Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

MacDermid, Joy Christine

Abstract

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy that negatively impacts hand function and quality of life. This thesis includes two studies addressing key gaps in the conservative management and outcome measurement of CTS. The first is an overview of systematic reviews examining non-biophysical conservative interventions—including orthoses, manual therapy, therapeutic exercise, and assistive technologies. Twenty-six reviews were critically appraised using the AMSTAR-2 tool. Exercise and splinting demonstrated the most consistent benefits, although the methodological quality of included reviews was often low. The second study is a retrospective observational analysis comparing the responsiveness of the PROMIS Pain Interference Short Form 6a (PISF) and the Numeric Pain Rating Scale (NPRS) in post-operative CTS patients. While both measures captured statistically significant changes, NPRS demonstrated greater responsiveness and efficiency in detecting short-term improvement. Collectively, the findings contribute to evidence-informed clinical decision-making and support the use of appropriate outcome measures in CTS rehabilitation.

Summary for Lay Audience

Carpal tunnel syndrome (CTS) is a common condition that results from pressure on the median nerve at the wrist, often leading to pain, tingling, and reduced hand function. This thesis addresses two key areas relevant to the management and assessment of CTS. First, it provides a summary of evidence from 26 systematic reviews evaluating non-surgical, non-electrotherapy treatments such as wrist splinting, therapeutic exercise, manual therapy techniques, and assistive technologies. Splinting and exercise emerge as the most consistently effective approaches, although the quality of the evidence varied. Second, the thesis compares two pain measurement tools in patients recovering from carpal tunnel surgery: the Numeric Pain Rating Scale (NPRS) and the PROMIS Pain Interference Short Form 6a (PISF). Both tools detected improvement over the first week after surgery, but the NPRS was more responsive to short-term changes. These findings support evidence-informed clinical decisions and underscore the importance of using outcome measures that are sensitive to meaningful changes in patient condition.

Creative Commons License

Creative Commons Attribution-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 License.

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