression: technique and early results Handchir Mikrochir Plast Chir Did not report infections

Menon, et al.1993 Endoscopic carpal tunnel release: a single-portal technique Contemp Orthop Did not report infections

McDonough, et al.1993 A comparison of endoscopic and open carpal tunnel release Wis Med J Retrospective

Menon, et al.1993 Endoscopic carpal tunnel release--current status J Hand Ther Did not report infections

Foucher, et al.1993 [Carpal tunnel syndrome. Can it still be a controversial topic?] Chirurgie Foreign Language




Okutsu, et al.1993

Results of endoscopic management of carpal-tunnel syndrome in long-term haemodialysis versus idiopathic patients Nephrol Dial Transplant Retrospective

Palmer, et al.1993 Endoscopic carpal tunnel release: a comparison of two techniques with open release Arthroscopy Did not report infections

Brown, et al.1992 Endoscopic carpal tunnel release J Hand Surg [Am ] Did not report infections

Pagnanelli, et al.1992 Bilateral carpal tunnel release at one operation: report of 228 patients Neurosurgery Did not report infections

Flaschka, et al.1991 Follow-up results of surgery for carpal tunnel syndrome in local anesthesia Zentralbl Neurochir Retrospective

Chow, et al.1990 Endoscopic release of the carpal ligament for carpal tunnel syndrome: 22-month clinical result Arthroscopy Did not report infections

Hanssen, et al.1989 Deep postoperative wound infection after carpal tunnel release J Hand Surg [Am ] Retrospective

Seradge, et al.1989 Piso-triquetral pain syndrome after carpal tunnel release J Hand Surg [Am ] Did not report infections

Altissimi, et al.1988 Surgical release of the median nerve under local anaesthesia for carpal tunnel syndrome J Hand Surg [Br ] Did not report infections

Duchateau, et al.1984 Carpal tunnel syndrome: postsurgical course of symptoms Ann Chir Main Did not report infections

Fissette, et al.1979 Treatment of carpal tunnel syndrome. Comparative study with and without epineurolysis Hand Did not report infections

Ariyan, et al.1977

The palmar approach for the visualization and release of the carpal tunnel. An analysis of 429 cases Plast Reconstr Surg Did not use electrodiagnostic


Das, et al.1976 In search of complications in carpal tunnel decompression Hand Did not report infections

Posch, et al.1975 Surgical treatment of the carpal tunnel syndrome Handchirurgie Did not report infections


Pre-operative AntibioticsIncluded Articles


Zyluk, et al.2006 A comparison of two limited open techniques for carpal tunnel release J Hand Surg [Br ]

Forward, et al.2006

Preservation of the ulnar bursa within the carpal tunnel: does it improve the outcome of carpal tunnel surgery? A randomized, controlled trial J Bone Joint Surg Am

Atroshi, et al.2006

Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial BMJ

Wilgis, et al.2006 A prospective assessment of carpal tunnel surgery with respect to age J Hand Surg [Br ]

Martins, et al.2006 Wrist immobilization after carpal tunnel release: A prospective study Arq Neuro-Psiquiatr

Rab, et al.2006

Intra-individual comparison between open and 2-portal endoscopic release in clinically matched bilateral carpal syndrome J Plast Reconstr Aesthet Surg

Cellocco, et al.2005

Mini-open blind procedure versus limited open technique for carpal tunnel release: a 30-month follow-up study J Hand Surg [Am ]

Fagan, et al.2004 A controlled clinical trial of postoperative hand elevation at home following day-case surgery J Hand Surg [Br ]

Dias, et al.2004 Carpal tunnel decompression. Is lengthening of the flexor retinaculum better than simple division? J Hand Surg [Br ]

Menovsky, et al.2004

Skin closure in carpal tunnel surgery: a prospective comparative study between nylon, polyglactin 910 and stainless steel sutures Hand Surg

Mondelli, et al.2004 Outcome of surgical release among diabetics with carpal tunnel syndrome Arch Phys Med Rehabil

Bhattacharya, et al.2004 A randomized controlled trial of knifelight and open carpal tunnel release J Hand Surg [Br]

Borisch, et al.2003

Neurophysiological recovery after open carpal tunnel decompression: comparison of simple decompression and decompression with epineurotomy J Hand Surg [Br]

Saw, et al.2003

Early outcome and cost-effectiveness of endoscopic versus open carpal tunnel release: a randomized prospective trial J Hand Surg [Br]

Helm, et al.2003 Evaluation of carpal tunnel release using the Knifelight instrument J Hand Surg [Br]

Serra, et al.2003 Endoscopic release in carpal tunnel syndrome: analysis of clinical results in 200 cases Minim Invasive Neurosurg




Reale, et al.2003 Protocol of outcome evaluation for surgical release of carpal tunnel syndrome Neurosurgery

Wong, et al.2003

Carpal tunnel release. A prospective, randomised study of endoscopic versus limited-open methods J Bone Joint Surg Br

Klein, et al.2003

Open carpal tunnel release using a 1-centimeter incision: technique and outcomes for 104 patients Plast Reconstr Surg

Jeffrey, et al.2002 Use of Arnica to relieve pain after carpal-tunnel release surgery Altern Ther Health Med

Erel, et al.2001 Absorbable versus non-absorbable suture in carpal tunnel decompression J Hand Surg [Br ]

Brief, et al.2000 Endoscopic carpal tunnel release: report of 146 cases Mt Sinai J Med

Finsen, et al.1999

No advantage from splinting the wrist after open carpal tunnel release. A randomized study of 82 wrists Acta Orthop Scand

Straub, et al.1999

Endoscopic carpal tunnel release: a prospective analysis of factors associated with unsatisfactory results Arthroscopy

Davies, et al.1998 Two-portal endoscopic carpal tunnel release: an outcome analysis of 333 hands Ann Plast Surg

Atroshi, et al.1997 Endoscopic carpal tunnel release: prospective assessment of 255 consecutive cases J Hand Surg [Br ]

Okutsu, et al.1996 Complete endoscopic carpal tunnel release in long-term haemodialysis patients J Hand Surg [Br ]

Cobb, et al.1996 Outcome of reoperation for carpal tunnel syndrome J Hand Surg [Am ]

Jacobsen, et al.1996

A prospective, randomized study with an independent observer comparing open carpal tunnel release with endoscopic carpal tunnel release J Hand Surg [Br ]

Dumontier, et al.1995

Early results of conventional versus two-portal endoscopic carpal tunnel release. A prospective study J Hand Surg [Br ]

Bury, et al.1995 Prospective, randomized trial of splinting after carpal tunnel release Ann Plast Surg

Shapiro, et al.1995 Microsurgical carpal tunnel release Neurosurgery




Cook, et al.1995 Early mobilization following carpal tunnel release. A prospective randomized study J Hand Surg [Br ]

Sennwald, et al.1995 The value of one-portal endoscopic carpal tunnel release: a prospective randomized study Knee Surg Sports Traumatol

Arthrosc

Slattery, et al.1994 Endoscopic carpal tunnel release. Use of the modified Chow technique in 215 cases Med J Aust

Erdmann, et al.1994 Endoscopic carpal tunnel decompression J Hand Surg [Br ]

Menon, et al.1994 Endoscopic carpal tunnel release: preliminary report Arthroscopy

Brown, et al.1993 Carpal tunnel release. A prospective, randomized assessment of open and endoscopic methods J Bone Joint Surg Am

Chow, et al.1993

The Chow technique of endoscopic release of the carpal ligament for carpal tunnel syndrome: four years of clinical results Arthroscopy

Waegeneers, et al.1993 Operative treatment of carpal tunnel syndrome Acta Orthop Belg

Agee, et al.1992 Endoscopic release of the carpal tunnel: a randomized prospective multicenter study J Hand Surg [Am ]

Pagnanelli, et al.1991 Carpal tunnel syndrome: surgical treatment using the Paine retinaculatome J Neurosurg

Paine, et al.1983 Carpal tunnel syndrome. Decompression using the Paine retinaculotome J Neurosurg

Lichtman, et al.1979 Carpal tunnel release under local anesthesia: evaluation of the outpatient procedure J Hand Surg [Am ]

Gainer, et al.1977 Carpal tunnel syndrome: report of 430 operations South Med J


Infection Rates in CTS Surgery - Controlled Trials

Atroshi, et al. 2006 Open Release Open ○ Not Reported Not Reported 65 65 0 0.00% 0.00%

Endoscopic Release Endo ● Not Reported Not Reported 63 63 0 0.00% 0.00%

Forward, et al. 2006 Ulnar Bursa Divided or Preserved Open ○ Not Reported Not Reported 111 111 8 7.21% 7.21%

Martins, et al. 2006 Open Surgery Open ○ Not Reported Not Reported 52 59 1 1.92% 1.69%

Rab, et al. 2006 Open Release Open ○ Not Reported Not Reported 10 10 0 0.00% 0.00%

2-Portal Endoscopic Release Endo ● Not Reported Not Reported 10 10 0 0.00% 0.00%

Zyluk, et al. 2006 Single or double incision limited open technique Open ○ Not Reported Not Reported 68 73 2 2.94% 2.74%

Cellocco, et al. 2005 Open Surgery Open ○ Not Reported Not Reported 185 222 0 0.00% 0.00%

Bhattacharya, et al. 2004 Open Surgery Open ○ Not Reported Not Reported 52 52 0 0.00% 0.00%

Dias, et al. 2004 Flexor Retinaculum Division or Lengthening Open ○ Not Reported Not Reported 26 52 1 3.85% 1.92%

Fagan, et al. 2004 Open Surgery Open ○ Not Reported Not Reported 43 43 0 0.00% 0.00%

Menovsky, et al. 2004 Polyglactin, Stainless Steel, or Nylon sutures Open ○ Not Reported Not Reported 61 61 2 3.28% 3.28%

Borisch, et al. 2003 CT Release with or w/o Epineurotomy Open ○ Not Reported Not Reported 307 307 0 0.00% 0.00%

Helm, et al. 2003 Open Surgery Open ○ Not Reported Not Reported 82 82 1 1.22% 1.22%

Saw, et al. 2003 Endoscopic Surgery Endo ● Not Reported Not Reported NR 74 1 n/a 1.35%

Open Surgery Open ○ Not Reported Not Reported NR 76 1 n/a 1.32%

Wong, et al. 2003 Minimal Incision Minimal ◐ Not Reported Not Reported 30 30 0 0.00% 0.00%

Endoscopic Surgery Endo ● Not Reported Not Reported 30 30 0 0.00% 0.00%

Jeffrey, et al. 2002 Bilateral Endoscopic Surgery Endo ● Not Reported Not Reported 40 80 0 0.00% 0.00%

Erel, et al. 2001 Not Reported NR X Not Reported Not Reported 64 64 0 0.00% 0.00%

Finsen, et al. 1999 Open Surgery Open ○ Not Reported Not Reported 74 82 0 0.00% 0.00%

Jacobsen, et al. 1996 Open Surgery Open ○ Not Reported Not Reported 16 16 0 0.00% 0.00%


Bury, et al. 1995 Open Surgery Open ○ Not Reported Not Reported 40 43 0 0.00% 0.00%

Cook, et al. 1995 Open Surgery Open ○ Not Reported Not Reported 50 50 0 0.00% 0.00%

Dumontier, et al. 1995 Open Surgery Open ○ Not Reported Not Reported 40 43 0 0.00% 0.00%


Sennwald, et al. 1995 Endoscopic Surgery Endo ● Not Reported Not Reported 25 25 0 0.00% 0.00%

Open Surgery Open ○ Not Reported Not Reported 22 22 0 0.00% 0.00%

Erdmann, et al. 1994 Open Surgery Open ○ Not Reported Not Reported NR 52 1 n/a 1.92%

Endoscopic Surgery Endo ● Not Reported Not Reported NR 53 0 n/a 0.00%

Brown, et al. 1993 Endoscopic Surgery Endo ● Not Reported Not Reported 76 84 0 0.00% 0.00%

Open Surgery Open ○ Not Reported Not Reported 75 85 0 0.00% 0.00%

Agee, et al. 1992 Open Surgery Open ○ Not Reported Not Reported NR 65 0 n/a 0.00%

Endoscopic Surgery Endo ● Not Reported Not Reported NR 82 0 n/a 0.00%

Patients Hands Infections Infection Rate by Patient

Infection Rate by Hand

1788 2342 18 1.01% 0.77%

Infection Rate by HandPatients Hands Infections Infection Rate by

Patient

Controlled Trials Total

Author Procedure / Technique Investigated Type of Surgery Pre-Operative Antibiotic

Artificial Implanted Device


Infection Rates in CTS Surgery - Other Study Designs

Wilgis, et al. 2006 Not Reported NR X Not Reported Not Reported 490 635 9 1.84% 1.42%

Mondelli, et al. 2004 Mini-incision of Palm Minimal ◐ Not Reported Not Reported 96 96 4 4.17% 4.17%

Klein, et al. 2003 Minimal-incision Release MInimal ◐ Not Reported Not Reported 104 149 3 2.88% 2.01%

Reale, et al. 2003 Mini-incision of the palm technique Minimal ◐ Yes (all) Not Reported 282 323 17 6.03% 5.26%

Serra, et al. 2003 Single-portal Agee Endoscopic Release Endo ● Not Reported Not Reported 164 200 0 0.00% 0.00%

Brief, et al. 2000 Brown technique Endo ● Not Reported Not Reported 128 146 0 0.00% 0.00%

Straub 1999 Chow Two-portal Endoscopic Release Endo ● Not Reported Not Reported 67 100 2 2.99% 2.00%

Davies, et al. 1998 Two-portal Endoscopic Release Endo ● Not Reported Not Reported 239 333 3 1.26% 0.90%

Atroshi, et al. 1997 Two-portal Endoscopic Release Endo ● Not Reported Not Reported 204 255 0 0.00% 0.00%

Cobb, et al. 1996 Not Reported NR X Not Reported Not Reported 262 262 7 2.67% 2.67%

Okutsu, et al. 1996 Single-portal Endoscopic Release Endo ● Not Reported Not Reported 217 257 0 0.00% 0.00%

Shapiro 1995 Microsurgical Approach Open ○ Not Reported Not Reported 378 461 7 1.85% 1.52%

Menon 1994 Concept Carpal Tunnel Relief Kit Endo ● Not Reported Not Reported 87 100 0 0.00% 0.00%

Slattery 1994 Modified Chow technique Endo ● Not Reported Not Reported 215 215 0 0.00% 0.00%

Chow 1993 Chow technique Endo ● Not Reported Not Reported 456 650 0 0.00% 0.00%

Waegeneers, et al. 1993 Curved Incision Open ○ Not Reported Not Reported 76 100 0 0.00% 0.00%

Pagnanelli, et al. 1991 Transverse technique (Paine Retinaculatome) Minimal ◐ Not Reported Not Reported 445 577 8 1.80% 1.39%

Paine, et al. 1983 Paine Retinaculatome Minimal ◐ Not Reported Not Reported 464 672 4 0.86% 0.60%

Lichtman, et al. 1979 Local Anesthesia Open Release Open ○ Not Reported Not Reported 85 100 0 0.00% 0.00%

Gainer, et al. 1977 S-Shaped Incision Open ○ Not Reported Not Reported 326 430 26 7.98% 6.05%



4785 6061 90 1.88% 1.48%



6573 8403 108 1.64% 1.29%



All Designs Total

Other Designs Total

Author Procedure / Technique Type of Surgery Pre-Operative Antibiotic

Artificial Implanted Device


Post-operative TreatmentExcluded Articles


Heuser, et al.2007

Telerehabilitation using the Rutgers Master II glove following carpal tunnel release surgery: proof-of-concept

IEEE Trans Neural Syst Rehabil Eng Less than 10 patients

Eskandari, et al.2005

Effect of patient age and symptom duration on subjective and objective outcomes of carpal tunnel surgery Orthopedics Not Relevant/Gender Restricted

Ozer, et al.2005

Alkalinisation of local anaesthetics prescribed for pain relief after surgical decompression of carpal tunnel syndrome J Orthop Surg (Hong Kong ) Not Relevant

Bhatia, et al.2000 Does splintage help pain after carpal tunnel release? J Hand Surg [Br ] No Data

Concannon, et al.2000 The incidence of recurrence after endoscopic carpal tunnel release Plast Reconstr Surg Retrospective

Atherton, et al.1999

Follow-up after carpal tunnel decompression - general practitioner surgery or hand clinic? A randomized prospective study J Hand Surg [Br ] Not Relevant

Nathan, et al.1993

Rehabilitation of carpal tunnel surgery patients using a short surgical incision and an early program of physical therapy J Hand Surg [Am ] Post-operative treatment not controlled


Post-operative TreatmentIncluded Articles


Martins, et al.2006 Wrist immobilization after carpal tunnel release: A prospective study Arq Neuro-Psiquiatr

Fagan, et al.2004

A controlled clinical trial of postoperative hand elevation at home following day-case surgery J Hand Surg [Br ]

Jeffrey, et al.2002 Use of Arnica to relieve pain after carpal-tunnel release surgery Altern Ther Health Med


A randomized prospective study to assess the efficacy of two cold-therapy treatments following carpal tunnel release J Hand Ther

Provinciali, et al.2000 Usefulness of hand rehabilitation after carpal tunnel surgery Muscle Nerve

Finsen, et al.1999

No advantage from splinting the wrist after open carpal tunnel release. A randomized study of 82 wrists Acta Orthop Scand

Bury, et al.1995 Prospective, randomized trial of splinting after carpal tunnel release Ann Plast Surg

Cook, et al.1995

Early mobilization following carpal tunnel release. A prospective randomized study J Hand Surg [Br ]


Post-operative TreatmentStudy Design and Quality


Martins, et al.2006 52 Nonrandomized

controlled trialPost-Op Splinting vs. No Post-Op Splinting 2 Weeks ● ● ▫ ▫ ▫ ▫ ● ● ● ● ● ● ▫ Level II

Fagan, et al.2004 43 RCT Post-Op Hand Elevation vs.

Standard crepe sling 5 Days ● ● ● ○ ▫ ▫ ▫ ● ● ● ● ● ● Level II

Jeffrey, et al.2002 37 RCT Arnica tablets and ointment vs.

Placebo 2 Weeks ● ● ● ▫ ● ● ▫ ● ▫ ● ● ● ▫ Level II

Hochberg, et al.2001 72 RCT Controlled Cold Therapy vs.

Ice therapy 3 Days ● ● ▫ ● ▫ ▫ ▫ ● ● ● ● ● ● Level II

Provinciali, et al.2000 100 RCT Multimodal Physiotherapy vs.

No physiotherapy 2 Months ● ● ● ○ ▫ ▫ ● ● ● ● ● ● ● Level II

Finsen, et al.1999 82 RCT Post-Op Splinting vs.

No Post-Op Splinting 6 Months ● ● ▫ ○ ▫ ▫ ▫ ● ● ● ● ● ● Level II

Bury, et al.1995 47 RCT Post-Op Splinting vs.

No Post-Op Splinting 2 Weeks ● ● ▫ ● ▫ ▫ ▫ ● ● ● ● ● ▫ Level II

Cook, et al.1995 50 RCT Post-Op Splinting vs.

No Post-Op Splinting 6 Months ● ● ▫ ○ ▫ ▫ ▫ ○ ● ● ● ● ▫ Level II


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Post-operative TreatmentPatient Characteristics



RangeAge Std.



