What Is The Evidence For The Effectiveness Of Resting Wrist And Hand Splints In Reducing Pain And Increasing Hand Function In Individuals With Musculoskeletal Conditions Of The Wrist And Hand?A Systematic Review Of The Literature.

Background Musculoskeletal (MSK) conditions of the wrist and hand encompass a broad spectrum of disorders from acute traumas to chronic pathologies. Extensive lists of potential treatments are presented in the literature; however the evidence supporting the use of each modality is limited, with no systematic review conducted which has examined the effectiveness of resting splints on a range of MSK conditions of the wrist and hand. Purpose To evaluate the effectiveness of resting wrist and hand splints in reducing pain and increasing hand function in individuals with MSK conditions of the wrist and hand. Search Strategy To locate studies, the databases MEDLINE, Scopus, Cochrane Library, ScienceDirect, CINAHL, PEDro and SportDiscus were searched using defined keywords. The search took place in February 2013. Selection Criteria Included within the review were all randomised controlled trials (RCT's), controlled clinical trials (CCT's), cohort studies, quasi experimental trials and crossover trials which evaluated the effectiveness of resting splints in individuals diagnosed with MSK conditions of the wrist and hand, excluding rheumatoid arthritis and carpal tunnel syndrome. Papers written only in English, involving participants 18 years and older were analyzed. Data Collection and Analysis The methodological quality of the included articles was evaluated using the Effective Public Health Practice Project (EPHPP) research appraisal tool. Main Results In total seven studies were selected for inclusion in this review. MSK conditions examined included first carpometacarpal joint osteoarthritis (three papers), extensor tendon repairs in zones V to VII of the hand (two papers), proximal interphalangeal joint hyperextension injuries (one paper) and displaced Colles fractures (one paper). Results suggest that resting splints can reduce pain and improve function in first carpometacarpal joint osteoarthritis, with no statistically significant improvements found amongst the other conditions examined. Conclusion This systematic review revealed that resting splints have positive effects on reducing pain and improving hand function in individuals with first carpometacarpal joint osteoarthritis, but that due to a lack of research, conclusions cannot be drawn on their effectiveness across a range of MSK conditions of the wrist and hand.msc_physpreunpub1662_ethesesunpu