Carpal Tunnel Syndrome: MCP-Inclusive Splinting and Virtual Reality Nerve Gliding Across Two Randomized Trials

Physical therapists and physical therapist assistants who see patients with mild-to-moderate carpal tunnel syndrome, along with occupational therapists and certified hand therapists who fabricate orthoses or prescribe tendon and nerve gliding programs.

Physical therapists and physical therapist assistants in outpatient orthopedic, hand therapy, occupational health and industrial rehabilitation settings. Physical therapist assistants carry out the plan of care established by the supervising physical therapist; evaluation, diagnosis and plan-of-care decisions remain with the physical therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Nadar MS, Alotaibi N, Manee F. Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial. BMJ Open. 2023;13(11):e076961. doi:10.1136/bmjopen-2023-076961

Arman S, Menekseoglu AK, Sezgin B, Ozgur B, Capan N, Oral A. The effects of virtual reality-mediated tendon and nerve gliding exercises in the conservative management of carpal tunnel syndrome: a double-blind randomized placebo controlled trial. Eur J Phys Rehabil Med. 2024;60(3):458–469. doi:10.23736/S1973-9087.24.08432-6

After completing this course, you will be able to:

1. Describe what the assessor-blinded splinting trial reported when an orthosis that also restricted the metacarpophalangeal joints was compared with a wrist-only cock-up splint in adults with mild-to-moderate carpal tunnel syndrome.
2. State which symptoms changed and which did not when tendon and nerve gliding exercises were delivered through a virtual reality system in the double-blind, placebo-controlled trial.
3. Distinguish the immobilization account of symptom relief from the movement account, and explain where these two trials agree, where they diverge, and what each left unanswered about combining the two.

1. Start Here: How This Course Works
2. Part One: Wrist-Only Versus MCP-Inclusive Splinting in Mild-to-Moderate Carpal Tunnel Syndrome
3. Who Was Studied in the Splinting Trial
4. How the Two Splints Were Built, Worn and Assessed
5. What the Splints Changed at Six Weeks and at Six Months
6. Limits of the Splinting Trial and What Its Authors Concluded
7. Part Two: Tendon and Nerve Gliding Exercise Delivered Through Virtual Reality
8. Who Was Studied in the Virtual Reality Trial
9. How the Three Exercise Groups Were Run
10. What Improved, and What Stayed the Same
11. Limits of the Virtual Reality Trial and What Its Authors Concluded
12. Bringing It Together
13. Where the Two Trials Agree
14. Where the Trials Diverge, and Which One Found What
15. Immobilization and Movement at the Treatment Table
16. What These Two Trials Leave Unanswered
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Nadar MS, Alotaibi N, Manee F. Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial. BMJ Open. 2023;13(11):e076961. doi:10.1136/bmjopen-2023-076961
2. Arman S, Menekseoglu AK, Sezgin B, Ozgur B, Capan N, Oral A. The effects of virtual reality-mediated tendon and nerve gliding exercises in the conservative management of carpal tunnel syndrome: a double-blind randomized placebo controlled trial. Eur J Phys Rehabil Med. 2024;60(3):458-469. doi:10.23736/S1973-9087.24.08432-6