Martins, et al.2006 All Groups 52 NR 49.8 { 26-74 } NR 46 NR NR NR NR 6 NR NR NR NR 29.31

Months6-72

Months NR NR NR NR

Fagan, et al.2004 Post-Op Hand Elevation 21 NR 44 NR NR 11 NR NR NR NR 10 NR NR NR NR NR NR NR NR NR NR

Control 22 NR 47 NR NR 16 NR NR NR NR 6 NR NR NR NR NR NR NR NR NR NR

Jeffrey, et al.2002 Arnica 20 NR 51 NR ± 14 8 NR NR NR NR 12 NR NR NR NR NR NR NR NR NR NR

Placebo 17 NR 55 NR ± 19 11 NR NR NR NR 6 NR NR NR NR NR NR NR NR NR NR

Hochberg, et al.2001 CCT 36 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Ice therapy 36 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

All Patients 72 NR NR NR NR 26 NR NR NR NR 46 NR NR NR NR NR NR NR NR NR NR

Provinciali, et al.2000 Physiotherapy 50 NR 57.42 { 24-86 } NR 40 NR NR NR NR 10 NR NR NR NR NR NR NR NR NR NR

Control 50 NR 55.48 { 29-79 } NR 42 NR NR NR NR 8 NR NR NR NR NR NR NR NR NR NR

All Patients 100 NR 54.69 { 24-86 } ± 12.43 82 NR NR NR NR 18 NR NR NR NR NR NR NR NR NR NR

Finsen, et al.1999 Immobilized 37 NR 51 { 21-86 } NR 26 NR NR NR NR 11 NR NR NR NR NR NR NR NR NR NR

Mobilized 45 NR 48 { 26-80 } NR 34 NR NR NR NR 11 NR NR NR NR NR NR NR NR NR NR

Bury, et al.1995 Post-Op Splinting NR 26 43 { 19-79 } NR NR 24 NR NR NR NR 2 NR NR NR NR NR NR NR NR NR

Control NR 17 39 { 21 -74 } NR NR 15 NR NR NR NR 2 NR NR NR NR NR NR NR NR NR

All Patients NR 43 NR NR NR NR 39 NR NR NR NR 4 NR NR NR 13Months

5 - 36Months NR NR NR NR

Cook, et al.1995 Post-Op Splinting 25 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR

Control 25 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR



Post-operative TreatmentPatient Characteristics


Right Handed


w/ Thenar Atrophy

w/ Axonal Loss

w/ Spontaneous

Remission

Want Surgery

Want Non-Surgical


by

Martins, et al.2006 All Groups 52 NR NR NR NR NR NR NR NR NR NR NR NR NR

Fagan, et al.2004 Post-Op Hand Elevation 21 NR NR NR NR NR NR NR NR NR NR NR

Control 22 NR NR NR NR NR NR NR NR NR NR NR

Jeffrey, et al.2002 Arnica 20 NR NR NR NR NR NR NR NR NR NR NR

Placebo 17 NR NR NR NR NR NR NR NR NR NR NR

Hochberg, et al.2001 CCT 36 NR NR NR NR NR NR NR NR NR NR NR

Ice therapy 36 NR NR NR NR NR NR NR NR NR NR NR

All Patients 72 NR NR NR NR NR NR NR NR NR NR NR

Provinciali, et al.2000 Physiotherapy 50 NR NR NR NR NR NR NR NR NR Moderate = 11

Severe= 39 EMG-ENG (Mayo)

Control 50 NR NR NR NR NR NR NR NR NR Moderate = 14Severe= 36 EMG-ENG (Mayo)

All Patients 100 NR NR NR NR NR NR NR NR NR Moderate = 25Severe = 75 EMG-ENG (Mayo)

Finsen, et al.1999 Immobilized 37 NR NR NR NR NR NR NR NR NR NR NR

Mobilized 45 NR NR NR NR NR NR NR NR NR NR NR

Bury, et al.1995 Post-Op Splinting NR NR NR NR NR NR NR NR NR NR NR

Control NR NR NR NR NR NR NR NR NR NR NR

All Patients NR NR NR NR NR NR NR NR NR NR NR

Cook, et al.1995 Post-Op Splinting 25 NR 13 12 NR NR NR NR NR NR NR NR

Control 25 NR 5 20 NR NR NR NR NR NR NR NR

Number of Patients

Hand exercise information provided

Vicodin ES

Bulky compression dressing for 2 days

post-op.

1 superficial hematoma, 1 spontaneous discharge from wound

NR

NR

NR

NR

NR

Guyon's canal release, 7Decrompression of the sensory branch of the radial nerve, 1Forearm neuroma, 1

Bulky dressing

NR

NR

One patient with reoperation

NR


Post-operative TreatmentPatient Characteristics - Inclusion/Exclusion Criteria


Martins, et al.2006 52 Post-Op Splinting vs.

No Post-Op Splinting All patients with idiopathic CTS.

Inability to complete a self-administered questionnaire;previous CTR;occurrence of medical conditions associated with increased incidence of CTS like diabetes meliitus and hypothyroidism;wrist trauma or surgery;musculoskeletal, metabolic or autoimmune disorders;presence of space occupying lesions at the wrist, identified before surgery or at intra-operative period;pregnancy

Fagan, et al.2004 43 Post-Op Hand Elevation vs.

Standard crepe slingPatients undergoing day-case, primary carpal tunnel decompression

Patients undergoing revision surgery or who had recently undergone other hand surgery, patients with concurrent disease of the hand such as Dupuytrens or rheumatoid arthritis, post traumatic carpal tunnel syndrome and those too infirm to erect/use the sling

Jeffrey, et al.2002 37 Arnica tablets and ointment vs.

PlaceboPatients receiving bilateral endoscopic carpal-tunnel releases

Age under 16, pregnancy or breast feeding, conversion to open technique, allergy to Arnica,lanolin, or beeswax (contained in the ointment)

Hochberg, et al.2001 72 Controlled Cold Therapy vs.

Ice therapy

Patients presenting with CTS who were to undergo single open surgical procedures after failing to improve after a minimum of 8 weeks of splinting, avoidance of repetitive motions, use on nonsteroidal agents, and clinical indication of median nerve entrapment

Rheumatoid Arthritis, Diabetes, Fractures of the wrist, Revision surgery


Post-operative TreatmentPatient Characteristics - Inclusion/Exclusion Criteria


Provinciali, et al.2000 100 Multimodal Physiotherapy vs.

No physiotherapy Carpal tunnel release Worker's compensation cases

Finsen, et al.1999 82 Post-Op Splinting vs.

No Post-Op Splinting Operated on with open carpal tunnel release NR

Bury, et al.1995 47 Post-Op Splinting vs.

No Post-Op SplintingOpen carpal tunnel release with a history characteristic of CTS Prior surgery

Cook, et al.1995 50 Post-Op Splinting vs.

No Post-Op Splinting

Isolated, uncomplicated idiopathic carpal tunnel syndrome scheduled for treatment by surgical release of the flexor retinaculum

Systemic disease (diabetes mellitus, thyroid disease, generalized peripheral neuropathy, vasospastic disease, active psychiatric disorder, pregnancy, reflex sympathetic dystrophy, chronic renal failure requiring dialysis, gout, amyloidosis); proximal neuropathy in the same arm, previous injury of the affected wrist or median nerve;sever thenar weakness; simultaneous ipsilateral upper extremity surgery; and CTS from an acute injury


Post-operative TreatmentPatient Characteristics - Workers Compensation



Martins, et al.2006 All Groups 52 NR NR NR NR

Fagan, et al.2004 Post-Op Hand Elevation 21 NR NR NR NR


Jeffrey, et al.2002 Arnica 20 NR NR NR NR

Placebo 17 NR NR NR NR

Hochberg, et al.2001 CCT 36 0

( 0% ) NR NR NR

Ice therapy 36 0( 0% ) NR NR NR

All Patients 72 0( 0% ) NR NR NR

Provinciali, et al.2000 Physiotherapy 50 NR NR NR NR


All Patients 100 NR NR NR NR

Finsen, et al.1999 Immobilized 37 NR NR NR NR

Mobilized 45 NR NR NR NR

Bury, et al.1995 Post-Op Splinting 26

hands NR NR NR NR

Control 17 hands NR NR NR NR

All Patients 43 hands

25 ( 58% ) NR NR NR

Cook, et al.1995 Post-Op Splinting 25 5

( 20% ) NR NR NR

Control 25 3( 12% ) NR NR NR


Post-operative TreatmentContinuous Data Results


Martins, et al.2006 52 SSS 0 Days Y Y Y Splint 26 33.38

± 7.33 SD No Splint 26 31.77 ± 7.56 SD NR NR NR NR NR NR

Martins, et al.2006 52 SSS 2 Weeks Y Y Y Splint 26 11.38


Martins, et al.2006 52 SSI n/a Y Y Y Splint 26 0.64

± 0.15 SD No Splint 26 0.61 ± 0.12 SD NR NR NR NR 0.059 Two-tailed T-test

Martins, et al.2006 52 SIS 0 Days Y N Y Splint 26 8.65


Martins, et al.2006 52 SIS 2 Weeks Y N Y Splint 26 0.77


Martins, et al.2006 52 SII n/a Y N Y Splint 26 0.91


Martins, et al.2006 52 2 Point Discrimination (mm) 0 Days N Y N Splint 26 5.85


Martins, et al.2006 52 2 Point Discrimination (mm) 2 Weeks N Y N Splint 26 3.69


Martins, et al.2006 52 DI n/a N N N Splint 26 0.27


Fagan, et al.2004 41 Hand Volume (ml) 0 Days N Unc N Hand Elevation 21 370

± 78 SD Control 22 363 ± 68 SD NR NR NR NR NR NR

Fagan, et al.2004 41 Hand Volume (ml) 3 Days N Unc N Hand Elevation 20 380

± 77 SD Control 21 376 ± 67 SD NR NR NR NR NR NR

Fagan, et al.2004 41 Swelling (ml) 3 Days N Unc N Hand Elevation 20 11

{4 - 17} 95% CI Control 21 13 {4 - 21} 95% CI NR NR NR NR NS One-tailed T-test

Fagan, et al.2004 41 VAS - Pain 3 Days Y Y Y Hand Elevation 20 2.2

± 1.3 SD Control 21 2.7 ± 1.5 SD NR NR NR NR NS One-tailed T-test

Jeffrey, et al.2002 37 Wrist Circumference -percent change of

preoperative value (%) 2 Weeks N Unc N Arnica 20 1.8 ± 2.1 SD Placebo 17 2.1

± 2.4 SD NR NR NR NR NS Two-tailed T-test

Jeffrey, et al.2002 37 Grip Strength - percentage of preoperative value

(%) 1 week N Unc N Arnica 20 74.0 ± 38.1 SD Placebo 17 62.6


Jeffrey, et al.2002 37 Grip Strength - percentage of preoperative value

(%) 2 Weeks N Unc N Arnica 20 100.2 ± 63.0 SD Placebo 17 94.8


Jeffrey, et al.2002 37 VAS - Pain 1 week Y Y Y Arnica 20 2.6 NR Placebo 17 3.5 NR NR NR NR NR NS Two-tailed T-test

Jeffrey, et al.2002 37 VAS - Pain 2 Weeks Y Y Y Arnica 20 1.3 NR Placebo 17 2.5 NR NR NR NR NR <.03 Two-tailed T-test

Jeffrey, et al.2002 37 Wrist Circumference -percent change of

preoperative value (%) 1 week N Unc N Arnica 20 1.7 ± 1.8 SD Placebo 17 1.5


Hochberg, et al.2001 72 VAS - Pain 0 Days Y Y Y CCT 22 8.3

± 1.8 SD Ice Therapy 23 8.3 ± 1.3 SD NR NR NR NR 1.000 ANOVA

Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y CCT 22 4.5


Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y CCT pre-op 22 8.3

± 1.8 SD CCT 3 days 22 4.5 ± 3.2 SD NR NR -3.8

± 4.1 SD <0.001 ANOVA

Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y Ice Therapy pre-op 23 8.3

± 1.3 SD Ice Therapy 3 days 22 7.3 ± 2.5 SD NR NR -1.0

± 2.5 SD 0.097 ANOVA

Hochberg, et al.2001 72 VAS - Pain 0 Days Y Y Y CCT (ITT) 33 8.0

± 2.0 SD Ice Therapy (ITT) 35 8.3 ± 1.2 SD NR NR NR NR 0.453 ANOVA

Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y CCT (ITT) 31 4.7

± 3.4 SD Ice Therapy (ITT) 34 6.6 ± 3.2 SD NR NR NR NR 0.024 ANOVA

Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y CCT pre-op (ITT) 33 8.0

± 2.0 SD CCT 3 days (ITT) 31 4.7 ± 3.4 SD NR NR -3.2

± 4.1 SD <0.001 ANOVA

Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y Ice Therapy pre-op (ITT) 35 8.3

± 1.2 SD Ice Therapy 3 days (ITT) 34 6.6 ± 3.2 SD NR NR -1.8

± 3.2 SD 0.005 ANOVA

Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y CCT Change 20 -3.8

± 4.1 SD Ice Therapy Change 22 -1.0 ± 2.5 SD NR NR NR NR 0.010 ANOVA

Hochberg, et al.2001 72 VAS - Pain 3 Days Y Y Y CCT Change (ITT) 29 -3.2

± 4.1 SD Ice Thearpy Change(ITT) 34 -1.8


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Hochberg, et al.2001 72 Wrist Circumference (cm) 3 Days N Y N CCT 24 17.8

± 1.7 SD Ice therapy 24 17.8 ± 1.9 SD NR NR NR NR 1.000 ANOVA

Hochberg, et al.2001 72 Wrist Circumference (cm) 0 Days N Y N CCT 24 18.1

± 1.7 SD Ice therapy 23 17.0 ± 1.8 SD NR NR NR NR 0.037 ANOVA

Hochberg, et al.2001 72 Wrist Circumference (cm) 3 Days N Y N CCT Change 24 -0.3

± 0.4 SD Ice Therapy Change 23 -0.7 ± 0.5 SD NR NR NR NR <0.001 ANOVA

Hochberg, et al.2001 72 Wrist Circumference (cm) 0 Days N Y N CCT (ITT) 36 17.9

± 1.8 SD Ice therapy (ITT) 35 17.2 ± 1.9 SD NR NR NR NR 0.116 ANOVA

Hochberg, et al.2001 72 Wrist Circumference (cm) 3 Days N Y N CCT (ITT) 36 17.5

± 1.6 SD Ice therapy (ITT) 36 17.9 ± 1.9 SD NR NR NR NR 0.337 ANOVA

Hochberg, et al.2001 72 Wrist Circumference (cm) 3 Days N Y N CCT Change (ITT) 36 -0.4

± 0.5 SD Ice Therapy Change (ITT) 35 -0.7

± 0.5 SD NR NR NR NR <0.001 ANOVA

Hochberg, et al.2001 72 Vicodin ES Pills remainig 3 Days N Unc N CCT 24 19.1


Hochberg, et al.2001 72 Daily Pill Count (pills) 1 Days N Unc N CCT 23 3.0

± 2.4 SD Ice Therapy 20 4.5 NR NR NR NR NR 0.099 ANOVA







Provinciali, et al.2000 100 BCTQ 0 Days Y Y Y Physiotherapy 50 2.49 NR Controls 50 2.38 NR NR NR NR NR NR NR

Provinciali, et al.2000 100 Nine-hole Peg Test (seconds) 0 Days N Y N Physiotherapy 50 22.35

± 5.14 SD Controls 50 22.38 ± 3.23 SD NR NR NR NR NR NR

Provinciali, et al.2000 100 Jebson-Taylor subtest 1 (seconds) 0 Days N Y N Physiotherapy 50 25.74














Provinciali, et al.2000 100 Return to Work (days) n/a Y Y N Physiotherapy 50 32.16

± 10.72 SD Controls 50 42.55 ± 13.39 SD NR NR NR NR <0.006 ANOVA

Finsen, et al.1999 82 VAS - Discomfort 0 Days Y Y Y Immobilized 37 56

{46 - 65} 95% CI Mobilized 45 51 {38 - 57} 95% CI NR NR NR NR NR NR

Finsen, et al.1999 82 VAS - Discomfort 2 Weeks Y Y Y Immobilized 37 6


Finsen, et al.1999 82 VAS - Discomfort 6 Weeks Y Y Y Immobilized 36 6


Finsen, et al.1999 82 VAS - Discomfort 6 Months Y Y Y Immobilized 37 3





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Bury, et al.1995 40 Grip Strength (kg) 2 Weeks N Y N Post-Op Splint NR 26.1 NR Control NR 29.4 NR NR NR NR NR > 0.05 Unclear

Bury, et al.1995 40 Pinch Strength (kg) 2 Weeks N Y N Post-Op Splint NR 3.9 NR Control NR 3.8 NR NR NR NR NR > 0.05 Unclear

Bury, et al.1995 40 Subjective Score 2 Weeks Y Unc Y Post-Op Splint 26 8.1 NR Control 17 8.0 NR NR NR NR NR NR Unclear

Bury, et al.1995 40 Range of Motion - Wrist (degrees) 2 Weeks N Y N Post-Op Splint 26 131.5 NR Control 17 129.0 NR NR NR NR NR NS Unclear

Cook, et al.1995 50 Pain (10 point scale) 14 Days Y Unc Y Post-Op Splinting 25 2.4 NR Control 25 0.9 NR NR NR NR NR 0.001 One-tailed T-test

Cook, et al.1995 50 Pain (10 point scale) 1 Month Y Unc Y Post-Op Splinting 25 1.5 NR Control 25 0.5 NR NR NR NR NR 0.01 One-tailed T-test

Cook, et al.1995 50 Grip Strength (kg) 14 Days N Y N Post-Op Splinting 25 10 NR Control 25 15 NR NR NR NR NR 0.003 One-tailed T-test

Cook, et al.1995 50 Grip Strength (kg) 1 Month N Y N Post-Op Splinting 25 14 NR Control 25 18 NR NR NR NR NR 0.02 One-tailed T-test

Cook, et al.1995 50 Pinch Strength (kg) 14 Days N Y N Post-Op Splinting 25 4 NR Control 25 6 NR NR NR NR NR 0.01 One-tailed T-test

Cook, et al.1995 50 Pinch Strength (kg) 1 Month N Y N Post-Op Splinting 25 5 NR Control 25 7 NR NR NR NR NR 0.01 One-tailed T-test

Cook, et al.1995 50 Pain (10 point scale) 3 Months Y Unc Y Post-Op Splinting 25 NR NR Control 25 NR NR 0 NR NR NR NR NR

Cook, et al.1995 50 Pain (10 point scale) 6 Months Y Unc Y Post-Op Splinting 25 NR NR Control 25 NR NR 0 NR NR NR NR NR

Cook, et al.1995 50 Grip Strength (kg) 3 Months N Y N Post-Op Splinting 25 NR NR Control 25 NR NR 0 NR NR NR NR NR

Cook, et al.1995 50 Grip Strength (kg) 6 Months N Y N Post-Op Splinting 25 NR NR Control 25 NR NR 0 NR NR NR NR NR

Cook, et al.1995 50 Pinch Strength (kg) 3 Months N Y N Post-Op Splinting 25 NR NR Control 25 NR NR 0 NR NR NR NR NR


Post-operative Treatment Dichotomous Data Results


Martins, et al.2006 52 Tinel sign 0 Days N Y N Number Splint 26 21 NR No Splint 26 23 NR None NR NR NR NR

Martins, et al.2006 52 Phalens test 0 Days N Y N Number Splint 26 24 NR No Splint 26 25 NR None NR NR NR NR

Martins, et al.2006 52 Durkans test 0 N Y N Number Splint 26 25 NR No Splint 26 26 NR None NR NR NR NR

Martins, et al.2006 52 Bowstringing 2 Weeks N Y N Number Splint 26 0 NR No Splint 26 0 NR None NR NR NR NR

Provinciali, et al.2000 100 BCTQ - Severity of Pain 0 Days Y Y Y Sum (without

Functional scores) Physiotherapy 50 149 NR Controls 50 145 NR None NR NR NR NR

Provinciali, et al.2000 100 BCTQ - Severity of Pain 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Severity of Pain 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Waking with pain 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Waking with pain 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Waking with pain 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Daytime pain 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Daytime pain 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Daytime pain 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Recurrence of pain 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Recurrence of pain 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Recurrence of pain 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Duration of episode 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Duration of episode 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Duration of episode 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Numbness 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Numbness 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Numbness 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Weakness 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Weakness 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Weakness 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Tingling sensation 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Tingling sensation 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Tingling sensation 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Severity of numbness 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Severity of numbness 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Severity of numbness 2 Months Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Waking with numbness 0 Days Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Waking with numbness 1 Month Y Y Y Sum (without


Provinciali, et al.2000 100 BCTQ - Waking with numbness 2 Months Y Y Y Sum (without


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Post-operative Treatment Dichotomous Data Results


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Finsen, et al.1999 82 Scar discomfort/pain 6 Weeks Y Y Y Number Immobilized 36 16 NR Mobilized 45 21 NR None NR NR NR NR

Finsen, et al.1999 82 Scar discomfort/pain 6 Months Y Y Y Number Immobilized 37 6 NR Mobilized 44 6 NR None NR NR NR NR

Finsen, et al.1999 82 Hypothenar Pain 6 Weeks Y Y Y Number Immobilized 36 5 NR Mobilized 45 5 NR None NR NR NR NR

Finsen, et al.1999 82 Hypothenar Pain 6 Months Y Y Y Number Immobilized 37 3 NR Mobilized 44 1 NR None NR NR NR NR

Finsen, et al.1999 82 Thenar Pain 6 Months Y Y Y Number Immobilized 37 1 NR Mobilized 44 1 NR None NR NR NR NR

Finsen, et al.1999 82 Thenar Pain 6 Weeks Y Y Y Number Immobilized 36 2 NR Mobilized 45 1 NR None NR NR NR NR

