Multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.
Background: Musculoskeletal disorders of the elbow, forearm, wrist and hand are associated with pain, functional impairment and decreased productivity in the general population. Combining several interventions in a multimodal program of care is reflective of current clinical practice; however there...
| Published in: | Chiropractic & Manual Therapies Vol. 24; pp. 1 - 21 |
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| Main Authors: | , , , , , , , , , , , , , , , |
| Format: | research systematic review tables/charts Journal Article |
| Published: |
BioMed Central
3/7/2016
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113757012&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113757012 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 2045709X BG1Z jtl: Chiropractic & Manual Therapies issn: 2045709X maglogo: N pubinfo: dt: 3/7/2016 vid: 24 pid: 24147 pub: BioMed Central artinfo: ui: 113757012 113757012 113757012 10.1186/s12998-016-0089-8 113757012 ppf: 1 ppct: 20 formats: fmt: @attributes: type: P tig: atl: Multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. aug: au: Sutton, Deborah Gross, Douglas P. Côté, Pierre Randhawa, Kristi Hainan Yu Wong, Jessica J. Stern, Paula Varatharajan, Sharanya Southerst, Danielle Shearer, Heather M. Stupar, Maja Goldgrub, Rachel van der Velde, Gabrielle Nordin, Margareta Carroll, Linda J. Taylor-Vaisey, Anne affil: UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memoria Chiropractic College (CMCC), 6100 Leslie Street, Toronto, Ontario, Canada, M2H 3J1 sug: subj: Combined Modality Therapy Methods Musculoskeletal Diseases Therapy Treatment Outcomes Hand Pathology Elbow Pathology Forearm Pathology Wrist Pathology Systematic Review Human Medline Embase CINAHL Database Cochrane Library Prospective Studies Case Control Studies Carpal Tunnel Syndrome Therapy Tennis Elbow Therapy Psycinfo Randomized Controlled Trials Questionnaires kappa Statistic Confidence Intervals Analysis of Covariance Summated Rating Scaling Odds Ratio Relative Risk Reaction Time Funding Source Ontario Bias (Research) Evaluation Child Adult Male Female Young Adult Middle Age Aged Internal Validity Meta Synthesis Descriptive Statistics Scales Child: 6-12 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Musculoskeletal disorders of the elbow, forearm, wrist and hand are associated with pain, functional impairment and decreased productivity in the general population. Combining several interventions in a multimodal program of care is reflective of current clinical practice; however there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand on self-rated recovery, functional recovery, or clinical outcomes in adults or children. Methods: We conducted a systematic review of the literature and best evidence synthesis. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from January 1990 to March 2015. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a low risk of bias were synthesized following best evidence synthesis principles. Results: We screened 5989 articles, and critically appraised eleven articles. Of those, seven had a low risk of bias; one addressed carpal tunnel syndrome and six addressed lateral epicondylitis. Our search did not identify any low risk of bias studies examining the effectiveness of multimodal care for the management of other musculoskeletal disorders of the elbow, forearm, wrist or hand. The evidence suggests that multimodal care for the management of lateral epicondylitis may include education, exercise (strengthening, stretching, occupational exercise), manual therapy (manipulation) and soft tissue therapy (massage). The evidence does not support the use of multimodal care for the management of carpal tunnel syndrome. Conclusions: The current evidence on the effectiveness of multimodal care for musculoskeletal disorders of the elbow, forearm, wrist and hand is limited. The available evidence suggests that there may be a role for multimodal care in the management of patients with persistent lateral epicondylitis. Future research is needed to examine the effectiveness of multimodal care and guide clinical practice. Systematic review registration number: CRD42014009093 pubtype: Academic Journal doctype: research systematic review tables/charts meta synthesis Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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