Werner Robert A, Franzblau Alfred, Gell Nancy
Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI 48105, USA.
Arch Phys Med Rehabil. 2005 Jan;86(1):1-7. doi: 10.1016/j.apmr.2004.05.013.
To determine whether nocturnal splinting of workers identified through active surveillance with symptoms consistent with carpal tunnel syndrome (CTS) would improve symptoms and median nerve function as well as impact medical care.
Randomized controlled trial.
A Midwestern auto assembly plant.
Active workers with symptoms suggestive of CTS based on a hand diagram.
The treatment group received customized wrist splints, which were worn at night for 6 weeks; the control group received ergonomic education alone.
Change in wrist, hand, and/or finger discomfort, carpal tunnel symptom severity index, median sensory nerve function, and the percentage of subjects who had carpal tunnel release surgery.
The splinted group, unlike the controls, had a significant reduction in wrist, hand, and/or finger discomfort and a similar trend in the Levine carpal tunnel symptom severity index, which was maintained at 12 months. A secondary analysis showed that more median nerve impairment at baseline was associated with less clinical improvement among controls but not among the splinted group.
Workers identified with CTS symptoms in an active symptom surveillance tended to benefit from a 6-week nocturnal splinting trial, and the benefits were still evident at the 1-year follow-up. The splinted group improved in terms of hand discomfort regardless of the degree of median nerve impairment, whereas the controls showed improvement only among subjects with normal median nerve function. Results suggest that a short course of nocturnal splinting may reduce wrist, hand, and/or finger discomfort among active workers with symptoms consistent with CTS.
确定通过主动监测识别出的有腕管综合征（CTS）相关症状的工人进行夜间夹板固定是否能改善症状和正中神经功能，以及对医疗护理产生影响。
随机对照试验。
中西部一家汽车装配厂。
根据手部示意图有CTS相关症状的在职工人。
治疗组接受定制的腕部夹板，夜间佩戴6周；对照组仅接受人体工程学教育。
手腕、手部和/或手指不适的变化、腕管症状严重程度指数、正中感觉神经功能，以及接受腕管松解手术的受试者百分比。
与对照组不同，夹板固定组的手腕、手部和/或手指不适显著减轻，Levine腕管症状严重程度指数也有类似趋势，且在12个月时保持不变。二次分析表明，基线时正中神经损伤程度越高，对照组的临床改善程度越低，但夹板固定组并非如此。
在主动症状监测中被识别出有CTS症状的工人往往从为期6周的夜间夹板固定试验中获益，且在1年随访时益处仍很明显。无论正中神经损伤程度如何，夹板固定组的手部不适均有所改善，而对照组仅在正中神经功能正常的受试者中有所改善。结果表明，短期夜间夹板固定可能减轻有CTS相关症状的在职工人的手腕、手部和/或手指不适。