Finsen, et al.1999 82 Grip Strength 6 Weeks Y Y N Percentage of Pre-op

value Immobilized 36 76 {71 - 85} 95% CI Mobilized 45 78

{70 - 86} 95% CI None NR NR NR NR

Finsen, et al.1999 82 Key-pinch Strength 6 Weeks Y Y N Percentage of Pre-op



Finsen, et al.1999 82 4/5 pinch Strength 6 Weeks Y Y N Percentage of Pre-op



Finsen, et al.1999 82 4/5 pinch Strength 6 Months Y Y N Percentage of Pre-op



Finsen, et al.1999 82 Key-pinch Strength 6 Months Y Y N Percentage of Pre-op



Finsen, et al.1999 82 Grip Strength 6 Months Y Y N Percentage of Pre-op



Bury, et al.1995 47 Satisfaction - Cured 2 Weeks Y Unc Y Number Post-Op Splinting 26 12 NR Control 17 8 NR None NR NR NR NR

Bury, et al.1995 47 Satisfaction - Improved 2 Weeks Y Unc Y Number Post-Op Splinting 26 11 NR Control 17 9 NR None NR NR NR NR

Bury, et al.1995 47 Satisfaction - Unchanged 2 Weeks Y Unc Y Number Post-Op Splinting 26 1 NR Control 17 0 NR None NR NR NR NR

Bury, et al.1995 47 Satisfaction - Worse 2 Weeks Y Unc Y Number Post-Op Splinting 26 2 NR Control 17 0 NR None NR NR NR NR

Bury, et al.1995 47 Symptom Free 2 Weeks Y Y Y Percent Improved Post-Op Splinting 26 50 NR Control 17 53 NR None NR NR NR NR

Bury, et al.1995 47 Return to Work 5.7 Months Y Y N Percent Improved Post-Op Splinting 26 73 NR Control 17 88 NR None NR NR NR NR

Bury, et al.1995 47 Bowstringing NR N Y N Number Post-Op Splinting 26 0 NR Control 17 0 NR None NR NR NR NR

Cook, et al.1995 50 Scar Tenderness 1 Month Y Y Y Percent Post-Op Splinting 25 56 NR Control 25 32 NR NR NR NR 0.04 One-tailed T-test

Cook, et al.1995 50 Pillar Pain 1 Month Y Y Y Percent Post-Op Splinting 25 48 NR Control 25 20 NR NR NR NR 0.02 One-tailed T-test

Cook, et al.1995 50 Return to ADL (days) n/a Y Y N Number Post-Op Splinting NR 12 NR Control NR 6 NR NR NR NR 0.0004 One-tailed T-test

Cook, et al.1995 50 Return to Full duty Work (days) n/a Y Y N Number Post-Op Splinting NR 27 NR Control NR 17 NR NR NR NR 0.005 One-tailed T-test

Cook, et al.1995 50 Return to Light duty Work (days) n/a Y Y N Number Post-Op Splinting NR 24 NR Control NR 15 NR NR NR NR 0.01 One-tailed T-test

Cook, et al.1995 50 Satisfaction - Excellent 14 Days Y Unc Y Number Post-Op Splinting 25 1 NR Control 25 9 NR NR NR NR NR NR

Cook, et al.1995 50 Satisfaction - Good 14 Days Y Unc Y Number Post-Op Splinting 25 14 NR Control 25 9 NR NR NR NR NR NR

Cook, et al.1995 50 Satisfaction - Fair 14 Days Y Unc Y Number Post-Op Splinting 25 10 NR Control 25 7 NR NR NR NR NR NR

Cook, et al.1995 50 Satisfaction - Excellent 1 Month Y Unc Y Number Post-Op Splinting 25 2 NR Control 25 12 NR NR NR NR NR NR

Cook, et al.1995 50 Satisfaction - Good 1 Month Y Unc Y Number Post-Op Splinting 25 18 NR Control 25 10 NR NR NR NR NR NR

Cook, et al.1995 50 Satisfaction - Fair 1 Month Y Unc Y Number Post-Op Splinting 25 5 NR Control 25 3 NR NR NR NR NR NR

Cook, et al.1995 50 Bowstringing NR N Y N Number Post-Op Splinting 25 0 NR Control 25 0 NR NR NR NR NR NR


Benefits and Harms


SSS Martins, et al. 2 weeks ? Level II

2 Point Discrimination Martins, et al. 2 weeks ● Level II

Patient Satisfaction (Cured/Improved) Bury, et al. 2 weeks ? Level II

Symptom Free Bury, et al. 2 weeks ? Level II

Patient Satisfaction (Excellent/Good) Cook, et al. 2 weeks ? Level II

Patient Satisfaction (Excellent/Good) Cook, et al. 1 month ? Level II

Grip Strength Cook, et al. 2 weeks ○ Level II

Grip Strength Cook, et al. 1 month ? Level II

Pinch Strength Cook, et al. 2 weeks ? Level II

Pinch Strength Cook, et al. 1 month ? Level II

Return to ADL Cook, et al. n/a ○ Level II

Return to Light Duty Work Cook, et al. n/a ○ Level II

Return to Full Duty Work Cook, et al. n/a ○ Level II

Pain Cook, et al. 2 weeks ○ Level II

Pain Cook, et al. 1 month ○ Level II

Discomfort Finsen, et al. 2 weeks ? Level II

Discomfort Finsen, et al. 6 weeks ○ Level II

Discomfort Finsen, et al. 6 months ? Level II

SSS Provinciali, et al. 1 month ? Level II

Return to Work Provinciali, et al. n/a ○ Level II


Pillar Pain Cook, et al. 1 month ○ Level II

Scar Tenderness Cook, et al. 1 month ? Level II

Scar Discomfort/Pain Finsen, et al. 6 weeks ? Level II

Scar Discomfort/Pain Finsen, et al. 6 months ? Level II

Thenar Pain Finsen, et al. 6 weeks ? Level II

Thenar Pain Finsen, et al. 6 months ? Level II

Hypothenar Pain Finsen, et al. 6 weeks ? Level II

Hypothenar Pain Finsen, et al. 6 months ? Level II

Bowstringing Martins, et al. 2 Weeks ? Level II

Bowstringing Bury, et al. 2 Weeks ? Level II

Bowstringing Cook, et al. 2 Weeks ? Level II


Post - Operative Splinting

● = Significant in favor of Post-operative treatment○ = Significant in favor of no Post-operative treatment◐ = Treatments "equal" in appropriately powered studies

Post - Operative Treatments


Post-Operative Physiotherapy






Martins, et al. SSS 2 weeks SMD 0.20 0.7

Martins, et al. 2 Point Discrimination 2 weeks SMD Significant n/a

Bury, et al. Patient Satisfaction (Cured/Improved) 2 weeks OR 0.19 ( 0.13 - 7.67 )

Bury, et al. Symptom Free 2 weeks OR 0.89 ( 0.12 - 8.45 )

Cook, et al. Patient Satisfaction (Excellent/Good) 2 weeks OR 0.58 ( 0.12 - 8.66 )

Cook, et al. Patient Satisfaction (Excellent/Good) 1 month OR 0.55 ( 0.28 - 3.60 )

Cook, et al. Grip Strength 2 weeks SMD Significant n/a

Cook, et al. Grip Strength 1 month SMD 0.30 0.81

Cook, et al. Pinch Strength 2 weeks SMD 0.53 0.81

Cook, et al. Pinch Strength 1 month SMD 0.44 0.81

Cook, et al. Return to ADL n/a SMD Significant n/a

Cook, et al. Return to Light Duty Work n/a SMD Significant n/a

Cook, et al. Return to Full Duty Work n/a SMD Significant n/a










Cook, et al. Pain 2 weeks SMD Significant n/a

Cook, et al. Pain 1 month SMD Significant n/a

Cook, et al. Pillar Pain 1 month OR Significant n/a

Cook, et al. Scar Tenderness 1 month OR 0.37 ( 0.53 - 1.89 )

Finsen, et al. Discomfort 2 weeks SMD 0.27 0.63

Finsen, et al. Discomfort 6 weeks SMD Significant n/a

Finsen, et al. Discomfort 6 months SMD 0.18 0.63

Finsen, et al. Scar Discomfort/Pain 6 weeks OR 1.09 ( 0.28 - 3.61 )

Finsen, et al. Scar Discomfort/Pain 6 months OR 0.82 ( 0.28 - 3.58 )

Finsen, et al. Thenar Pain 6 weeks OR 0.39 ( 0.21 - 4.81 )

Finsen, et al. Thenar Pain 6 months OR 0.84 ( 0.10 - 10.28 )

Finsen, et al. Hypothenar Pain 6 weeks OR 0.77 ( 0.27 - 3.69 )

Finsen, et al. Hypothenar Pain 6 months OR 0.26 ( 0.31 - 3.24 )


Post - Operative Splinting (cont.)







Provinciali, et al. SSS 1 month SMD 0.05 0.57

Provinciali, et al. Return to Work n/a SMD Significant n/a

* If the value of the effect size was statistically significant (p < 0.05) the minimal detectable effect size is not calculated† For OR: underpowered studies will have an effect size within the listed range

Post - Operative Physiotherapy

OR = Odds Ratio ; SMD = Standardized Mean Differrence (Hedges d) ; n/a = not applicable


Instrument EvaluationExcluded Articles


Changulani, et al.2007 Outcome evaluation measures for wrist and hand - which one to choose? Int Orthop Literature Review

Sambandam, et al.2007 Critical analysis of outcome measures used in the assessment of carpal tunnel syndrome Int Orthop Literature Review

Imaeda, et al.2006

Validation of the Japanese Society for Surgery of the Hand Version of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH-JSSH) questionnaire J Orthop Sci No usable data, evaluating shortened version

of DASH - Quick DASH

Atroshi, et al.2006

Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial BMJ Not relevant, compare endo vs open surgery,

no usable data

Mondelli, et al.2006 A self-administered questionnaire of ulnar neuropathy at the elbow Neurol Sci Not relevant, questionnaire on ulnar neuropathy


A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF) as a reference tool

BMC Musculoskelet Disord

No usable data, assess most relevant outcomes

Boyd, et al.2005 Outcomes in carpal tunnel syndrome: symptom severity, conservative management and progression to surgery Clin Invest Med No usable data, only pre and post data

Kane, et al.2005 Visual Analog Scale pain reporting was standardized J Clin Epidemiol No usable data, standarizing pain through VAS

Padua, et al.2005 Boston Carpal Tunnel Questionnaire: the influence of diagnosis on patient-oriented results Neurol Res Not relevant, diagnosis related, no usable data

Goitz, et al.2005 Microvascular omental transfer for the treatment of severe recurrent median neuritis of the wrist: a long-term follow-up Plast Reconstr Surg Not relevant, <10 patients

Reale, et al.2003 Protocol of outcome evaluation for surgical release of carpal tunnel syndrome Neurosurgery No usable data, objective to create protocol for

evaluation

Heybeli, et al.2002

Assessment of outcome of carpal tunnel syndrome: a comparison of electrophysiological findings and a self-administered Boston questionnaire J Hand Surg [Br ] BCTQ compared to electrophsiological findings,

no usable data

Kane, et al.2002 Efforts to standardize the reporting of pain J Clin Epidemiol No usable data, trying to standardize pain

through severity comparisons

Szabo, et al.2001 Outcomes assessment in hand surgery: when are they meaningful? J Hand Surg [Am ] Review, No data

Carr, et al.2001 Are quality of life measures patient centred? BMJ Literature Review, no data

Randolph, et al.2000 Carpal tunnel syndrome. Testing the sensitivity and validity of four 'localized discomfort' instruments AAOHN J No usable data

Mondelli, et al.2000

Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome J Hand Surg [Br ] Comparing BCTQ to electrophysiological

findings, no usable data

Davis, et al.1999 Measuring disability of the upper extremity: a rationale supporting the use of a regional outcome measure J Hand Ther No usable data, rationale for regional outcome

measure use

Feuerstein, et al.1999 Clinical management of carpal tunnel syndrome: a 12-year review of outcomes Am J Ind Med Not relevant, worker's comp information

Finsen, et al.1999 No advantage from splinting the wrist after open carpal tunnel release. A randomized study of 82 wrists Acta Orthop Scand Not relevant, no usable data

MacDermid, et al.1998 Patient rating of wrist pain and disability: a reliable and valid measurement tool J Orthop Trauma Did not meet our definitions of reproducibility or

criterion validity

Hudak, et al.1996

Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG) Am J Ind Med No usable data, describing development of

DASH

Chertow, et al.1996 Performance characteristics of a dialysis-related amyloidosis questionnaire J Am Soc Nephrol Not relevant, questionnaire on dialysis, no

usable data

Katz, et al.1994 A preliminary scoring system for assessing the outcome of carpal tunnel release J Hand Surg [Am ] Not relevant, Global Score not in database,

recs, or any found article


Instrument EvaluationExcluded Articles


McHorney, et al.1993

The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs Med Care Patient groups are not explicitly defined,

compare diff. severity of disease

Ware, et al.1992 The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection Med Care Literature Review only

Wewers, et al.1990 A critical review of visual analogue scales in the measurement of clinical phenomena Res Nurs Health Literature Review only

Patrick, et al.1989 Generic and disease-specific measures in assessing health status and quality of life Med Care Literature Review, no data

Guyatt, et al.1989 Responsiveness and validity in health status measurement: a clarification J Clin Epidemiol Not relevant, unrelated questionnaires

Guyatt, et al.1987 Measuring change over time: assessing the usefulness of evaluative instruments J Chronic Dis No usable data, evaluating usefulness of

evaluation instruments

Deyo, et al.1986 Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance J Chronic Dis Not relevant, unrelated questionnaires


Instrument EvaluationIncluded Articles


Forward, et al.2007 The internal consistency and validity of the patient evaluation measure for outcomes assessment in distal radius fractures J Hand Surg [Br ]

Kotsis, et al.2007

Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment J Hand Surg [Am ]

De, et al.2007 Responsiveness of the Dutch version of the DASH as an outcome measure for carpal tunnel syndrome J Hand Surg [Br ]

Ozyurekoglu, et al.2006 The minimal clinically important difference of the Carpal Tunnel Syndrome Symptom Severity Scale J Hand Surg [Am ]

Singh, et al.2006

Quality of life assessment using the Short Form-12 (SF-12) questionnaire in patients with cervical spondylotic myelopathy: comparison with SF-36 Spine

Wah, et al.2006 Construct validity of the Chinese version of the Patient-rated Wrist Evaluation Questionnaire (PRWE-Hong Kong Version) J Hand Ther

Williams, et al.2006 The validity and utility of the BPI interference measures for evaluating the impact of osteoarthritic pain J Pain Symptom Manage

Imaeda, et al.2006

Comparative responsiveness of Japanese versions of the DASH and SF-36 questionnaires and physical measurement to clinical changes after carpal tunnel release Hand Surg

Leite, et al.2006 A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire BMC Musculoskelet

Disord

Spies-Dorgelo, et al.2006

Reproducibility and responsiveness of the Symptom Severity Scale and the hand and finger function subscale of the Dutch arthritisimpact measurement scales (Dutch-AIMS2-HFF) in primary care patients with wrist or hand problems

Health Qual Life Outcomes

Kotsis, et al.2005

Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire in carpal tunnel surgery J Hand Surg [Am ]

Hobby, et al.2005 Validity and responsiveness of the patient evaluation measure as an outcome measure for carpal tunnel syndrome J Hand Surg [Br ]

Keller, et al.2004 Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain Clin J Pain

Tan, et al.2004 Validation of the Brief Pain Inventory for chronic nonmalignant pain J Pain

Greenslade, et al.2004

Dash and Boston questionnaire assessment of carpal tunnel syndrome outcome: what is the responsiveness of an outcome questionnaire? J Hand Surg [Br ]

Gay, et al.2003

Comparative responsiveness of the disabilities of the arm, shoulder, and hand, the carpal tunnel questionnaire, and the SF-36 to clinical change after carpal tunnel release J Hand Surg [Am ]

Gummesson, et al.2003

The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery

BMC Musculoskelet Disord

Rosales, et al.2002

Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: cross-cultural adaptation process and reliability J Hand Surg [Am ]

Dias, et al.2001 Assessing the outcome of disorders of the hand. Is the patient evaluation measure reliable, valid, responsive and without bias? J Bone Joint Surg Br


Instrument EvaluationIncluded Articles


Beaton, et al.2001

Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity J Hand Ther

MacDermid, et al.2000

Responsiveness of the short form-36, disability of the arm, shoulder, and hand questionnaire, patient-rated wrist evaluation, and physical impairment measurements in evaluating recovery after a distal radius fracture J Hand Surg [Am ]

Chung, et al.1998 Reliability and validity testing of the Michigan Hand Outcomes Questionnaire J Hand Surg [Am ]

Bessette, et al.1998

Comparative responsiveness of generic versus disease-specific and weighted versus unweighted health status measures in carpal tunnel syndrome Med Care

Atroshi, et al.1997 Assessment of the carpal tunnel outcome instrument in patients with nerve-compression symptoms J Hand Surg [Am ]

Amadio, et al.1996 Outcome after Colles fracture: the relative responsiveness of three questionnaires and physical examination measures J Hand Surg [Am ]

Amadio, et al.1996

Outcome assessment for carpal tunnel surgery: the relative responsiveness of generic, arthritis-specific, disease-specific, and physical examination measures J Hand Surg [Am ]

Jenkinson, et al.1994 Criterion validity and reliability of the SF-36 in a population sample Qual Life Res

Katz, et al.1992 Comparative measurement sensitivity of short and longer health status instruments Med Care

Brazier, et al.1992 Validating the SF-36 health survey questionnaire: new outcome measure for primary care BMJ

Meenan, et al.1992 AIMS2. The content and properties of a revised and expanded Arthritis Impact Measurement Scales Health Status Questionnaire Arthritis Rheum


Instrument EvaluationSummary of Instruments

Instrument Instrument Classification*

# of Subscales Name of Subscales # of Items per

subscale

Arthritis Impact Measurement Scale 2, AIMS2 Disease Specific 16 Mobility Level 4Walking and Bending 5

Hands and Finger Function 5Arm Function 5

Self-Care Tasks 4Household Tasks 4

Social Activity 5Support of Family and Friends 4

Arthritis Pain 5Work 5

Level of Tension 5Mood 5

Satisfaction with each of 12 health areas 1Arthritis Impact on each of 12 areas of health 1

Three Areas most like to see improve 1Current and future health 5Overall Arthritis Impact 6Demographic Profile 6

Boston Carpal Tunnel Questionnaire, BCTQ Disease Specific 2 Symptom Severity Scale 11Functional Status Scale 8

Brief Pain Inventory, BPI Dimension Specific 1 Pain 32Disabilities of the Arm, Shoulder, and Hand, DASH Region-Site Specific 3 Disability/symptom 30

2 optional work 4sport/music 4

Michigan Hand Outcomes Quesionnaire, MHOQ Region-Site Specific 13 Function - Rt Hand 5Function - Lt Hand 5Tasks - Rt Hand 5Tasks - Lt Hand 5

Tasks - Both Hands 7Work 5

Pain - Rt hand 5Pain Lt Hand 5

Appearance - Rt Hand 4Appearance - Lt Hand 4Satisfaction -Rt Hand 6Satisfaction - Lt Hand 6Demographic Profile 8


Instrument EvaluationSummary of Instruments

Instrument Instrument Classification*

# of Subscales Name of Subscales # of Items per

subscale

Patient Evaluation Measure Region-Site Specific 3 Treatment 5Current Feeling 10

Overall Assessment 3Patient Rated Wrist Evaluation, PRWE Region-Site Specific 3 Pain 5

Function 6Activities 4

SF-12 Generic 8 General Health 12SF-36 Generic 8 Physical Functioning 10

Role-Physical 4Role-Emotional 3

Pain 2Social Functioning 2

Mental Health 5Energy/Fatigue 4

General Health Perceptions 5Change in Health 1

Visual Analog Scale Dimension Specific NA Tool NA

* Classifications per Fitzpatrick (1998).


