Selections From This Month in the Archives

Article Outline

• The Comparative Effectiveness of Combined Lumbrical Muscle Splints and Stretches on Symptoms and Function in Carpal Tunnel Syndrome
• A Structured Protocol of Evidence-Based Conservative Care Compared With Usual Care for Acute Nonspecific Low Back Pain: A Randomized Clinical Trial
• Mobile Telephone Short Message Service Reminders Can Reduce Nonattendance in Physical Therapy Outpatient Clinics: A Randomized Controlled Trial
• A Randomized Controlled Trial to Investigate the Effects of Water-Based Exercise to Improve Falls Risk and Physical Function in Older Adults With Lower-Extremity Osteoarthritis

Nancy A. Baker, ScD, MPH

Krissy K. Moehling, MPH

Elaine N. Rubinstein, PhD

Ronit Wollstein, MD

Norman P. Gustafson, MS, CHT

Mark Baratz, MD

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The Comparative Effectiveness of Combined Lumbrical Muscle Splints and Stretches on Symptoms and Function in Carpal Tunnel Syndrome 

Although splinting and lumbrical stretching are frequently recommended in the treatment of Carpal Tunnel Syndrome (CTS), the evidence for the efficacy of stretching is limited and the effects of different splinting and stretching combinations have not been thoroughly studied. Therefore, Baker and colleagues examined the effects of 4 different stretching and splinting combinations in a 4-week program involving 124 adults with mild to moderate CTS. Significant main effects over time were noted at follow-up 20 weeks later for all outcome measures with a significantly greater percentage of subjects in the group assigned to wrist cock-up splints and lumbrical stretching achieving clinically important improvements in pain and function. The authors conclude that, while additional study is needed, a combination of cock-up splints and lumbrical stretches may be effective conservative treatment of CTS. • SEE THE FULL ARTICLE AT PAGE 1

Gregory F. Parkin-Smith, MTech(Chiro), MSc, DrHC

Ian J. Norman, BSc, MSc, PhD

Emma Briggs, BSc, PhD, RN

Elizabeth Angier, BSc, MSc(Chiro)

Timothy G. Wood, BSc, MTech(Chiro)

James W. Brantingham, DC, PhD

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A Structured Protocol of Evidence-Based Conservative Care Compared With Usual Care for Acute Nonspecific Low Back Pain: A Randomized Clinical Trial 

Parkin-Smith and colleagues note that the optimal treatment of low back pain remains controversial. These investigators, therefore, conducted a randomized controlled trial to compare the effects of a structured protocol of evidence-based conservative care with usual care in 118 adults with nonspecific low back pain of less than 6 weeks duration. Participants were divided into 2 groups with those in each group receiving a maximum of 7 treatments over a 4-week period. Evaluation at the end of the trial revealed a relative benefit favoring the intervention group in terms of pain but no differences between the groups with respect to their Ostwestry Disability scores or satisfaction with their care. The authors note that while the overall benefits of the 2 approaches were similar, that an earlier onset of improvement in the intervention group suggested a more rapid response to the evidence-based approach. • SEE THE FULL ARTICLE AT PAGE 11

Nicholas F. Taylor, PhD

Judy Bottrell, BPhty

Katherine Lawler, BPhty

Deenika Benjamin, MPhty

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Mobile Telephone Short Message Service Reminders Can Reduce Nonattendance in Physical Therapy Outpatient Clinics: A Randomized Controlled Trial 

Taylor and colleagues conducted a randomized controlled trial to evaluate whether the introduction of short message service (SMS) reminders could reduce the high nonattendance rates that are common in many medical and physical therapy clinics. In particular, the authors divided 679 patients scheduled for a physical therapy appointment into 2 groups. Half received a reminder SMS 1-2 days prior to their appointments and half did not. Evaluation revealed while there were no overall differences in attendance rates between the groups, those that received SMS messages were about 60% more likely to call to cancel/reschedule their sessions than those not being reminded. The authors conclude that SMS messaging appears capable of reducing missed appointment rates in physical therapy clinics. • SEE THE FULL ARTICLE AT PAGE 21

Leigh A. Hale, PhD

Debra Waters, PhD

Peter Herbison, DSc

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A Randomized Controlled Trial to Investigate the Effects of Water-Based Exercise to Improve Falls Risk and Physical Function in Older Adults With Lower-Extremity Osteoarthritis 

Hale and colleagues explored the efficacy of a water-based exercise program designed to improve balance and reduce the risk of falls in a controlled trial of 39 older adults with hip and/or knee osteoarthritis and assessed as at risk for falls. Twenty-three were assigned to attend the 24 water-based exercise sessions over a 12-week period and 16 served as a control group by participating in a sedentary time-matched computer skills training program. Evaluation at the completion of training revealed that the balance-focused water exercise program did not result in a significant reduction in fall risk (as measured by the Physiological Profile Assessment [short form]) relative to the sedentary computer training activity. The authors conclude that further investigation is needed to determine the reasons for the lack of a between-group difference for the 2 groups. • SEE THE FULL ARTICLE AT PAGE 27