Current Practice Patterns After Carpal Tunnel Release. A Survey of Clinical Practice Trends Across the World

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Since Phalen popularized the diagnosis and treatment of carpal tunnel syndrome (CTS) in the 1950s  there has been continued debate over the optimal management of the condition regarding conservative treatment, surgical approach, and post-surgical intervention. The goal of postoperative rehabilitation is to speed up and en hance symptom resolution and restore functional recovery following surgery. Although the evidence base for rehabilitation for hand conditions has grown throughout the last decade, evidence and guidelines for the use of specific interventions after CTR (carpal tunnel release) are limited. 

Studies suggest postsurgical treatment intervention should combine different methods of scar treatment and numerous strategies  for controlling edema as well as passive, assisted and active mobilization, strengthening, and functional exercises and the gradual progression of activities. However, no clinical practice guidelines exist regarding the optimal post-surgical approach. None of the studies that addressed the effectiveness of the variety of interventions have been described with high quality evidence. Literature provides us with an overview of the effectiveness of various rehabilitation treatments to optimize results following CTR compared with no treatment, placebo, or another non-surgical intervention. No evidence-based practice survey has been performed to assess the current practice patterns around the globe after carpal tunnel release. The aims of this research study was to assess the practice patterns around the globe after carpal tunnel release interventions.

In order to assess the current practice patterns of physical and occupational therapies regarding interventions after CTR, an internet-based survey was designed to address the study aims outlined above using the Google database online electronic survey program. A total of 78 occupational and physical therapists were contacted between September and December 2017 through social networks. Therapists were invited to participate voluntary on the survey and were directed to a Web site link containing the electronic survey. No incentives were provided to participants.