Instrument EvaluationStudy Design and Patient Characteristics

Author Study Design Instrument(s) Disease of Interest N Mean Age SD Age Range

Percent Female

De Smet, et al.2007 Prospective Disabilities of the Arm, Shoulder, and

Hand (DASH) CTS 119 51 NR 26 - 60 98/119

Imaeda, et al.2006 Prospective DASH, Medical Outcomes Study 36 Item

Short Form (SF-36) CTS 25 57 ± 14 19 - 78 24/25

Leite, et al. 2006 Systematic Review Boston Carpal Tunnel Questionnaire

(BCTQ) CTS

Ozyurekoglu, et al.2006 Prospective BCTQ Symptom Severity Scale (SSS) CTS 28 38 NR 28 - 77 19/28

Hobby, et al.2005 Prospective Patient Evaluation Measure (PEM),

DASH CTS 32 51 NR 31-86 72%

Kotsis, et al.2005 Prospective Michigan Hand Outcomes Questionnaire (MHQ),

DASH CTS 51 54 ± 13 NR 41/50

Greenslade, et al.2004 Total = 173 NR NR NR NR

Responsiveness = 100 NR NR NR NR

Reproducibility = 73 NR NR NR NR

Gay, et al.2003 Prospective DASH, BCTQ, SF-36 CTS 42 55 ± 13 31 - 81 55%

Gummesson, et al.2003

upper-extremity musculoskeletal conditions 118 52 NR 18 - 83 63/109

CTS 19 52 NR 30 - 83 17/19

Arthroscopic Acromioplasty 25 54 NR 37 - 71 12 of 25

Bessette, et al.1998 Prospective BCTQ, SF-36, SF-12 CTS 270 49 ± 15 NR 69%

Atroshi, et al.1997 Prospective Boston Carpal Tunnel Questionnaire

(BCTQ)Carpal Tunnel Syndrome and other nerve compression neuropathies 114 NR NR NR NR

Amadio, et al.1996 Prospective

SF-36, Arthritis Impact Measurement Scales (AIMS2), Brigham and Women's

carpal tunnel questionnaire (BCTQ)CTS 22 60 NR 33-80 13/22

NR=Not Reported

Prospective DASH

Varied across primary articles.

CTSDASH, BCTQ-SSS, BCTQ-Functional Status Scale (FSS)Prospective


Instrument EvaluationQuality Summary

Author N Instruments Compared Study Design Follow-up/

Response Rate %

Enrollment of patients at same

time point/ severity account?

**BlindingFunded by a not for profit

agency?

***Theory and a priori hypothesis

(Correlation)

Study Power "a priori"

Level of Evidence

De Smet, et al.2007 119 DASH/BCTQ Prospective/

Mail Questionnaire 83 Y N NR N N II

Forward, et al.2007 200 DASH/PEM Cross-Sectional 100 N N NR N N II

Kotsis et al. 2007 96 MHQ Prospective NR Y N Y N N II

Imaeda, et al.2006 25 DASH/SF36 Prospective DASH Work = 60

All Other Modules = 84 Y Y NR N N II

Ozyurekoglu, et al.2006 28 SSS Prospective NR Y Y Y Y N I

Singh, et al.2006 105 SF36/SF12 Prospective NR Y N Y N N II

Spies-Dorgelo, et al.2006 84 AIMS2/SSS Prospective 96 N N Y N Y II

Wah, et al.2006 47 PRWE/ SF36/VAS Prospective 100 N N NR N N II

Williams, et al.2006 132 BPI

RCT* Note: Unclear if this is a retrospective

summary of two studies.

Study 1 = 50 Study 2 = 37 N Y N Y N III

Hobby, et al.2005 32 DASH/PEM Prospective 75 Y N UC Y N II

Kotsis, et al.2005 51 DASH/MHQ Prospective 98 Y N Y NA N II

Greenslade, et al.2004 88 DASH/BCTQ Prospective 72 Y N NR NA N II

Keller S., et al.2004 250 BPI/SF36 Prospective 79 N N N Y N II

Tan, et al.2004 440 BPI Prospective V1-V2=43

V1-V3= 22 N N NR Y N III

Gay, et al.2003 42 DASH/BCTQ/SF36 Prospective 95 Y N Y Y Y I

Gummesson, et al.2003 118 DASH Prospective 92 N N Y N N II

Mondelli, et al. 2002 219 Hi-Ob Scale Prospective 92 Y N NR NA N III

Rosales, et al. 2002 42 DASH/BCTQ Prospective 100 N N Y Y N II

Beaton, et al.2001 200 DASH/BCTQ Prospective 86 N N Y Y Y I


Instrument EvaluationQuality Summary

Author N Instruments Compared Study Design Follow-up/

Response Rate %

Enrollment of patients at same

time point/ severity account?

**BlindingFunded by a not for profit

agency?

***Theory and a priori hypothesis

(Correlation)

Study Power "a priori"

Level of Evidence

Dias, et al.2001 80 PEM Prospective NR Y N Y N N II

MacDermid, et al.2000 59 DASH/SF36/PRWE Prospective 100 N N Y N N II

Atroshi, et al. 1998 102 BCTQ Prospective 92 N UC Y Y N II

Bessette, et al.1998 270 BCTQ/SF36/SF12 Prospective 73 Y N Y N N II

Chung, et al.1998 200 MHQ/SF12 Prospective 99 N N Y Y N II

Wah et al 47 PRWE/ SF36/VAS Prospective 100 N Y NAtroshi, et al.1997 114 BCTQ Prospective NA N N Y Y N II

Amadio PC, et al.1996 21 BCTQ/SF36/AIMS2 Prospective 100 Y N Y NA Y II

Amadio, et al.1996 22 SF36/AIMS2/BCTQ Prospective 64 Y N Y NA Y II

Katz et al. 1996 268 BCTQ Prospective 81 N N Y Y N II

Jenkinson C, et al. 1994 9332 SF36 Cross-Sectional/

Mail Questionnaire 72 N N N Y N III

Katz et al. 1994 104 BCTQ Prospective 41 Y N Y Y N III

Levine et al. 1993 67 BCTQ Prospective On-going N N Y Y N II

Brazier, et al.1992 1582 SF36/Nottingham

health profileCross-Sectional/

Mail Questionnaire 83 N N Y N N II

Katz, et al.1992 54 SF36/AIMS2/

FSQ/SIP/MHQProspective/

Mail Questionnaire 51 Y N Y NA N III

Meenan, et al.1992 408 AIMS2 Cross-Sectional/

Mail Questionnaire 51 Y N Y Y N II

Y = Yes

N = No

Note: All studies reported quantitative results.

*Four studies made efforts to improve response rates: De Smet et al., Beaton et al, Jenkinson et al and Brazier et al. These were all mail questionnaires.

**Studies that reported blinding indicated the caregivers were blinded to the questionnaire given and all results.

***If a study only investigated responsiveness, an a priori hypothesis would not be expected to be stated and was therefore identified as Not applicable.

NR = Not Reported

UC = Unclear

NA = Not Applicable


Instrument EvaluationFunding

Author N Funding reported? Funding Statement or Source

De Smet, et al.2007 144 NR NR

Forward, et al.2007 200 NR NR

Kotsis, et al.2007 96 R No benefits in any form have been received or will be recieved from a commercial party related

directly or indirectly to the subject of this article.

Imaeda, et al.2006 25 NR NR

Ozyurekoglu, et al.2006 28 R No benefits in any form have been received or will be received from a commercial party related


Singh, et al.2006 105 R No funds were received in support of this work. No benefits in any form have been or will be

received from a commercial party related directly or indirectly to the subject of this manuscript.

Spies-Dorgelo, et al.2006 84 R This study was funded by the Netherlands Organization for Health Research and Development

(ZonMW) in The Hague.

Wah, et al.2006 47 NR NR

Williams, et al.2006 132 R This research was supported under a contract with Purdue Pharma LP.

Hobby, et al.2005 32 R A research grant was provided by the Chelmsford Medical Education and Research Trust to support

this study.

Kotsis, et al.2005 51 R No benefits in any form have been received or will be received from a commercial party related


Greenslade, et al.2004 173 NR NR

Keller S., et al.2004 250 R This work was supported by a contract with Janssen Pharmaceutica, Inc.

Tan, et al.2004 440 NR NR

Gay, et al.2003 42 R

No benefits in any form have been received or will be recieved from a commercial party related directly or indirectly to the subject of this article. This research was supported in part by the National

Institute on Disability and Rehabilitation Research and the Research Enrichment Program for Physiatrists of the Missouri Arthritis Rehabilitation Research and Training Center.

NR = Not ReportedR = Reported




Gummesson, et al.2003 118 R This research was supported by the Swedish Foundation for Health Care Sciences and Allergy

Research, the Kristianstad County Council and the Skane County Council.

Mondelli et al. 2002 219 NR NR

Rosales et al. 2002 42 R No benefits in any form have been received or will be received from a commercial party related


Beaton, et al.2001 200 R

This work was supported by the research grants from the American Society for Surgery of the Hand; the Institute for Work and Health; by a PhD fellowship in health research from the Medical Research Council of Canada for Dr. Beaton, a scientist award from the Medical Research Council of Canada (Dr. Wright) and grant # AR36308 from the U. S. National Institutes of Health and the US National

Arthritis Foundation (Dr. Katz).

Dias, et al.2001 80 R No benefits in any form have been received or will be received from a commercial party related


MacDermid, et al.2000 59 R No benefits in any form have been received or will be received from a commercial party related


Atroshi, et al. 1998 102 R The study was supported by a grant from the Kristianstad County Council and the Swedish Medical

Research Council.

Bessette, et al.1998 270 R

Supported in part by NIH grant #AR36308 and an Arthritis Investigator Award from the Arthritis Foundation to Dr. Katz. Dr. Bessette is a recipient of a fellowship of the Fonds de la Recherche en

Sanre du Quebec.

Chung, et al.1998 200 R

No benefits in any form have been received or will be recieved from a commercial party related directly or indirectly to the subject of this article. Research is supported by the Robert Wood Johnson Foundation and the Department of Veterans Affairs Health Services Research and

Development.

Atroshi, et al.1997 114 R No benefits in any form have been received or will be received from a commercial party related


Amadio PC, et al.1996 21 R

Supported in part by a grant from the American Society for Surgery of the Hand. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to

the subject of this article.

Amadio, et al.1996 22 R

Supported by a grant from the American Society for Surgery of the Hand. No benefits in any form have been received or will be received from a commercial partly related directly or indirectly to the

subject of this article.

Katz et al. 1995 268 R

This research was supported in part by National Institutes of Health grant AR36308, Agency for Health Care Policy and Research grant 5R18 H50 6813-04, and an Arthritis Foundation Investigator

Award to Dr. Katz.





Jenkinson C, et al. 1994 13042 NR NR

Katz et al. 1994 104 R Supported in part by the National Institutes of Health (grant no. AR36308) and an Arthritis

Investigator Award from the Arthritis Foundations (JNK)

Levine et al. 1993 38 R

No benefits in any form have been received or will be recieved from a commercial party related directly or indirectly to the subject of this article. Funds were received in total or partial support of the

research or clinical study presented in this article. The funding sources were the Brigham Orthopaedic Foundation, the National Institutes of Health (Grant AR36308) the Agency for Health

Care Plicy and Research (Grant H506326), and post-doctoral fellowships from the Arthritis Foundation (Dr. Katz)and the Agency for Health Care Policy and Research (Dr. Levine).

Brazier, et al.1992 1582 R Grant from the Medical Research Council. The Medical Research Unit is funded by the Department

of Health and Trent regional Health Authority

Katz, et al.1992 54 R

Supported in part by the Agency for Health Care Policy Research grant #HS06326-01 and the National Institutes of Health grant #AR36308. Dr. Katz is supported in part by a post-doctoral

fellowship from the Arthritis Foundation.

Meenan, et al.1992 408 R Supported by NIH Multipurpose Arthritis and Muskoskeletal Disease Center grant AR-20613 from

NIAMS



Instrument EvaluationBCTQ Summary

Author Psychometric Properties Assessed * Methods

Face/Content Validity

Construct Validity Responsiveness Reliability Acceptability Interpretability Population No. of Patients included in the analyses

Leite, et al. 2006 (Greenslade, et al. 2004) C C C >49 years,

72% womenAcceptability n=88, Responsiveness n=57,

Test-Retest n=31

Leite, et al. 2006 (Gay, et al. 2003) C C C 31-81 years,

55% women n=40

Leite, et al. 2006 (Mondelli, et al. 2002) C C C 20-90 years,

81% women n=219

Leite, et al. 2006 (Rosales, et al. 2002) C C 34-63 years,

86% women n=42

Leite, et al. 2006 (Atroshi, et al. 1998) C C C C 21-88 years,

66% womenResponsiveness/Construct Validity n=102,

Test-Retest n=22

Leite, et al. 2006 (Bessette, et al. 1998) C C C C >18 years,

84% women n=196

Leite, et al. 2006 (Amadio, et al. 1996) C C C 33-80 years,

72% women n=22

Leite, et al. 2006 (Katz, et al. 1996) C C C C 18-55 years,

70% women n=268

Leite, et al. 2006 (Katz, et al. 1994) C >18 years,

70% women n=43

Leite, et al. 2006 (Levine, et al. 1993) C C C C C 19-88 years,

75% womenConstruct Validity n=43,

Responsiveness n=39, Test-Retest n=31

Ozyurekoglu, et al 2006 ‡ C‡ C‡ 28-77 years, 68% women n=28

‡ Assessing Symptom Severity Scale (SSS) Only

The author in parenthesis is the author of the primary article found in the Leite, et al. systematic review.* C=Carpal Tunnel Syndrome, F=Colles Fracture, H=hand and wrist problems


Instrument EvaluationAIMS2 Summary




Amadio, et al. 1996

C C33 - 80 years, (mean age 60) 59% women

n = 22

C = Carpal Tunnel Syndrome


Instrument EvaluationDASH Summary




De Smet, et al. 2007 C C C

24 - 60 years, (mean age 51) 82.4% women

n = 144

Imaeda, et al. 2006 C C

19 - 78 years, (mean age 57) 96% women

n = 25

Hobby, et al. 2005 C C C C


n = 32

Kotsis, et al. 2005 C C mean age 54,

82% women n = 51

Greenslade, et al 2004 C C C >49 years,

72% womenAcceptability n=88, Responsiveness n=57,

Test-Retest n=31

Gay, et al. 2003 C C C

31-81 years, (mean age 55) 55% women

n = 42

Gummesson, et al. 2003 C C


n = 19



Instrument EvaluationMHQ Summary




Kotsis, et al. 2005 C C mean age 54,

82% women n = 50



Instrument EvaluationPEM Summary




Hobby, et al. 2005 C C C C


n = 32



Instrument EvaluationVAS Summary




Imaeda, et al. 2006 C C


n = 25



Instrument EvaluationSF-36 Summary




Imaeda, et al. 2006 C C C


n = 25

Gay, et al. 2003 C C C

31-81 years, (mean age 55) 55% women

n = 42

Bessette, et al. 1998 C C mean age 49,

69% women n = 196

Amadio, et al. 1996 C C


n = 22



Instrument EvaluationSF-12 Summary




Bessette, et al. 1998 C C mean age 49,

69% women n = 196



Instrument EvaluationBCTQ Reliability (CTS)

Author Disease Instrument Analyzed N Statistic Used Value N ‡ Mean Difference

95% Confidence Interval SD p-value Statistic Used Value

Leite, et al. 2006 BCTQ - SSS 0.1 (-0.1 to 0.3) NS Pearson

Correlation 0.82

* (Greenslade, et al. 2004) BCTQ - FSS 0.0 (-0.2 to 0.2) NS Pearson Correlation 0.79

Leite, et al. 2006 BCTQ - SSS Cronbach's Alpha 0.9 Pearson

Correlation 0.87

* (Rosales, et al. 2002) BCTQ - FSS Cronbach's Alpha 0.91 Pearson Correlation 0.85

Leite, et al. 2006 BCTQ - SSS Cronbach's Alpha 0.8 -0.1 p<0.05 Pearson

Correlation 0.64

* (Atroshi, et al. 1998) BCTQ - FSS Cronbach's Alpha 0.87 0.08 p<0.05 Pearson Correlation 0.71

Leite, et al. 2006 BCTQ - SSS WC/WCNon Cronbach's Alpha 0.89/0.88

* (Katz, et al. 1996) † BCTQ - FSS WC/WCNon Cronbach's Alpha 0.89/0.89

Leite, et al. 2006 BCTQ - SSS Cronbach's Alpha 0.89 Pearson

Correlation 0.91

* (Levine, et al. 1993) BCTQ - FSS Cronbach's Alpha 0.91 Pearson Correlation 0.93

Bessette et al 1998 CTS BCTQ (7 items) NR Cronbach's Alpha 0.81 NA NA NA NA NA NA NA

* The authors in parenthesis are the authors of the primary articles in the Leite, et al. systematic review.

SSS = Symptom Severity Scale, FSS = Functional Severity Scale

WC = Workers' Compensation Recipient, WCNon = Workers' Compensation Non-Recipient

BCTQ = Boston Carpal Tunnel Questionnaire

Internal Consistency Reproducibility

NA NA 31

CTS 67

CTS NA

102

31 NR

NR

NR NR

22

NA NA NA

CTS

CTS 268 NA NA NA

CTS 42 42 NR NR NR NR

NR NR

FSS Pearson Correlation Range 0.71 - 0.93

NA

NR

BCTQ Summary of Reproducibility:

Pearson Correlation Range 0.64 - 0.91SSS

BCTQ Reproducibility CTS only

† Fisher's Z transformation, significant differenct between two groups, p<0.05

‡ Mean differences were not statistically different from zero.

Cronbach's Alpha Range 0.87 - 0.91

BCTQ Summary of Internal Consistency:

FSS


BCTQ Internal Consistency CTS only

SSS


Instrument EvaluationDASH Reliability (CTS)

Author Disease Instrument Analyzed N Statistic Used Value N Mean Difference


Hobby, et al.2005 CTS DASH 32 Cronbach's Alpha 0.97 NR NR NR NR NR NR NR

Greenslade, et al.2004 CTS DASH NR NR NR 31 1 (-2 to 4) ± 8 0.21 Pearson's

Correlation 0.9

Gummesson, et al.2003 CTS DASH - preoperative 19 Cronbach's Alpha 0.96 NR NR NR NR NR NR NR

DASH - postoperative 19 Cronbach's Alpha 0.98 NR NR NR NR NR NR NR

Rosales, et al. 2002 CTS DASH 42 Cronbach's Alpha 0.95 42 -0.73 (-1.98 to 0.52) NR 0.245 Pearson's Correlation 0.97

DASH = Disabilities of the Arm, Shoulder, and HandNR = Not Reported DASH CTS only Summary of Internal Consistency: DASH CTS only Summary of Reproducibility:


DASH's Internal Consistency CTS only


DASH's Reproducibility CTS only

Pearson Correlation 0.9 - 0.97


Instrument EvaluationPEM Reliability (CTS)

Author Disease Instrument Analyzed N Statistic Used Value N Mean Difference


Hobby, et al.2005 CTS PEM 32 Cronbach's Alpha 0.94 NR NR NR NR NR NR NR

PEM = Patient Evaluation Measure


NR = Not Reported


Instrument EvaluationBCTQ Convergent Validity (CTS)

Author Disease Comparison Instrument 1 Comparison Instrument 2 Spearman Correlation Coefficient Notes/Additional Information

Leite, et al. 2006 CTS BCTQ DASH 0.9 6 weeks

(Gay, et al. 2003) BCTQ DASH 0.87 12 weeks

BCTQ - FSS DASH 0.88 6 weeks

Leite, et al. 2006 CTS BCTQ Historical-Objective severity scale Significant Correlation p<0.001

(Mondelli, et al. 2002) BCTQ Duration of Symptoms Significant Correlation p<0.001

BCTQ Electrophysiological Study Significant Correlation p<0.001

Leite, et al. 2006 CTS SSS SF-36 0.20 - 0.64 preoperative

(Atroshi, et al. 1998) FSS SF-36 0.29 - 0.70 preoperative

SSS SF-36 0.33 - 0.64 postoperative

FSS SF-36 0.34 - 0.67 postoperative

Leite, et al. 2006 CTS BCTQ Expectation of Symptom Relief 0.51 NR

(Bessette, et al. 1998) BCTQ Symptom Relief 0.51 NR

BCTQ Quality of Life 0.50 NR

BCTQ Satisfaction with the Outcomes of Surgery 0.56 NR

Leite, et al. 2006 CTS BCTQ - FSS AIMS2 - Hand and finger function 0.71 post-operative, AIMS2 normalized

(Amadio, et al. 1996) BCTQ - FSS SF-36 - Physical Role 0.70 postoperative

BCTQ - FSS Grip Strength 0.87 postoperative

BCTQ - FSS Pinch Strength 0.73 postoperative

BCTQ Convergent Validity

Legend:BCTQ = Boston Carpal Tunnel Syndrome SSS = Symptom Severity Scale FSS = Functional Status ScaleDASH = Disabilities of the Arm, Shoulder and Hand SF-36 = 36 Item Short Form AIMS2 = Arthritis Impact Measurement Scale 2


Instrument EvaluationBCTQ Convergent Validity (CTS)

Author Disease Comparison Instrument 1 Comparison Instrument 2 Spearman Correlation Coefficient Notes/Additional Information

BCTQ Convergent Validity

Leite, et al. 2006 CTS SSS Symptom Relief 0.59 NR

(Katz, et al. 1996) Workers' Compensation Recipients FSS Symptom Relief 0.48 NR

SSS Quality of Life 0.68 NR

FSS Quality of Life 0.54 NR

SSS Satisfaction with the Outcomes of Surgery 0.69 NR

FSS Satisfaction with the Outcomes of Surgery 0.55 NR

CTS Workers' Compensation Non-Recipients FSS Quality of Life 0.41 NR

Leite, et al. 2006 CTS FSS 2-Point Discrimination 0.42 NR

(Levine, et al. 1993) SSS Pinch Strength 0.47 NR

FSS Pinch Strength 0.60 NR

FSS Grip Strength 0.50 NR

Gay, et al.2003 CTS BCTQ - FSS DASH 0.91 12 weeks

BCTQ - SSS DASH 0.74 6 weeks

BCTQ - SSS DASH 0.76 12 weeks

Atroshi, et al.1997

Carpal Tunnel Syndrome and other nerve compression neuropathies Symptom Severity Scale Functional Status Scale 0.62 NR

Legend:BCTQ = Boston Carpal Tunnel Syndrome SSS = Symptom Severity Scale FSS = Functional Status ScaleDASH = Disabilities of the Arm, Shoulder and Hand SF-36 = 36 Item Short Form AIMS2 = Arthritis Impact Measurement Scale 2


Instrument EvaluationBCTQ Discriminant Validity (CTS)

Author Disease Comparison Instrument 1 Comparison Instrument 2Spearman Correlation Coefficient

Notes/Additional Information

Leite, et al. 2006 CTS SSS SF-36 0.20 - 0.64 preoperative

(Atroshi, et al. 1998) FSS SF-36 0.29 - 0.70 preoperative

SSS SF-36 0.33 - 0.64 postoperative

FSS SF-36 0.34 - 0.67 postoperative

Leite, et al. 2006 CTS SSS Symptom Relief 0.31 NR

(Katz, et al. 1996) Workers' Compensation Non-Recipients FSS Symptom Relief 0.19 NR

SSS Quality of Life 0.37 NR

SSS Satisfaction with the Outcomes of Surgery 0.37 NR

FSS Satisfaction with the Outcomes of Surgery 0.21 NR

Leite, et al. 2006 CTS SSS Median Sensory Conduction Velocity 0.11 NR

(Levine, et al. 1993) FSS Median Sensory Conduction Velocity 0.12 NR

SSS Semmes-Weinstein Monofilaments 0.17 NR

FSS Semmes-Weinstein Monofilaments 0.24 NR

SSS 2-Point Discrimination 0.15 NR

SSS Grip Strength 0.38 NR

Atroshi, et al.1997

Carpal Tunnel Syndrome and other nerve compression neuropathies Symptom Severity Scale Probability of CTS by Katz-Stirrat

Hand Diagram 0.31 NR

Functional Status Scale Probability of CTS by Katz-Stirrat Hand Diagram 0.13 NR

BCTQ Discriminant Validity

Legend:BCTQ = Boston Carpal Tunnel Syndrome SSS = Symptom Severity Scale FSS = Fuctional Status Scale NR = Not Reported


Instrument EvaluationBCTQ Summary Construct Validty (CTS)

Author Preoperative or Postoperative Correlation Converges With: Diverges With:

Leite, et al. 2006 post, 6 weeks DASH ――

(Gay, et al. 2003) post, 12 weeks DASH ――

Leite, et al. 2006 Historical-Objective severity Scale ――

(Mondelli, et al. 2002) Duration of symptoms ――

Electrophysiological Study ――

Leite, et al. 2006 Quality of Life ――

(Bessette, et al. 1998) Satisfaction with the outcomes of surgery ――

BCTQ Summary Construct Validty


Instrument EvaluationBCTQ-SSS Summary Construct Validty (CTS)


Leite, et al. 2006 Preoperative

(Atroshi, et al. 1998)

Postoperative

Leite, et al. 2006

(Katz, et al. 1996)

Quality of Life for Workers' Compensation Recipients

Quality of Life for Workers' Compensation Non-Recipients

Satisfaction with the outcomes of surgery for Workers' Compensation Recipients

Satisfaction with the outcomes of surgery for Workers' Compensation Non-Recipients

Leite, et al. 2006 Pinch Strength Median Sensory Conduction Velocity

(Levine, et al. 1993) ―― Semmes-Weinstein Monofilaments

―― 2-Point Discrimination

―― Grip Strength

Atroshi, et al. 1997 Functional Status Scale Probability of CTS by Kats-Stirrat Hand Diagram

BCTQ - SSS Summary Construct Validity

Symptom Relief for Workers' Compensation Recipients

Symptom Relief for Workers' Compensation Non-Recipients

SF-36 - Physical Role, Bodily Pain

SF-36 - Physical Functioning, General Health, Vitality, Social Functioning, Emotional Role, Mental

Health

SF-36 - Physical Role, Bodily Pain, Vitality, Emotional

Role

SF-36 - Physical Functioning, General Health, Social

Functioning, Mental Health


Instrument EvaluationBCTQ-FSS Summary Construct Validty (CTS)


Leite, et al. 2006 Preoperative

(Atroshi, et al. 1998)

Postoperative

Leite, et al. 2006

(Katz, et al. 1996)

Quality of Life for Workers' Compensation Recipients ――

Quality of Life for Workers' Compensation Non-Recipients ――

Satisfaction with the outcomes of surgery for Workers' Compensation Recipients

Satisfaction with the outcomes of surgery for Workers' Compensation Non-Recipients

Leite, et al. 2006 Pinch Strength Median Sensory Conduction Velocity

(Levine, et al. 1993) 2-Point Discrimination Semmes-Weinstein Monofilaments

Grip Strength ――

Atroshi, et al. 1997 Symptom Severity Scale Probability of CTS by Katz-Stirrat Hand Diagram

Leite, et al. 2006 post Pinch Strength ――

(Amadio, et al. 1996) Grip Strength ――

AIMS2 hand and finger function ――

SF-36 physical role scale ――

BCTQ - FSS Summary Construct Validity

SF-36 - Physical Functioning, Physical Role, Bodily

Pain, General Health

SF-36 - Vitality, Social Functioning, Emotional Role,

Mental Health

Symptom Relief for Workers' Compensation Recipients

Symptom Relief for Workers' Compensation Non-Recipients

SF-36 - Physical Functioning, Physical Role, Bodily

Pain, General Health, Vitality, Social Functioning, Emotional Role

SF-36 - Mental Health


Instrument EvaluationAIMS2 Convergent Validity

Author Disease Comparison Instrument 1 Comparison Instrument 2 Statistic Used Value Notes/Additional Information

Amadio, et al.1996 CTS AIMS2 - Walking and bending SF-36 - Physical Functioning Spearman Correlation

Coefficient -0.75 pre-operative, AIMS2 normalized

AIMS2 - Household tasks SF-36 - Pain Spearman Correlation Coefficient -0.71 pre-operative, AIMS2 normalized

AIMS2 - Satisfaction SF-36 - Physical Role Spearman Correlation Coefficient -0.79 pre-operative, AIMS2 normalized

AIMS2 - Health status/affect SF-36 - Mental Health Spearman Correlation Coefficient -0.73 pre-operative, AIMS2 normalized

AIMS2 - Mobility SF-36 - Social Functioning Spearman Correlation Coefficient -0.74 pre-operative, AIMS2 normalized

AIMS - Mobility SF-36 - Social Functioning Spearman Correlation Coefficient -0.74 pre-operative, AIMS2 arthritis

adusted

AIMS - Household tasks SF-36 - Pain Spearman Correlation Coefficient -0.75 pre-operative, AIMS2 arthritis

adusted

AIMS - Work SF-36 - Mental Health Spearman Correlation Coefficient 0.84 pre-operative, AIMS2 arthritis

adusted

AIMS2 - Hand and finger function BCTQ - FSS Spearman Correlation Coefficient 0.71 post-operative, AIMS2 normalized

AIMS2 - Walking and bending SF-36 - Physical Functioning Spearman Correlation Coefficient -0.92 post-operative, AIMS2 normalized

AIMS2 - Walking and bending SF-36 - Vitality Spearman Correlation Coefficient -0.79 post-operative, AIMS2 normalized

AIMS2 - Walking and bending SF-36 - Social Functioning Spearman Correlation Coefficient -0.75 post-operative, AIMS2 normalized

AIMS2 - Satisfaction SF-36 - Pain Spearman Correlation Coefficient -0.80 post-operative, AIMS2 normalized

AIMS2 - Satisfaction SF-36 - Vitality Spearman Correlation Coefficient -0.82 post-operative, AIMS2 normalized

AIMS2 - Satisfaction SF-36 - Social Functioning Spearman Correlation Coefficient -0.80 post-operative, AIMS2 normalized

AIMS2 - Health status-physical SF-36 - Pain Spearman Correlation Coefficient -0.74 post-operative, AIMS2 normalized

AIMS2 - Arthritis impact SF-36 - General Health Spearman Correlation Coefficient -0.71 post-operative, AIMS2 normalized

AIMS2 - Hand and finger function BCTQ - FSS Spearman Correlation Coefficient 0.71 post-operative, AIMS2 normalized

AIMS2 Convergent Validity

SF-36 = MOS 36 Item Short Form BCTQ = Boston Carpal Tunnel Questionnaire FSS = BCTQ Functional Status Scale AIMS2 = Arthritis Impact Measurement Scale 2


Instrument EvaluationAIMS2 Convergent Validity


AIMS2 Convergent Validity

Amadio, et al.1996 CTS AIMS2 - Pain Grip Strength Spearman Correlation

Coefficient 0.81 post-operative, AIMS2 normalized

AIMS2 - Satisfaction Grip Strength Spearman Correlation Coefficient 0.82 post-operative, AIMS2 normalized

AIMS2 - Physical Health Grip Strength Spearman Correlation Coefficient 0.80 post-operative, AIMS2 normalized

AIMS2 - Symptom Grip Strength Spearman Correlation Coefficient 0.81 post-operative, AIMS2 normalized

AIMS2 Normalized Work Pinch Strength Spearman Correlation Coefficient 0.71

AIMS2 Normalized Role Pinch Strength Spearman Correlation Coefficient 0.71

SF-36 = MOS 36 Item Short Form BCTQ = Boston Carpal Tunnel Questionnaire FSS = BCTQ Functional Status Scale AIMS2 = Arthritis Impact Measurement Scale 2


Instrument EvaluationDASH Convergent Validity (CTS)


DeSmet, et al. 2007 CTS DASH SSS Correlation Coefficient 0.64 p<0.0001

DASH FSS Correlation Coefficient 0.78 p<0.0001

Imaeda, et al.2006 CTS DASH disability/symptom scale DASH work Spearman Correlation

Coefficients 0.75 p<0.01, preoperative correlation

DASH disability/symptom scale SF-36 physical functioning Spearman Correlation Coefficients -0.58 p<0.01, preoperative correlation

DASH disability/symptom scale SF-36 role-physical Spearman Correlation Coefficients -0.67 p<0.01, preoperative correlation

DASH work SF-36 role-physical Spearman Correlation Coefficients -0.74 p<0.01, preoperative correlation

DASH disability/symptom scale SF-36 bodily pain Spearman Correlation Coefficients -0.57 p<0.01, preoperative correlation

DASH work SF-36 bodily pain Spearman Correlation Coefficients -0.58 p<0.01, preoperative correlation

DASH disability/symptom scale SF-36 general health Spearman Correlation Coefficients -0.43 p<0.05, preoperative correlation

DASH work SF-36 general health Spearman Correlation Coefficients -0.58 p<0.01, preoperative correlation

DASH disability/symptom scale SF-36 vitality Spearman Correlation Coefficients -0.41 p<0.05, preoperative correlation

DASH work SF-36 vitality Spearman Correlation Coefficients -0.47 p<0.05, preoperative correlation

DASH disability/symptom scale SF-36 mental health Spearman Correlation Coefficients -0.43 p<0.01, preoperative correlation

DASH work SF-36 mental health Spearman Correlation Coefficients -0.42 preoperative correlation

DASH disability/symptom scale Grip Strength Spearman Correlation Coefficients -0.67 p<0.01, preoperative correlation

DASH disability/symptom scale Pulp Pinch Spearman Correlation Coefficients -0.45 p<0.05, preoperative correlation

DASH work Grip Strength Spearman Correlation Coefficients -0.52 p<0.05, preoperative correlation

DASH work DASH disability/symptom scale Spearman Correlation Coefficients 0.73 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale SF-36 physical functioning Spearman Correlation Coefficients -0.74 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale SF-36 role-physical Spearman Correlation Coefficients -0.83 p<0.01, postoperative correlation, 3

months

DASH work SF-36 role-physical Spearman Correlation Coefficients -0.76 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale SF-36 bodily pain Spearman Correlation Coefficients -0.86 p<0.01, postoperative correlation, 3

months

DASH work SF-36 bodily pain Spearman Correlation Coefficients -0.76 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale SF-36 general health Spearman Correlation Coefficients -0.59 p<0.01, postoperative correlation, 3

months

DASH Convergent Validity

Legend:DASH = Disabilities of the Arm, Shoulder, and Hand SF-36 = Medical Outcomes Study 36-Item Short Form Health Survey VAS = Visual Analogue Scale BCTQ = Boston Carpal Tunnel Questionnaire 2PD = Two Point Discrimmination


Instrument EvaluationDASH Convergent Validity (CTS)


DASH Convergent Validity

Imaeda, et al.2006 CTS DASH work SF-36 general health Spearman Correlation

Coefficients -0.55 p<0.05, postoperative correlation, 3 months

DASH disability/symptom scale SF-36 vitality Spearman Correlation Coefficients -0.53 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale SF-36 social functioning Spearman Correlation Coefficients -0.72 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale SF-36 mental health Spearman Correlation Coefficients -0.47 p<0.05, postoperative correlation, 3

months

DASH disability/symptom scale VAS Spearman Correlation Coefficients 0.47 p<0.01, postoperative correlation, 3

months

DASH work VAS Spearman Correlation Coefficients 0.59 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale Grip Strength Spearman Correlation Coefficients -0.53 p<0.01, postoperative correlation, 3

months

DASH disability/symptom scale Pulp Pinch Spearman Correlation Coefficients -0.46 p<0.05, postoperative correlation, 3

months

DASH disability/symptom scale s-2PD Spearman Correlation Coefficients 0.54 p<0.01, postoperative correlation, 3

months

DASH work Pulp Pinch Spearman Correlation Coefficients -0.43 postoperative correlation, 3 months

DASH work s-2PD Spearman Correlation Coefficients 0.51 p<0.01, postoperative correlation, 3

months

Hobby, et al.2005 CTS DASH % grip strength Spearman Correlation

Coefficient -0.48 preoperative correlation

Gay, et al.2003 CTS DASH BCTQ Spearman Correlation

Coefficient 0.9 postoperative correlation, 6 weeks

DASH BCTQ Spearman Correlation Coefficient 0.87 postoperative correlation, 12 weeks

DASH BCTQ - FSS Spearman Correlation Coefficient 0.88 postoperative correlation, 6 weeks

DASH BCTQ - FSS Spearman Correlation Coefficient 0.91 postoperative correlation, 12 weeks

DASH BCTQ - SSS Spearman Correlation Coefficient 0.74 postoperative correlation, 6 weeks

DASH BCTQ - SSS Spearman Correlation Coefficient 0.76 postoperative correlation, 12 weeks

DASH SF-36 role physical subscale Spearman Correlation Coefficient 0.43 postoperative correlation, 6 weeks

DASH SF-36 role physical subscale Spearman Correlation Coefficient 0.46 postoperative correlation, 12 weeks

DASH SF-36 bodily pain subscale Spearman Correlation Coefficient 0.53 postoperative correlation, 6 weeks

DASH SF-36 bodily pain subscale Spearman Correlation Coefficient 0.43 postoperative correlation, 12 weeks



Instrument EvaluationDASH Discriminant Validity (CTS)


Imaeda, et al.2006 CTS DASH work SF-36 physical functioning Spearman Correlation

Coefficients -0.33 preoperative correlation

DASH disability/symptom scale SF-36 social functioning Spearman Correlation Coefficients -0.18 preoperative correlation

DASH work SF-36 social functioning Spearman Correlation Coefficients -0.11 preoperative correlation

DASH disability/symptom scale SF-36 role-emotional Spearman Correlation Coefficients -0.29 preoperative correlation

DASH work SF-36 role-emotional Spearman Correlation Coefficients -0.28 preoperative correlation

DASH disability/symptom scale VAS Spearman Correlation Coefficients 0.21 preoperative correlation

DASH work VAS Spearman Correlation Coefficients 0.3 preoperative correlation

DASH disability/symptom scale s-2PD Spearman Correlation Coefficients 0.29 preoperative correlation

DASH work Pulp Pinch Spearman Correlation Coefficients -0.39 preoperative correlation

DASH work s-2PD Spearman Correlation Coefficients 0 preoperative correlation

DASH work SF-36 physical functioning Spearman Correlation Coefficients -0.27 postoperative correlation, 3 months

DASH work SF-36 vitality Spearman Correlation Coefficients -0.15 postoperative correlation, 3 months

DASH work SF-36 social functioning Spearman Correlation Coefficients -0.36 postoperative correlation, 3 months

DASH disability/symptom scale SF-36 role-emotional Spearman Correlation Coefficients -0.37 postoperative correlation, 3 months

DASH work SF-36 role-emotional Spearman Correlation Coefficients -0.11 postoperative correlation, 3 months

DASH work SF-36 mental health Spearman Correlation Coefficients -0.17 postoperative correlation, 3 months

DASH work Grip Strength Spearman Correlation Coefficients -0.37 postoperative correlation, 3 months

Hobby, et al. 2005 CTS DASH Static 2 PD Spearman Correlation

Coefficient 0.12 preoperative correlation

DASH 9-hole peg test Spearman Correlation Coefficient 0.16 preoperative correlation

DASH Discriminant Validity



Instrument EvaluationDASH Summary Construct Validity (CTS)


DeSmet, et al. 2007 SSS ――

FSS ――

Imaeda, et al. 2006 preoperative DASH work SF-36 - social functioning, role-emotional

SF-36 - physical functioning, role-physical,bodily pain, general health, vitality, and

mental healthVAS

Grip Strength Static 2 PD

Pulp Pinch ―—

postoperative, 3 months VAS SF-36 - role-emotional

SF-36 - physical functioning, role-physical,bodily pain, general health, vitality, social

functioning, and mental health―—

Grip Strength ―—

Pulp Pinch ―—

Static 2 PD ―—

Hobby, et al. 2005 Static 2 PD

9-hole peg test

Gay, et al.2003 post, 6 and 12 weeks BCTQ ――

BCTQ - FSS ――

BCTQ - SSS ――

SF-36 role physical subscale ――

SF-36 bodily pain subscale ――

Grip Strength

DASH Summary Construct Validity

pre

post, 12 months


Instrument EvaluationPEM Convergent Validity (CTS)


Hobby, et al.2005 CTS PEM total score % grip strength Spearman Correlation

Coefficient -0.54 p=0.02

PEM cold intolerance % grip strength Spearman Correlation Coefficient -0.44 p=0.02

PEM pain % grip strength Spearman Correlation Coefficient -0.67 p=0.02

PEM movement % grip strength Spearman Correlation Coefficient -0.46 p=0.02

PEM grip % grip strength Spearman Correlation Coefficient -0.47 p=0.02

PEM ADL % grip strength Spearman Correlation Coefficient -0.61 p=0.02

PEM work % grip strength Spearman Correlation Coefficient -0.43 p=0.02

PEM feeling Static 2 PD Spearman Correlation Coefficient 0.43 p=0.02

PEM dexterity Static 2 PD Spearman Correlation Coefficient 0.42 p=0.02

PEM total score 9-hole peg test Spearman Correlation Coefficient 0.47 p=0.02

PEM feeling 9-hole peg test Spearman Correlation Coefficient 0.44 p=0.02

PEM dexterity 9-hole peg test Spearman Correlation Coefficient 0.46 p=0.02

PEM movement 9-hole peg test Spearman Correlation Coefficient 0.55 p=0.02

PEM grip 9-hole peg test Spearman Correlation Coefficient 0.6 p=0.02

PEM ADL 9-hole peg test Spearman Correlation Coefficient 0.44 p=0.02

PEM Convergent Validity

Legend:PEM = Patient Evaluation Measure2 PD = 2 Point Discrimination


Instrument EvaluationPEM Discriminant Validity (CTS)


Hobby, et al.2005 CTS PEM feeling % grip strength Spearman Correlation

Coefficient -0.39 p=0.02

PEM dexterity % grip strength Spearman Correlation Coefficient -0.25 p=0.02

PEM appearance % grip strength Spearman Correlation Coefficient -0.37 p=0.02

PEM hand in general % grip strength Spearman Correlation Coefficient -0.28 p=0.02

PEM total score Static 2 PD Spearman Correlation Coefficient 0.27 p=0.02

PEM cold intolerance Static 2 PD Spearman Correlation Coefficient -0.1 p=0.02

PEM pain Static 2 PD Spearman Correlation Coefficient 0.22 p=0.02

PEM movement Static 2 PD Spearman Correlation Coefficient 0.36 p=0.02

PEM grip Static 2 PD Spearman Correlation Coefficient 0.38 p=0.02

PEM ADL Static 2 PD Spearman Correlation Coefficient 0.29 p=0.02

PEM work Static 2 PD Spearman Correlation Coefficient 0.03 p=0.02

PEM appearance Static 2 PD Spearman Correlation Coefficient -0.16 p=0.02

PEM hand in general Static 2 PD Spearman Correlation Coefficient 0.03 p=0.02

PEM cold intolerance 9-hole peg test Spearman Correlation Coefficient 0.36 p=0.02

PEM pain 9-hole peg test Spearman Correlation Coefficient 0.26 p=0.02

PEM work 9-hole peg test Spearman Correlation Coefficient 0.25 p=0.02

PEM appearance 9-hole peg test Spearman Correlation Coefficient 0.18 p=0.02

PEM hand in general 9-hole peg test Spearman Correlation Coefficient 0.32 p=0.02

PEM Discriminant Validity

Legend:PEM = Patient Evaluation Measure2 PD = 2 Point Discrimination


Instrument Evaluation PEM Summary Construct Validity (CTS)


Hobby, et al. 2005 Grip Strength

9-hole peg test

PEM Summary Construct Validity

pre Static 2 PD


Instrument EvaluationVAS Convergent Validity (CTS)


Imaeda, et al.2006 CTS VAS SF-36 bodily pain Spearman Correlation

Coefficients -0.65 p<0.01, preoperative correlation

VAS SF-36 social functioning Spearman Correlation Coefficients -0.45 p<0.05, preoperative correlation

VAS SF-36 bodily pain Spearman Correlation Coefficients -0.49 p<0.05, postoperative correlation, 3

months

VAS SF-36 general health Spearman Correlation Coefficients -0.48 p<0.05, postoperative correlation, 3

months

VAS DASH disability/symptom scale Spearman Correlation Coefficients 0.47 p<0.01, postoperative correlation, 3

months

VAS DASH work Spearman Correlation Coefficients 0.59 p<0.01, postoperative correlation, 3

months

VAS Convergent Validity

Legend:VAS = Visual Analogue Scale DASH = Disabilities of the Arm, Shoulder and Hand SF-36 = MOS 36 Item Short Form


Instrument EvaluationVAS Discriminant Validity (CTS)


Imaeda, et al.2006 CTS VAS SF-36 physical functioning Spearman Correlation


VAS SF-36 role-physical Spearman Correlation Coefficients -0.07 preoperative correlation

VAS SF-36 general health Spearman Correlation Coefficients -0.25 preoperative correlation

VAS SF-36 vitality Spearman Correlation Coefficients -0.2 preoperative correlation

VAS SF-36 role-emotional Spearman Correlation Coefficients -0.25 preoperative correlation

VAS SF-36 mental health Spearman Correlation Coefficients -0.13 preoperative correlation

VAS DASH disability/symptom scale Spearman Correlation Coefficients 0.21 preoperative correlation

VAS DASH work Spearman Correlation Coefficients 0.3 preoperative correlation

VAS Grip Strength Spearman Correlation Coefficients -0.25 preoperative correlation

VAS Pulp Pinch Spearman Correlation Coefficients 0.09 preoperative correlation

VAS s-2PD Spearman Correlation Coefficients 0.03 preoperative correlation

VAS SF-36 physical functioning Spearman Correlation Coefficients -0.26 postoperative correlation, 3 months

VAS SF-36 role-physical Spearman Correlation Coefficients -0.39 postoperative correlation, 3 months

VAS SF-36 vitality Spearman Correlation Coefficients -0.01 postoperative correlation, 3 months

VAS SF-36 social functioning Spearman Correlation Coefficients -0.34 postoperative correlation, 3 months

VAS SF-36 role-emotional Spearman Correlation Coefficients -0.37 postoperative correlation, 3 months

VAS SF-36 mental health Spearman Correlation Coefficients -0.08 postoperative correlation, 3 months

VAS Grip Strength Spearman Correlation Coefficients -0.11 postoperative correlation, 3 months

VAS Pulp Pinch Spearman Correlation Coefficients -0.26 postoperative correlation, 3 months

VAS s-2PD Spearman Correlation Coefficients 0.28 postoperative correlation, 3 months

VAS Discriminant Validity

Legend:VAS = Visual Analogue Scale DASH = Disabilities of the Arm, Shoulder and Hand SF-36 = MOS 36 Item Short Form s2PD = static 2 point discrimination


Instrument EvaluationVAS Summary Construct Validity (CTS)


Imaeda, et al. 2006 pre SF-36 bodily pain SF-36 physical functioning

SF-36 social functioning SF-36 role-physical

―― SF-36 general health

―― SF-36 vitality

―― SF-36 role-emotional

―― SF-36 mental health

―― DASH disability/symptom scale

―― DASH work


―― Pulp Pinch

―― s-2PD

VAS pain Summary Construct Validity


Instrument EvaluationVAS Summary Construct Validity (CTS)


VAS pain Summary Construct Validity

Imaeda, et al. 2006 post, 3 months SF-36 social functioning SF-36 physical functioning

SF-36 bodily pain SF-36 role-physical

SF-36 general health SF-36 vitality

DASH disability/symptom scale SF-36 social functioning

DASH work SF-36 role-emotional

―― SF-36 mental health


―― Pulp Pinch

―― s-2PD


Instrument EvaluationSF-36 Convergent Validity (CTS)


Imaeda, et al.2006 CTS SF-36 physical functioning DASH disability/symptom scale Spearman Correlation

Coefficients -0.58 p<0.01, preoperative correlation

SF-36 physical functioning Grip Strength Spearman Correlation Coefficients 0.62 p<0.01, preoperative correlation

SF-36 role-physical DASH disability/symptom scale Spearman Correlation Coefficients -0.67 p<0.01, preoperative correlation

SF-36 role-physical DASH work Spearman Correlation Coefficients -0.74 p<0.01, preoperative correlation

SF-36 role-physical Grip Strength Spearman Correlation Coefficients 0.56 p<0.01, preoperative correlation

SF-36 role-physical Pulp Pinch Spearman Correlation Coefficients 0.64 p<0.01, preoperative correlation

SF-36 role-physical s-2PD Spearman Correlation Coefficients -0.4 preoperative correlation

SF-36 bodily pain DASH disability/symptom scale Spearman Correlation Coefficients -0.57 p<0.01, preoperative correlation

SF-36 bodily pain DASH work Spearman Correlation Coefficients -0.58 p<0.01, preoperative correlation

SF-36 bodily pain VAS Spearman Correlation Coefficients -0.65 p<0.01, preoperative correlation

SF-36 bodily pain Grip Strength Spearman Correlation Coefficients 0.56 p<0.01, preoperative correlation

SF-36 general health DASH disability/symptom scale Spearman Correlation Coefficients -0.43 p<0.05, preoperative correlation

SF-36 general health DASH work Spearman Correlation Coefficients -0.58 p<0.01, preoperative correlation

SF-36 vitality DASH disability/symptom scale Spearman Correlation Coefficients -0.41 p<0.05, preoperative correlation

SF-36 vitality DASH work Spearman Correlation Coefficients -0.47 p<0.05, preoperative correlation

SF-36 social functioning VAS Spearman Correlation Coefficients -0.45 p<0.05, preoperative correlation

SF-36 role-emotional Grip Strength Spearman Correlation Coefficients 0.42 p<0.05, preoperative correlation

SF-36 mental health DASH disability/symptom scale Spearman Correlation Coefficients -0.43 p<0.01, preoperative correlation

SF-36 mental health DASH work Spearman Correlation Coefficients -0.42 preoperative correlation

SF-36 physical functioning DASH disability/symptom scale Spearman Correlation Coefficients -0.74 p<0.01, postoperative correlation, 3

months

SF-36 role-physical DASH disability/symptom scale Spearman Correlation Coefficients -0.83 p<0.01, postoperative correlation, 3

months

SF-36 role-physical DASH work Spearman Correlation Coefficients -0.76 p<0.01, postoperative correlation, 3

months

SF-36 Convergent Validity

Legend: SF-36 = Medical Outcomes Study 36 Item Short Form NR = Not Reported DASH = Disabilities of the Arm, Shoulder and Hand AIMS2 = Arthritis Impact Scale 2 VAS = Visual Analogue Scale s2PD = static 2-point discrimination





Imaeda, et al.2006 CTS SF-36 role-physical Grip Strength Spearman Correlation

Coefficients 0.53 p<0.01, postoperative correlation, 3 months

SF-36 role-physical s-2PD Spearman Correlation Coefficients -0.59 p<0.01, postoperative correlation, 3

months

SF-36 bodily pain DASH disability/symptom scale Spearman Correlation Coefficients -0.86 p<0.01, postoperative correlation, 3

months

SF-36 bodily pain DASH work Spearman Correlation Coefficients -0.76 p<0.01, postoperative correlation, 3

months

SF-36 bodily pain VAS Spearman Correlation Coefficients -0.49 p<0.05, postoperative correlation, 3

months

SF-36 bodily pain Grip Strength Spearman Correlation Coefficients 0.5 p<0.05, postoperative correlation, 3

months

SF-36 bodily pain Pulp Pinch Spearman Correlation Coefficients 0.49 p<0.05, postoperative correlation, 3

months

SF-36 bodily pain s-2PD Spearman Correlation Coefficients -0.5 p<0.01, postoperative correlation, 3

months

SF-36 general health DASH disability/symptom scale Spearman Correlation Coefficients -0.59 p<0.01, postoperative correlation, 3

months

SF-36 general health DASH work Spearman Correlation Coefficients -0.55 p<0.05, postoperative correlation, 3

months

SF-36 general health VAS Spearman Correlation Coefficients -0.48 p<0.05, postoperative correlation, 3

months

SF-36 vitality DASH disability/symptom scale Spearman Correlation Coefficients -0.53 p<0.01, postoperative correlation, 3

months

SF-36 vitality Grip Strength Spearman Correlation Coefficients 0.46 p<0.05, postoperative correlation, 3

months

SF-36 vitality Pulp Pinch Spearman Correlation Coefficients 0.42 p<0.05, postoperative correlation, 3

months

SF-36 social functioning DASH disability/symptom scale Spearman Correlation Coefficients -0.72 p<0.01, postoperative correlation, 3

months

SF-36 social functioning Grip Strength Spearman Correlation Coefficients 0.52 p<0.01, postoperative correlation, 3

months

SF-36 social functioning Pulp Pinch Spearman Correlation Coefficients 0.45 postoperative correlation, 3 months

SF-36 social functioning s-2PD Spearman Correlation Coefficients -0.47 p<0.05, postoperative correlation, 3

months

SF-36 role-emotional s-2PD Spearman Correlation Coefficients -0.4 postoperative correlation, 3 months

SF-36 mental health DASH disability/symptom scale Spearman Correlation Coefficients -0.47 p<0.05, postoperative correlation, 3

months






Gay, et al.2003 CTS SF-36 role physical subscale DASH Spearman Correlation

Coefficient 0.43 6 weeks

SF-36 role physical subscale DASH Spearman Correlation Coefficient 0.46 12 weeks

SF-36 bodily pain subscale DASH Spearman Correlation Coefficient 0.53 6 weeks

SF-36 bodily pain subscale DASH Spearman Correlation Coefficient 0.43 12 weeks

Amadio, et al.1996 CTS SF-36 - Physical Functioning AIMS2 - Walking and bending Spearman Correlation

Coefficient -0.75 pre-operative, AIMS2 normalized

SF-36 - Pain AIMS2 - Household tasks Spearman Correlation Coefficient -0.71 pre-operative, AIMS2 normalized

SF-36 - Physical Role AIMS2 - Satisfaction Spearman Correlation Coefficient -0.79 pre-operative, AIMS2 normalized

SF-36 - Mental Health AIMS2 - Health status/affect Spearman Correlation Coefficient -0.73 pre-operative, AIMS2 normalized

SF-36 - Social Functioning AIMS2 - Mobility Spearman Correlation Coefficient -0.74 pre-operative, AIMS2 normalized

SF-36 - Social Functioning AIMS - Mobility Spearman Correlation Coefficient -0.74 pre-operative, AIMS2 arthritis

adusted

SF-36 - Pain AIMS - Household tasks Spearman Correlation Coefficient -0.75 pre-operative, AIMS2 arthritis

adusted

SF-36 - Mental Health AIMS - Work Spearman Correlation Coefficient 0.84 pre-operative, AIMS2 arthritis

adusted

SF-36 - Physical Functioning AIMS2 - Walking and bending Spearman Correlation Coefficient -0.92 post-operative, AIMS2 normalized

SF-36 - Vitality AIMS2 - Walking and bending Spearman Correlation Coefficient -0.79 post-operative, AIMS2 normalized

SF-36 - Social Functioning AIMS2 - Walking and bending Spearman Correlation Coefficient -0.75 post-operative, AIMS2 normalized

SF-36 - Pain AIMS2 - Satisfaction Spearman Correlation Coefficient -0.80 post-operative, AIMS2 normalized

SF-36 - Vitality AIMS2 - Satisfaction Spearman Correlation Coefficient -0.82 post-operative, AIMS2 normalized

SF-36 - Social Functioning AIMS2 - Satisfaction Spearman Correlation Coefficient -0.80 post-operative, AIMS2 normalized

SF-36 - Pain AIMS2 - Health status-physical Spearman Correlation Coefficient -0.74 post-operative, AIMS2 normalized

SF-36 - General Health AIMS2 - Arthritis impact Spearman Correlation Coefficient -0.71 post-operative, AIMS2 normalized

SF-36 - Physical RoleBoston Carpal Tunnel

Questionnaire Functional Status Scale

Spearman Correlation Coefficient 0.70 post-operative

SF-36 Pain Grip Strength Spearman Correlation Coefficient 0.77



Instrument EvaluationSF-36 Discriminant Validity (CTS)


Imaeda, et al.2006 CTS SF-36 physical functioning DASH work Spearman Correlation


SF-36 physical functioning VAS Spearman Correlation Coefficients -0.13 preoperative correlation

SF-36 physical functioning Pulp Pinch Spearman Correlation Coefficients 0.33 preoperative correlation

SF-36 physical functioning s-2PD Spearman Correlation Coefficients -0.17 preoperative correlation

SF-36 role-physical VAS Spearman Correlation Coefficients -0.07 preoperative correlation

SF-36 bodily pain Pulp Pinch Spearman Correlation Coefficients 0.19 preoperative correlation

SF-36 bodily pain s-2PD Spearman Correlation Coefficients -0.1 preoperative correlation

SF-36 general health VAS Spearman Correlation Coefficients -0.25 preoperative correlation

SF-36 general health Grip Strength Spearman Correlation Coefficients 0.37 preoperative correlation

SF-36 general health Pulp Pinch Spearman Correlation Coefficients 0.12 preoperative correlation

SF-36 general health s-2PD Spearman Correlation Coefficients 0.02 preoperative correlation

SF-36 vitality VAS Spearman Correlation Coefficients -0.2 preoperative correlation

SF-36 vitality Grip Strength Spearman Correlation Coefficients 0.32 preoperative correlation

SF-36 vitality Pulp Pinch Spearman Correlation Coefficients 0.01 preoperative correlation

SF-36 vitality s-2PD Spearman Correlation Coefficients 0.14 preoperative correlation

SF-36 social functioning DASH disability/symptom scale Spearman Correlation Coefficients -0.18 preoperative correlation

SF-36 social functioning DASH work Spearman Correlation Coefficients -0.11 preoperative correlation

SF-36 social functioning Grip Strength Spearman Correlation Coefficients 0.2 preoperative correlation

SF-36 social functioning Pulp Pinch Spearman Correlation Coefficients 0.15 preoperative correlation

SF-36 social functioning s-2PD Spearman Correlation Coefficients -0.33 preoperative correlation

SF-36 Discriminant Validity

Legend: SF-36 = Medical Outcomes Study 36 Item Short Form NR = Not Reported DASH = Disabilities of the Arm, Shoulder and Hand VAS = Visual Analogue Scale s2PD = static 2-point discrimination





Imaeda, et al.2006 CTS SF-36 role-emotional DASH disability/symptom scale Spearman Correlation


SF-36 role-emotional DASH work Spearman Correlation Coefficients -0.28 preoperative correlation

SF-36 role-emotional VAS Spearman Correlation Coefficients -0.25 preoperative correlation

SF-36 role-emotional Pulp Pinch Spearman Correlation Coefficients 0.31 preoperative correlation

SF-36 role-emotional s-2PD Spearman Correlation Coefficients -0.27 preoperative correlation

SF-36 mental health VAS Spearman Correlation Coefficients -0.13 preoperative correlation

SF-36 mental health Grip Strength Spearman Correlation Coefficients 0.22 preoperative correlation

SF-36 mental health Pulp Pinch Spearman Correlation Coefficients 0.23 preoperative correlation

SF-36 mental health s-2PD Spearman Correlation Coefficients -0.08 preoperative correlation

SF-36 physical functioning DASH work Spearman Correlation Coefficients -0.27 postoperative correlation, 3 months

SF-36 physical functioning VAS Spearman Correlation Coefficients -0.26 postoperative correlation, 3 months

SF-36 physical functioning Grip Strength Spearman Correlation Coefficients 0.38 postoperative correlation, 3 months

SF-36 physical functioning Pulp Pinch Spearman Correlation Coefficients 0.35 postoperative correlation, 3 months

SF-36 physical functioning s-2PD Spearman Correlation Coefficients -0.23 postoperative correlation, 3 months

SF-36 role-physical DASH disability/symptom scale Spearman Correlation Coefficients -0.83 p<0.01, postoperative correlation, 3

months

SF-36 role-physical VAS Spearman Correlation Coefficients -0.39 postoperative correlation, 3 months

SF-36 role-physical Pulp Pinch Spearman Correlation Coefficients 0.39 postoperative correlation, 3 months

SF-36 general health Grip Strength Spearman Correlation Coefficients 0.3 postoperative correlation, 3 months

SF-36 general health Pulp Pinch Spearman Correlation Coefficients 0.34 postoperative correlation, 3 months

SF-36 general health s-2PD Spearman Correlation Coefficients -0.36 postoperative correlation, 3 months






Imaeda, et al.2006 CTS SF-36 vitality DASH work Spearman Correlation

Coefficients -0.15 postoperative correlation, 3 months

SF-36 vitality VAS Spearman Correlation Coefficients -0.01 postoperative correlation, 3 months

SF-36 vitality s-2PD Spearman Correlation Coefficients -0.18 postoperative correlation, 3 months

SF-36 social functioning DASH work Spearman Correlation Coefficients -0.36 postoperative correlation, 3 months

SF-36 social functioning VAS Spearman Correlation Coefficients -0.34 postoperative correlation, 3 months

SF-36 social functioning Pulp Pinch Spearman Correlation Coefficients 0.45 postoperative correlation, 3 months

SF-36 social functioning s-2PD Spearman Correlation Coefficients -0.47 p<0.05, postoperative correlation, 3

months

SF-36 role-emotional DASH disability/symptom scale Spearman Correlation Coefficients -0.37 postoperative correlation, 3 months

SF-36 role-emotional DASH work Spearman Correlation Coefficients -0.11 postoperative correlation, 3 months

SF-36 role-emotional VAS Spearman Correlation Coefficients -0.37 postoperative correlation, 3 months

SF-36 role-emotional Grip Strength Spearman Correlation Coefficients 0.23 postoperative correlation, 3 months

SF-36 role-emotional Pulp Pinch Spearman Correlation Coefficients 0.17 postoperative correlation, 3 months

SF-36 mental health DASH disability/symptom scale Spearman Correlation Coefficients -0.47 p<0.05, postoperative correlation, 3

months

SF-36 mental health DASH work Spearman Correlation Coefficients -0.17 postoperative correlation, 3 months

SF-36 mental health VAS Spearman Correlation Coefficients -0.08 postoperative correlation, 3 months

SF-36 mental health Grip Strength Spearman Correlation Coefficients 0.38 postoperative correlation, 3 months

SF-36 mental health Pulp Pinch Spearman Correlation Coefficients 0.3 postoperative correlation, 3 months

SF-36 mental health s-2PD Spearman Correlation Coefficients -0.26 postoperative correlation, 3 months



Instrument EvaluationBCTQ Responsiveness (CTS)

Author Disease N Instrument Mean SD Median Mean SD Median Mean Change SD 95% CI p value Standardized

Response Mean Effect Size Duration

Leite, et al. 2006 CTS BCTQ - SSS NR NR NR NR NR NR NR NR NR NR 1.07 NR 13 weeks

(Greenslade, et al. 2004) BCTQ - FSS NR NR NR NR NR NR NR NR NR NR 0.62 NR 13 weeks

Leite, et al. 2006 CTS NR NR NR NR NR NR NR NR NR NR 1.67 1.74 6 weeks

(Gay, et al. 2003) NR NR NR NR NR NR NR NR NR NR 2.01 1.96 12 weeks

NR NR NR NR NR NR NR NR NR NR 0.46 0.48 6 weeks

NR NR NR NR NR NR NR NR NR NR 1.05 1.05 12 weeks

Leite, et al. 2006 CTS BCTQ - SSS NR NR NR NR NR NR NR NR NR NR NR 2.33 26 weeks

(Mondelli, et al. 2002) BCTQ - FSS NR NR NR NR NR NR NR NR NR NR NR 1.23 26 weeks

Leite, et al. 2006 CTS BCTQ - SSS NR NR NR NR NR NR NR NR NR NR 1.7 2.1 13 weeks

(Atroshi, et al. 1998) BCTQ - FSS NR NR NR NR NR NR NR NR NR NR 0.94 0.94 13 weeks

Leite, et al. 2006 CTS BCTQ - SSS Male WC NR NR NR NR NR NR NR NR NR NR NR 1.43 26 weeks

(Katz, et al. 1996 †) BCTQ - SSS Male WCNon NR NR NR NR NR NR NR NR NR NR NR 1.33 26 weeks

BCTQ - SSS Female WC NR NR NR NR NR NR NR NR NR NR NR 1.63 26 weeks

BCTQ - SSS Female WCNon NR NR NR NR NR NR NR NR NR NR NR 2.13 26 weeks

BCTQ - FSS Male WC NR NR NR NR NR NR NR NR NR NR NR 0.65 26 weeks

BCTQ - FSS Male WCNon NR NR NR NR NR NR NR NR NR NR NR 0.76 26 weeks

BCTQ - FSS Female WC NR NR NR NR NR NR NR NR NR NR NR 1.25 26 weeks

BCTQ - FSS Female WCNon NR NR NR NR NR NR NR NR NR NR NR 1.44 26 weeks


(Katz, et al. 1994) BCTQ - FSS NR NR NR NR NR NR NR NR NR NR 0.96 0.86 13 weeks


(Levine, et al. 1993) BCTQ - FSS NR NR NR NR NR NR NR NR NR NR 0.71 0.82 13 weeks

Ozyurekoglu et al 2006 ** CTS 1.21 NR

AUC (ROC) 0.846

Gay, et al.2003 CTS 42 BCTQ - Total NR NR NR NR NR NR NR NR NR NR 1.21 1.3 6 weeks

42 BCTQ - Total NR NR NR NR NR NR NR NR NR NR 1.66 1.71 12 weeks

Bessette, et al.1998 CTS 196 Unweighted BCTQ 3.13 ± 0.8 NR 1.87 ± 0.81 NR 1.25 ± 0.92 NR NR 1.36 1.57 26 weeks

Amadio, et al.1996 CTS 21 BCTQ - SSS 3.42 ± 0.72 NR 2.09 ± 0.91 NR 1.33 ± 0.76 NR <0.01 1.75 NR 13 weeks

21 BCTQ - FSS 2.6 ± 0.65 NR 1.77 ± 0.68 NR 0.83 ± 0.65 NR <0.01 1.28 NR 13 weeks

The authors in parenthesis are the authors of the primary articles in the Leite, et al. systematic review. † ES were not reported in paper but have been calculated based on values given in tables.‡ ES reported in the paper and SRM calculated from data in the paper.** AUC (ROC) reported in the paper and SRM calculated from data in the paper.

SSS 1.07 - 2.02 1.33 - 2.03

FSS 0.46 - 1.05 0.48 - 1.44

BCTQ Total 1.21 - 1.66 1.30 - 1.71

Effect Size Range

BCTQ CTS only Summary of Responsivenss:

NR NR NRNRNR NR

Standardized Response Mean Range

NR

43

268

3 weeksNRNRNR

26

28 BCTQ - SSS

Change Scores Correlation

219

102

57

34

BCTQ - SSS

BCTQ - FSS

Before Treatment After Treatment

Legend:BCTQ = Boston Carpal Tunnel QuestionnaireSSS = Symptom Severity Scale, FSS = Functional Status ScaleNR = Not Reported By AuthorWC = Worker's Compensation Recipients, WCNon = Workers' Compensation Nonrecipients


Instrument EvaluationBCTQ Responsiveness: Calculated Variance (CTS)

Author Disease N Instrument Standardized Response Mean Variance * Confidence

Interval Effect Size Duration

Leite, et al. 2006 CTS BCTQ - SSS 1.07 0.041 1.029 - 1.111 NR 13 weeks

(Greenslade, et al. 2004) BCTQ - FSS 0.62 0.037 0.58 - 0.66 NR 13 weeks

Leite, et al. 2006 CTS 1.67 0.082 1.59 - 1.75 1.74 6 weeks

(Gay, et al. 2003) 2.01 0.092 1.92 - 2.1 1.96 12 weeks

0.46 0.062 0.40 - 0.52 0.48 6 weeks

1.05 0.069 0.98 - 1.12 1.05 12 weeks

Leite, et al. 2006 CTS BCTQ - SSS NR NR NR 2.33 26 weeks

(Mondelli, et al. 2002) BCTQ - FSS NR NR NR 1.23 26 weeks

Leite, et al. 2006 CTS BCTQ - SSS 1.7 0.027 1.67 - 1.73 2.1 13 weeks

(Atroshi, et al. 1998) BCTQ - FSS 0.94 0.022 0.92 - 0.96 0.94 13 weeks

Leite, et al. 2006 CTS BCTQ - SSS Male WC NR NR NR 1.43 26 weeks

(Katz, et al. 1996 †) BCTQ - SSS Male WCNon NR NR NR 1.33 26 weeks

BCTQ - SSS Female WC NR NR NR 1.63 26 weeks

BCTQ - SSS Female WCNon NR NR NR 2.13 26 weeks

BCTQ - FSS Male WC NR NR NR 0.65 26 weeks

BCTQ - FSS Male WCNon NR NR NR 0.76 26 weeks

BCTQ - FSS Female WC NR NR NR 1.25 26 weeks

BCTQ - FSS Female WCNon NR NR NR 1.44 26 weeks

102

268


57

34

BCTQ - SSS

BCTQ - FSS

219

* The confidence intervals for the Standardized Response Means were conservatively estimated using the calculation of variance for Cohen's d values.


Instrument EvaluationBCTQ Responsiveness: Calculated Variance (CTS)




Leite, et al. 2006 CTS 43 BCTQ - SSS 2.02 0.072 1.95 - 2.09 2.03 13 weeks

(Katz, et al. 1994) BCTQ - FSS 0.96 0.053 0.91 - 1.01 0.86 13 weeks

Leite, et al. 2006 CTS BCTQ - SSS 1.13 0.093 1.04 - 1.22 1.4 13 weeks

(Levine, et al. 1993) BCTQ - FSS 0.71 0.085 0.62 - 0.80 0.82 13 weeks

Ozyurekoglu et al 2006 ** CTS 1.21 0.088 1.12 - 1.30 NR

AUC (ROC) 0.846

Gay, et al. 2003 1.21 0.058 1.15 - 1.26 1.3 6 weeks

1.66 0.066 1.59 - 1.72 1.71 12 weeks

Bessette, et al.1998 CTS 196 Unweighted BCTQ 1.36 0.013 1.35 - 1.37 1.57 26 weeks

Amadio, et al.1996 CTS 21 BCTQ - SSS 1.75 0.14 1.61 - 1.89 NR 13 weeks

21 BCTQ - FSS 1.28 0.122 1.16 - 1.40 NR 13 weeks

3 weeks28 BCTQ - SSS

26

CTS 42 BCTQ - Total



Instrument EvaluationAIMS2 Responsiveness (CTS)



Response Mean Duration

Amadio, et al.1996 CTS 22 AIMS2 - Mobility 1.05 ± 1.63 NR 0.66 ± 1.08 NR 0.39 ± 1.34 NR NS 0.29 3 months

22 AIMS2 - Walking and Bending 3.05 ± 2.41 NR 3.3 ± 2.76 NR -0.25 ± 1.93 NR NS -0.13 3 months

22 AIMS2 - Hand and Finger Function 4.55 ± 3.18 NR 3.34 ± 2.91 NR 1.21 ± 3.38 NR NS 0.36 3 months

22 AIMS2 - Arm Function 1.7 ± 1.86 NR 1.48 ± 2.39 NR 0.22 ± 1.51 NR NS 0.15 3 months

22 AIMS2 - Self-Care 9.57 ± 0.99 NR 9.63 ± 0.96 NR -0.06 ± 0.98 NR NS -0.06 3 months

22 AIMS2 - Household Tasks 0.65 ± 1.15 NR 0.6 ± 1.23 NR 0.05 ± 0.74 NR NS 0.07 3 months

22 AIMS2 - Social Activity 4.61 ± 1.91 NR 4.86 ± 2.01 NR -0.25 ± 1.67 NR NS -0.15 3 months

22 AIMS2 - Support from Family 1.42 ± 2.33 NR 1.76 ± 2.45 NR -0.34 ± 0.98 NR NS -0.35 3 months

22 AIMS2 - Arthritis Pain 6 ± 1.85 NR 2.86 ± 2.15 NR 3.14 ± 2 NR <0.01 1.57 3 months

11 AIMS2 - Work 6.59 ± 2.22 NR 7.84 ± 1.71 NR -1.25 ± 2.4 NR NS -0.52 3 months

20 AIMS2 - Work-categoric 1.85 ± 0.81 NR 2.15 ± 0.93 NR -0.3 ± 0.73 NR NS -0.41 3 months

22 AIMS2 - Level of tension 4.09 ± 1.04 NR 4 ± 1.1 NR 0.09 ± 0.84 NR NS 0.11 3 months

22 AIMS2 - Mood 2.34 ± 1.52 NR 2.2 ± 1.58 NR 0.14 ± 0.98 NR NS 0.14 3 months

22 AIMS2 - Satisfaction 3.75 ± 1.98 NR 2.47 ± 2.08 NR 1.28 ± 1.81 NR <0.01 0.71 3 months

22 AIMS2 - Health Perceptions 8.5 ± 2.47 NR 3.95 ± 2.22 NR 4.55 ± 2.64 NR NS 1.72 3 months

22 AIMS2 - Arthritis Impact 3.98 ± 3.24 NR 2.39 ± 2.73 NR 1.59 ± 2.84 NR <0.05 0.56 3 months

0.06 - 1.72


Standardized Response Mean RangeAIMS2 Subscale Range

AIMS2 CTS only Summary of Responsiveness:

Legend:AIMS2 = Arthritis Impact Measurement Scale NR = Not Reported by Author


Instrument EvaluationAIMS2 Responsiveness: Calculated Variance (CTS)


Interval Duration

Amadio, et al.1996 CTS 22 AIMS2 - Mobility 0.29 0.096 0.19 - 0.39 3 months

22 AIMS2 - Walking and Bending -0.13 0.095 (-0.225 - -0.035) 3 months

22 AIMS2 - Hand and Finger Function 0.36 0.097 0.26 - 0.46 3 months

22 AIMS2 - Arm Function 0.15 0.0955 0.05 - 0.25 3 months

22 AIMS2 - Self-Care -0.06 0.095 (-0.155 - 0.035) 3 months

22 AIMS2 - Household Tasks 0.07 0.095 (-0.025 - 0.165) 3 months

22 AIMS2 - Social Activity -0.15 0.0955 (-0.25 - -0.05) 3 months

22 AIMS2 - Support from Family -0.35 0.097 (-0.45 - -0.25) 3 months

22 AIMS2 - Arthritis Pain 1.57 0.126 1.44 - 1.70 3 months

11 AIMS2 - Work -0.52 0.21 (-0.73 - -0.31) 3 months

20 AIMS2 - Work-categoric -0.41 0.11 (-0.52 - -0.30) 3 months

22 AIMS2 - Level of tension 0.11 0.095 0.015 - 0.205 3 months

22 AIMS2 - Mood 0.14 0.095 0.045 - 0.235 3 months

22 AIMS2 - Satisfaction 0.71 0.101 0.61 - 0.81 3 months

22 AIMS2 - Health Perceptions 1.72 0.132 1.59 - 1.85 3 months

22 AIMS2 - Arthritis Impact 0.56 0.099 0.46 - 0.66 3 months




Instrument EvaluationDASH Responsiveness (CTS)



De Smet, et al.2007 CTS 119 DASH 38.2 ± 18.7 NR 22 ± 22.8 NR NR NR NR NR 0.69 0.87 12 months

Imaeda, et al.2006 CTS 25 DASH - disability/symptom 29.8 ± 21.2 NR 21.6 ± 19.4 NR -8.2 ± 11.5 NR 0.003 0.72 0.39 3 months

19 DASH - work module 33.9 ± 27.3 NR 20.4 ± 20.7 NR -13.5 ± 18.3 NR 0.008 0.74 0.49 3 months

Hobby, et al.2005 CTS 24 DASH 37.7 ± 19.1 NR 27.8 NR NR 9.2 ± 21.4 NR NR 0.43 0.49 3 months

Greenslade, et al.2004 CTS 57 DASH 41 NR NR 25 NR NR 15 ± 23 (9 to 21) <0.001 0.66 NR 3 months

Gay, et al.2003 CTS 42 DASH NR NR NR NR NR NR NR NR NR NR 0.54 0.57 6 weeks

42 DASH NR NR NR NR NR NR NR NR NR NR 1.13 1.01 12 weeks

Gummesson, et al.2003 CTS 19 DASH 41 ± 20 40 28 ± 26 15 13 ± 14 NR NR 1 0.7 6 -21 months

Standardized Response Mean Effect Size

0.54 - 1.13 0.49 - 1.01

0.72 0.39

0.74 0.49

Change Scores CorrelationBefore Treatment After Treatment

DASH - Total Scale Range

DASH - disability/symptom subscale

DASH - work module subscale

DASH CTS only Summary of Responsivenss:

Legend:DASH = Disabilities of the Arm, Shoulder, and Hand NR = Not Reported by Author


Instrument EvaluationDASH Responsiveness: Calculated Variance (CTS)



De Smet, et al.2007 CTS 119 DASH 0.69 0.018 0.67 - 0.71 0.87 12 months

Imaeda, et al.2006 CTS 25 DASH -

disability/symptom 0.72 0.089 0.63 - 0.81 0.39 3 months

19 DASH - work module 0.74 0.119 0.62 - 0.86 0.49 3 months

Hobby, et al.2005 CTS 24 DASH 0.43 0.089 0.34 - 0.52 0.49 3 months

Greenslade, et al.2004 CTS 57 DASH 0.66 0.038 0.62 - 0.70 NR 3 months

Gay, et al.2003 CTS 42 DASH 0.54 0.051 0.49 - 0.59 0.57 6 weeks

42 DASH 1.13 0.057 1.07 - 1.19 1.01 12 weeks

Gummesson, et al.2003 CTS 19 DASH 1 0.126 0.87 - 1.13 0.7 6 -21 months




Instrument EvaluationMHQ Responsiveness (CTS)



Response Mean Duration

Kotsis, et al.2005 CTS 50 MHQ - Function 53.4 ± 21.5 NR 70.5 ± 21.3 NR NR NR NR <0.01 0.6 6 months

50 MHQ - Activities of Daily Living 64.5 ± 24.8 NR 81.3 ± 24 NR NR NR NR <0.01 0.5 6 months

50 MHQ - Work 52.1 ± 28.9 NR 72.2 ± 27.8 NR NR NR NR <0.01 0.5 6 months

50 MHQ - Pain 59 ± 23 NR 29.1 ± 24.8 NR NR NR NR <0.01 0.9 6 months

50 MHQ - Satisfaction 31.6 ± 23.4 NR 70.3 ± 28.6 NR NR NR NR <0.01 1.1 6 months

0.5 - 1.1MHQ Subscale Range Standardized Response Mean Range


MHQ CTS only Summary of Responsiveness:Legend:MHQ = Michigan Hand Outcomes Questionnaire NR = Not Reported by Author


Instrument EvaluationMHQ Responsiveness: Calculated Variance (CTS)


Interval Duration

Kotsis, et al.2005 CTS 50 MHQ - Function 0.6 0.043 0.56 - 0.64 6 months

50 MHQ - Activities of Daily Living 0.5 0.042 0.46 - 0.54 6 months

50 MHQ - Work 0.5 0.042 0.46 - 0.54 6 months

50 MHQ - Pain 0.9 0.045 0.85 - 0.95 6 months

50 MHQ - Satisfaction 1.1 0.047 1.05 - 1.15 6 months




Instrument Evaluation PEM Responsiveness (CTS)


Response MeanEffect Size Duration

Hobby, et al.2005 CTS 24 PEM feeling 4.75 ± 1.65 NR 2.96 NR NR 1.79 ± 1.4 NR NR 1.28 1.09 3 months

24 PEM cold intolerance 4.38 ± 1.74 NR 2.75 NR NR 1.63 ± 1.73 NR NR 0.94 0.93 3 months

24 PEM pain 3.54 ± 1.98 NR 2.42 NR NR 1.13 ± 1.47 NR NR 0.76 0.57 3 months

24 PEM dexterity 5 ± 1.82 NR 2.92 NR NR 2.08 ± 1.77 NR NR 1.18 1.15 3 months

24 PEM movement 4.04 ± 1.52 NR 2.46 NR NR 1.58 ± 1.41 NR NR 1.12 1.04 3 months

24 PEM grip 4.33 ± 1.81 NR 3.17 NR NR 1.17 ± 1.44 NR NR 0.82 0.65 3 months

24 PEM ADL 4.04 ± 1.57 NR 2.71 NR NR 1.33 ± 1.43 NR NR 0.93 0.85 3 months

24 PEM work 4.5 ± 1.82 NR 3.08 NR NR 1.42 ± 1.69 NR NR 0.84 0.78 3 months

24 PEM appearance 2.13 ± 1.87 NR 1.88 NR NR 0.25 ± 1.48 NR NR 0.17 0.13 3 months

24 PEM hand in general 3.83 ± 1.76 NR 2.88 NR NR 0.96 ± 2.23 NR NR 0.43 0.54 3 months

24 PEM total score 40.5 ± 13.7 NR 27.2 NR NR 13.3 ± 14.1 NR NR 0.95 0.97 3 months

Effect Size

0.97

0.13 - 1.15Range of PEM Subscales

Standardized Response Mean

PEM Total Scale 0.95

0.17 - 1.28

Before Treatment After Treatment Change Scores Correlation

PEM CTS only Summary of Responsiveness:

Legend:PEM = Patient Evaluation Measure NR = Not Reported by Author


Instrument EvaluationPEM Responsiveness: Calculated Variance (CTS)



Hobby, et al.2005 CTS 24 PEM feeling 1.28 0.1055 1.17 - 1.39 1.09 3 months

24 PEM cold intolerance 0.94 0.097 0.84 - 1.04 0.93 3 months

24 PEM pain 0.76 0.0935 0.67 - 0.85 0.57 3 months

24 PEM dexterity 1.18 0.103 1.08 - 1.28 1.15 3 months

24 PEM movement 1.12 0.101 1.02 - 1.22 1.04 3 months

24 PEM grip 0.82 0.0946 0.73 - 0.91 0.65 3 months

24 PEM ADL 0.93 0.097 0.83 - 1.03 0.85 3 months

24 PEM work 0.84 0.095 0.75 - 0.94 0.78 3 months

24 PEM appearance 0.17 0.087 0.08 - 0.26 0.13 3 months

24 PEM hand in general 0.43 0.089 0.34 - 0.52 0.54 3 months

24 PEM total score 0.95 0.097 0.85 - 1.05 0.97 3 months




Instrument EvaluationVAS Responsiveness (CTS)



Imaeda, et al.2006 CTS 25 VAS pain 4.2 ± 2.8 NR 2.8 ± 2.4 NR -1.4 ± 2.7 NR 0.017 0.51 0.50 3 months


Legend:VAS = Visual Analogue Scale NR = Not Reported by Author


Instrument EvaluationVAS Responsiveness: Calculated Variance (CTS)



Imaeda, et al.2006 CTS 25 VAS pain 0.51 0.086 0.42 - 0.60 0.50 3 months




Instrument EvaluationSF-36 Responsiveness (CTS)



Imaeda, et al.2006 CTS 25 SF-36 - physical functioning 73.6 ± 25.9 NR 77.2 ± 24.8 NR 3.6 ± 13.6 NR NS 0.27 0.14 3 months

25 SF-36 - role-physical 39 ± 40.9 NR 50 ± 42.1 NR 11 ± 36.6 NR NS 0.3 0.27 3 months

25 SF-36 - bodily pain 50.7 ± 24.5 NR 60.1 ± 25.2 NR 10.1 ± 25.1 NR NS 0.4 0.41 3 months

25 SF-36 - general health 49.4 ± 22.4 NR 54.3 ± 20.7 NR 4.8 ± 11.2 NR 0.048 0.43 0.22 3 months

25 SF-36 - vitality 56 ± 25.6 NR 57.4 ± 21.3 NR 1.4 ± 18.2 NR NS 0.08 0.05 3 months

25 SF-36 - social functioning 76.5 ± 27 NR 75.5 ± 26.9 NR -1 ± 23.9 NR NS -0.04 -0.04 3 months

25 SF-36 - role-emotional 54.7 ± 44 NR 64 ± 42.9 NR 9.3 ± 28.1 NR NS 0.33 0.21 3 months

25 SF-36 - mental health 66.6 ± 21.7 NR 70.4 ± 20.4 NR 3.8 ± 11 NR NS 0.35 0.18 3 months

Gay, et al.2003 CTS 42 SF-36 role physical subscale NR NR NR NR NR NR NR NR NR NR 0.57 0.61 6 weeks

42 SF-36 role physical subscale NR NR NR NR NR NR NR NR NR NR 0.39 0.39 12 weeks

42 SF-36 bodily pain subscale NR NR NR NR NR NR NR NR NR NR 0.14 0.12 6 weeks

42 SF-36 bodily pain subscale NR NR NR NR NR NR NR NR NR NR 0.52 0.57 12 weeks

Bessette, et al.1998 CTS 196 SF-36 Physical Health Component 38.54 ± 8.37 NR 43.87 ± 11.36 NR 5.33 ± 10.11 NR NR 0.53 0.64 6 months

196 SF-36 Mental Health Component 48.52 ± 12.37 NR 48.71 ± 10.61 NR 0.19 ± 12.32 NR NR 0.02 0.02 6 months

196 SF-36 Physical Function 67.83 ± 22.64 NR 73.32 ± 26.11 NR 5.49 ± 21.82 NR NR 0.25 0.24 6 months

196 SF-36 Role Function-Physcal 25.64 ± 34.48 NR 51.24 ± 43.93 NR 25.6 ± 48.24 NR NR 0.53 0.74 6 months

196 SF-36 Bodily Pain 42.94 ± 24.04 NR 64.1 ± 28.38 NR 21.16 ± 31.08 NR NR 0.68 0.88 6 months

196 SF-36 General Health 72.74 ± 21.9 NR 68.87 ± 21.96 NR -3.87 ± 17.09 NR NR -0.23 -0.18 6 months

196 SF-36 Vitality 50.26 ± 22.56 NR 54.58 ± 21.14 NR 4.32 ± 21.04 NR NR 0.21 0.19 6 months

196 SF-36 Social Function 73.02 ± 27.59 NR 78.27 ± 25.5 NR 5.25 ± 30.14 NR NR 0.17 0.19 6 months

196 SF-36 Role Function-Emotional 62.84 ± 43.6 NR 70.39 ± 39.85 NR 7.55 ± 48.68 NR NR 0.16 0.17 6 months

196 SF-36 Mental Health 68.73 ± 21 NR 70.68 ± 19.93 NR 1.95 ± 18.7 NR NR 0.1 0.09 6 months

134 SF-36 Physical Health Component NR NR NR NR NR NR 6.87 ± 10.74 NR NR 0.64 NR 6 months, very or completely satisfied

134 SF-36 Role Function-Physcal NR NR NR NR NR NR 33.25 ± 50.34 NR NR 0.66 NR 6 months, very or completely satisfied

134 SF-36 Bodily Pain NR NR NR NR NR NR 27.7 ± 31.6 NR NR 0.88 NR 6 months, very or completely satisfied


Legend:SF-36 = Medical Outcomes Survey 36-Item Short Form Health Survey NR = Not Reported by Author






Amadio, et al.1996 CTS 22 SF-36 - physical functioning 57.5 ± 20.7 NR 62.3 ± 24.6 NR 4.8 ± 18.3 NR NS 0.26 NR 3 months

22 SF-36 - role-physical 28.4 ± 38 NR 51.1 ± 42.6 NR 22.7 ± 40.8 NR <0.05 0.56 NR 3 months

22 SF-36 - mental health 76.2 ± 17.9 NR 76.2 ± 16.9 NR 0 ± 11.1 NR NS 0 NR 3 months

22 SF-36 - general health 73.6 ± 17.1 NR 72.3 ± 18.8 NR -1.32 ± 11.96 NR NS -0.11 NR 3 months

22 SF-36 - vitality 56.6 ± 20.3 NR 49.5 ± 21.4 NR -7 ± 15.6 NR NS -0.45 NR 3 months

22 SF-36 - social functioning 79.2 ± 22 NR 83.6 ± 22.2 NR 4.4 ± 22 NR NS 0.2 NR 3 months

22 SF-36 - role-emotional 65.2 ± 41.8 NR 84.8 ± 32.1 NR 19.7 ± 44.4 NR <0.05 0.44 NR 3 months

22 SF-36 - bodily pain 42.8 ± 16.1 NR 57.1 ± 22.5 NR 14.3 ± 16.6 NR <0.01 0.86 NR 3 months

22 SF-36 - change in health 50 ± 25.6 NR 42 ± 24.9 NR -8 ± 22.3 NR NS -0.36 NR 3 months

Standardized Response Mean Range

Effect Size Range

0.53 - 0.64 0.64

0.02 0.02

0.14 - 0.88 0.12 - 0.57

0.25 - 0.27 0.14 - 0.24

0.3 - 0.66 0.27 - 0.74

0.16 - 0.44 0.17 - 0.21

0.11 - 0.43 0.18 - 0.22

0.08 - 0.45 0.05 - 0.19

0.04 - 0.20 0.04 - 0.19

0 - 0.35 0.09 - 0.18

0 - 0.88 0.02 - 0.74SF-36 Subscales Range

SF-36 General Health

SF-36 Vitality

SF-36 Social Functioning

SF-36 Mental Health

2 Key Components:

SF-36 Physical Functioning

SF-36 Role Limitations-Physical

SF-36 Role Limitations-Emotional

SF-36 Bodily Pain

SF-36 Physical Component

SF-36 Mental Component

8 Subscales:

SF-36 Responsiveness

Legend:SF-36 = Medical Outcomes Survey 36-Item Short Form Health Survey NR = Not Reported by Author


Instrument EvaluationSF-36 Responsiveness: Calculated Variance (CTS)


Intervals Effect Size Duration

Imaeda, et al.2006 CTS 25 SF-36 - physical

functioning 0.27 0.084 0.19 - 0.35 0.14 3 months

25 SF-36 - role-physical 0.3 0.084 0.22 - 0.38 0.27 3 months

25 SF-36 - bodily pain 0.4 0.085 0.32 - 0.49 0.41 3 months

25 SF-36 - general health 0.43 0.085 0.35 - 0.52 0.22 3 months

25 SF-36 - vitality 0.08 0.083 0 - 0.16 0.05 3 months

25 SF-36 - social functioning -0.04 0.083 (-0.12 - 0.04) -0.04 3 months

25 SF-36 - role-emotional 0.33 0.0845 0.25 - 0.41 0.21 3 months

25 SF-36 - mental health 0.35 0.0847 0.27 - 0.43 0.18 3 months

Gay, et al.2003 CTS 42 SF-36 role physical

subscale 0.57 0.051 0.52 - 0.62 0.57 6 weeks

42 SF-36 role physical subscale 0.39 0.050 0.34 - 0.44 0.39 12 weeks

42 SF-36 bodily pain subscale 0.14 0.049 0.09 - 0.19 0.14 6 weeks

42 SF-36 bodily pain subscale 0.52 0.0505 0.47 - 0.57 0.52 12 weeks








Bessette, et al.1998 CTS 196 SF-36 Physical Health

Component 0.53 0.011 0.52 - 0.54 0.64 6 months

196 SF-36 Mental Health Component 0.02 0.010 0.01 - 0.03 0.02 6 months

196 SF-36 Physical Function 0.25 0.0103 0.24 - 0.26 0.24 6 months

196 SF-36 Role Function-Physcal 0.53 0.011 0.52 - 0.54 0.74 6 months

196 SF-36 Bodily Pain 0.68 0.011 0.67 - 0.69 0.88 6 months

196 SF-36 General Health -0.23 0.0103 (-0.24 - -0.22) -0.18 6 months

196 SF-36 Vitality 0.21 0.0103 0.20 - 0.22 0.19 6 months

196 SF-36 Social Function 0.17 0.0103 0.16 - 0.18 0.19 6 months

196 SF-36 Role Function-Emotional 0.16 0.0103 0.15 - 0.17 0.17 6 months

196 SF-36 Mental Health 0.1 0.0103 0.09 - 0.11 0.09 6 months

134 SF-36 Physical Health Component 0.64 0.016 0.62 - 0.66 NR 6 months, very or

completely satisfied

134 SF-36 role physical subscale

0.66 0.016 0.64 - 0.68 NR 6 months, very or completely satisfied

134 SF-36 Bodily Pain 0.88 0.0165 0.86 - 0.90 NR NR







Amadio, et al.1996 CTS 22

SF-36 Physical Function 0.26 0.096 0.16 - 0.36 NR 3 months

22 SF-36 - role-physical 0.56 0.099 0.46 - 0.66 NR 3 months

22 SF-36 - mental health 0 0.095 (-0.1 - 0.1) NR 3 months

22 SF-36 - general health -0.11 0.095 (-0.21- -0.02) NR 3 months

22 SF-36 - vitality -0.45 0.098 (-0.55 - -0.35) NR 3 months

22 SF-36 - social functioning 0.2 0.096 0.10 - 0.30 NR 3 months

22 SF-36 - role-emotional 0.44 0.098 0.34 - 0.54 NR 3 months

22 SF-36 - bodily pain 0.86 0.104 0.76 - 0.96 NR 3 months

22 SF-36 - change in health -0.36 0.097 (-0.46 - -0.26) NR 3 months






Bessette, et al.1998 CTS 196 SF-12 Physical Health Component 35.1 ± 8.51 NR 41.96 ± 11.68 NR 6.86 ± 11.92 NR NR 0.58 0.81 6 months

196 SF-12 Mental Health Component 48.52 ± 11.32 NR 49.44 ± 9.05 NR 0.92 ± 11.83 NR NR 0.08 0.08 6 months

134 SF-12 Physical Health Component NR NR NR NR NR NR 8.99 ± 12.37 NR NR 0.73 NR 6 months, very or completely satisfied


Legend:SF-12 = 12-Item Short Form Health Survey NR = Not Reported by Author





Bessette, et al.1998 CTS 196 SF-12 Physical Health

Component 0.58 0.01 0.57 - 0.59 0.81 6 months

196 SF-12 Mental Health Component 0.08 0.01 0.07 - 0.09 0.08 6 months

134 SF-12 Physical Health Component 0.73 0.011 0.63 - 0.83 NR 6 months, very or

completely satisfied* The confidence intervals for the Standardized Response Means were conservatively estimated using the calculation of variance for Cohen's d values.



This document contains bookmarks for easier navigation of evidence tables

Table 1. Systematic Review (and Meta Analysis) Bibliographic Information ............................................................. 1 Table 2. Non-Operative/Conservative Treatment Excluded Articles ........................................................................... 5 Table 3. Non-Operative/Conservative Treatment Relevant Articles from Systematic Reviews .................................. 9 Table 4. Non-Operative/Conservative Treatment Included Articles ..........................................................................10 Table 5. Non-Operative/Conservative Treatment Study Design and Quality.............................................................11 Table 6. Non-Operative/Conservative Treatment Patient Characteristics ..................................................................12 Table 7. Non-Operative/Conservative Treatment Study Inclusion/Exclusion Criteria...............................................16 Table 8. Non-Operative/Conservative Treatment Workers Compensation ................................................................19 Table 9. Non-Operative/Conservative Treatment Continuous Data Results ..............................................................22 Table 10. Non-Operative/Conservative Treatment Dichotomous Data Results .........................................................43 Table 11. Non-Operative/Conservative Treatment (bilateral) Relevant Articles from Systematic Reviews..............45 Table 12. Non-Operative/Conservative Treatment (bilateral) Included Articles........................................................46 Table 13. Non-Operative/Conservative Treatment (bilateral) Study Design and Quality ..........................................47 Table 14. Non-Operative/Conservative Treatment (bilateral) Patient Characteristics................................................48 Table 15. Non-Operative/Conservative Treatment (bilateral) Study Inclusion/Exclusion Criteria ............................ 50 Table 16. Non-Operative/Conservative Treatment (bilateral) Workers Compensation..............................................53 Table 17. Non-Operative/Conservative Treatment (bilateral) Continuous Data Results............................................55 Table 18. Non-Operative/Conservative Treatment (bilateral) Dichotomous Data Results.........................................67 Table 19. Comparisons for Non-Operative/Conservative Treatment .........................................................................72 Table 20. Benefits and Harms for Non-Operative/Conservative Treatment...............................................................89 Table 21. Minimal Detectable Effect Size for Non-Operative/Conservative Treatment ............................................96 Table 22. Work-Related CTS Excluded Articles......................................................................................................104 Table 23. Surgical Treatment Excluded Articles ......................................................................................................108 Table 24. Surgical Treatment Relevant Articles from Systematic Reviews .............................................................109 Table 25. Surgical Treatment Included Articles .......................................................................................................110 Table 26. Surgical Treatment Study Design and Quality .........................................................................................111 Table 27. Surgical Treatment Patient Characteristics...............................................................................................112 Table 28. Surgical Treatment Study Inclusion/Exclusion Criteria ...........................................................................114 Table 29. Surgical Treatment Workers Compensation.............................................................................................116 Table 30. Surgical Treatment Continuous Data Results ...........................................................................................118 Table 31. Surgical Treatment Dichotomous Data Results........................................................................................126 Table 32. Benefits and Harms for Surgical Treatment - Minimal Incision vs. OCTR..............................................132 Table 33. Minimal Detectable Effect Size for Surgical Treatment - Minimal Incision vs. OCTR...........................133 Table 34. Benefits and Harms for Surgical Treatment - Minimal Incision vs. ECTR..............................................134 Table 35. Minimal Detectable Effect Size for Surgical Treatment - Minimal Incision vs. ECTR ...........................135 Table 36. Benefits and Harms for Surgical Treatment - Adjuvant Methods ............................................................136 Table 37. Minimal Detectable Effect Size for Surgical Treatment - Adjuvant Methods..........................................137 Table 38. Pre-operative Antibiotics Excluded Articles ............................................................................................139 Table 39. Pre-operative Antibiotics Included Articles..............................................................................................144 Table 40. Pre-operative Antibiotics Infection Rates from Controlled Trials ............................................................147 Table 41. Pre-operative Antibiotics Infection Rates from Other Study Designs ......................................................148 Table 42. Post-operative Treatment Excluded Articles ............................................................................................149 Table 43. Post-operative Treatment Included Articles .............................................................................................150 Table 44. Post-operative Treatment Study Design and Quality................................................................................151 Table 45. Post-operative Treatment Patient Characteristics .....................................................................................152 Table 46. Post-operative Treatment Study Inclusion/Exclusion Criteria..................................................................154



Table 47. Post-operative Treatment Workers Compensation ...................................................................................156 Table 48. Post-operative Treatment Continuous Data Results .................................................................................157 Table 49. Post-operative Treatment Dichotomous Data Results ..............................................................................160 Table 50. Benefits and Harms for Post-operative Treatment....................................................................................162 Table 51. Minimal Detectable Effect Size for Post-operative Treatment .................................................................163 Table 52. Instrument Evaluation Excluded Articles .................................................................................................166 Table 53. Instrument Evaluation Included Articles ..................................................................................................168 Table 54. Instrument Evaluation Summary of Instruments ......................................................................................170 Table 55. Instrument Evaluation Study Design and Patient Characteristics.............................................................172 Table 56. Instrument Evaluation Quality..................................................................................................................173 Table 57. Instrument Evaluation Funding ................................................................................................................175 Table 58. Instrument Evaluation BCTQ Summary...................................................................................................178 Table 59. Instrument Evaluation AIMS2 Summary .................................................................................................179 Table 60. Instrument Evaluation DASH Summary ..................................................................................................180 Table 61. Instrument Evaluation MHQ Summary....................................................................................................181 Table 62. Instrument Evaluation PEM Summary .....................................................................................................182 Table 63. Instrument Evaluation VAS Summary .....................................................................................................183 Table 64. Instrument Evaluation SF-36 Summary ...................................................................................................184 Table 65. Instrument Evaluation SF-12 Summary ...................................................................................................185 Table 66. Instrument Evaluation BCTQ Reliability .................................................................................................186 Table 67. Instrument Evaluation DASH Reliability .................................................................................................187 Table 68. Instrument Evaluation PEM Reliability....................................................................................................188 Table 69. Instrument Evaluation BCTQ Convergent Validity..................................................................................189 Table 70. Instrument Evaluation BCTQ Discriminant Validity ...............................................................................191 Table 71. Instrument Evaluation BCTQ Summary Construct Validity ....................................................................192 Table 72. Instrument Evaluation BCTQ-SSS Summary Construct Validity ............................................................193 Table 73. Instrument Evaluation BCTQ-FSS Summary Construct Validity ............................................................194 Table 74. Instrument Evaluation AIMS2 Convergent Validity ................................................................................195 Table 75. Instrument Evaluation DASH Convergent Validity .................................................................................197 Table 76. Instrument Evaluation DASH Discriminant Validity ...............................................................................199 Table 77. Instrument Evaluation DASH Summary Construct Validity ....................................................................200 Table 78. Instrument Evaluation PEM Convergent Validity....................................................................................201 Table 79. Instrument Evaluation PEM Discriminant Validity..................................................................................202 Table 80. Instrument Evaluation PEM Summary Construct Validity.......................................................................203 Table 81. Instrument Evaluation VAS Convergent Validity ....................................................................................204 Table 82. Instrument Evaluation VAS Discriminant Validity ..................................................................................205 Table 83. Instrument Evaluation VAS Summary Construct Validity.......................................................................206 Table 84. Instrument Evaluation SF-36 Convergent Validity ..................................................................................208 Table 85. Instrument Evaluation SF-36 Discriminant Validity ................................................................................211 Table 86. Instrument Evaluation BCTQ Responsiveness.........................................................................................214 Table 87. Instrument Evaluation BCTQ Responsiveness - Variance .......................................................................215 Table 88. Instrument Evaluation AIMS2 Responsiveness........................................................................................217 Table 89. Instrument Evaluation AIMS2 Responsiveness - Variance......................................................................218 Table 90. Instrument Evaluation DASH Responsiveness.........................................................................................219 Table 91. Instrument Evaluation DASH Responsiveness - Variance .......................................................................220 Table 92. Instrument Evaluation MHQ Responsiveness ..........................................................................................221



Table 93. Instrument Evaluation MHQ Responsiveness - Variance.........................................................................222 Table 94. Instrument Evaluation PEM Responsiveness ...........................................................................................223 Table 95. Instrument Evaluation PEM Responsiveness - Variance..........................................................................224 Table 96. Instrument Evaluation VAS Responsiveness............................................................................................225 Table 97. Instrument Evaluation VAS Responsiveness - Variance..........................................................................226 Table 98. Instrument Evaluation SF-36 Responsiveness..........................................................................................227 Table 99. Instrument Evaluation SF-36 Responsiveness - Variance ........................................................................229 Table 100. Instrument Evaluation SF-12 Responsiveness........................................................................................232 Table 101. Instrument Evaluation SF-12 Responsiveness - Variance ......................................................................233


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