[ { "key": "6I99EV42", "version": 24, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/6I99EV42", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/6I99EV42", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/411551/items/R3BBCG8U", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } } }, "data": { "key": "6I99EV42", "version": 24, "parentItem": "R3BBCG8U", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2015-10-12T23:23:10Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/23543580", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-10-12T23:23:10Z", "dateModified": "2015-10-12T23:23:10Z" } }, { "key": "R3BBCG8U", "version": 24, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/R3BBCG8U", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/R3BBCG8U", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } }, "creatorSummary": "Page et al.", "parsedDate": "2013", "numChildren": 1 }, "data": { "key": "R3BBCG8U", "version": 24, "itemType": "journalArticle", "title": "Therapeutic ultrasound for carpal tunnel syndrome", "creators": [ { "creatorType": "author", "firstName": "Matthew J.", "lastName": "Page" }, { "creatorType": "author", "firstName": "Denise", "lastName": "O'Connor" }, { "creatorType": "author", "firstName": "Veronica", "lastName": "Pitt" }, { "creatorType": "author", "firstName": "Nicola", "lastName": "Massy-Westropp" } ], "abstractNote": "BACKGROUND: Therapeutic ultrasound may be offered to people experiencing mild to moderate symptoms of carpal tunnel syndrome (CTS). The effectiveness and duration of benefit of this non-surgical intervention remain unclear.\nOBJECTIVES: To review the effects of therapeutic ultrasound compared with no treatment, placebo or another non-surgical intervention in people with CTS.\nSEARCH METHODS: On 27 November 2012, we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL (2012, Issue 11 in The Cochrane Library), MEDLINE (January 1966 to November 2012), EMBASE (January 1980 to November 2012), CINAHL Plus (January 1937 to November 2012), and AMED (January 1985 to November 2012).\nSELECTION CRITERIA: Randomised controlled trials (RCTs) comparing any regimen of therapeutic ultrasound with no treatment, a placebo or another non-surgical intervention in people with CTS.\nDATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias in the included studies. We calculated risk ratio (RR) and mean difference (MD) with 95% confidence intervals (CIs) for primary and secondary outcomes. We pooled results of clinically homogenous trials in a meta-analysis using a random-effects model, where possible, to provide estimates of the effect.\nMAIN RESULTS: We included 11 studies including 414 participants in the review. Two trials compared therapeutic ultrasound with placebo, two compared one ultrasound regimen with another, two compared ultrasound with another non-surgical intervention, and six compared ultrasound as part of a multi-component intervention with another non-surgical intervention (for example, exercises and splint). The risk of bias was low in some studies and unclear or high in other studies, with only two reporting that the allocation sequence was concealed and six reporting that participants were blinded. Overall, there is insufficient evidence that one therapeutic ultrasound regimen is more efficacious than another. Only two studies reported the primary outcome of interest, short-term overall improvement (any measure in which patients indicate the intensity of their complaints compared with baseline, for example, global rating of improvement, satisfaction with treatment, within three months post-treatment). One low quality trial with 68 participants found that when compared with placebo, therapeutic ultrasound may increase the chance of experiencing short-term overall improvement at the end of seven weeks treatment (RR 2.36; 95% CI 1.40 to 3.98), although losses to follow-up and failure to adjust for the correlation between wrists in participants with bilateral CTS in this study suggest that this data should be interpreted with caution. Another low quality trial with 60 participants found that at three months post-treatment therapeutic ultrasound plus splint increased the chance of short-term overall improvement (patient satisfaction) when compared with splint alone (RR 3.02; 95% CI 1.36 to 6.72), but decreased the chance of short-term overall improvement when compared with low-level laser therapy plus splint (RR 0.87; 95% CI 0.57 to 1.33), though participants were not blinded to treatment, it was unclear if the random allocation sequence was adequately concealed, and there was a potential unit of analysis error. Differences between groups receiving different frequencies and intensities of ultrasound, and between ultrasound as part of a multi-component intervention versus other non-surgical interventions, were generally small and not statistically significant for symptoms, function, and neurophysiologic parameters. No studies reported any adverse effects of therapeutic ultrasound, but this outcome was only measured in three studies. More adverse effects data are required before any firm conclusions on the safety of therapeutic ultrasound can be made.\nAUTHORS' CONCLUSIONS: There is only poor quality evidence from very limited data to suggest that therapeutic ultrasound may be more effective than placebo for either short- or long-term symptom improvement in people with CTS. There is insufficient evidence to support the greater benefit of one type of therapeutic ultrasound regimen over another or to support the use of therapeutic ultrasound as a treatment with greater efficacy compared to other non-surgical interventions for CTS, such as splinting, exercises, and oral drugs. More methodologically rigorous studies are needed to determine the effectiveness and safety of therapeutic ultrasound for CTS.", "publicationTitle": "The Cochrane Database of Systematic Reviews", "publisher": "", "place": "", "date": "2013", "volume": "3", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "CD009601", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD009601.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 23543580", "tags": [ { "tag": "Carpal Tunnel Syndrome", "type": 1 }, { "tag": "Combined Modality Therapy", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "Ultrasonic Therapy", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2015-10-12T23:23:10Z", "dateModified": "2015-10-12T23:23:10Z" } }, { "key": "HW2SHRMZ", "version": 23, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/HW2SHRMZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/HW2SHRMZ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/411551/items/KGRF5WCV", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } } }, "data": { "key": "HW2SHRMZ", "version": 23, "parentItem": "KGRF5WCV", "itemType": "attachment", "linkMode": "imported_url", "title": "Cochrane Snapshot", "accessDate": "2015-10-12T23:20:28Z", "url": "http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/342/CN-00762342/sect0.html", "note": "", "contentType": "text/html", "charset": "utf-8", "filename": "sect0.html", "md5": "7c8bf2c359ff92d8cc4f8aca263a0898", "mtime": 1444692028727, "tags": [], "relations": {}, "dateAdded": "2015-10-12T23:20:28Z", "dateModified": "2015-10-12T23:20:28Z" } }, { "key": "KGRF5WCV", "version": 22, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/KGRF5WCV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/KGRF5WCV", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } }, "creatorSummary": "Dincer et al.", "parsedDate": "2009", "numChildren": 1 }, "data": { "key": "KGRF5WCV", "version": 22, "itemType": "journalArticle", "title": "The effectiveness of conservative treatments of carpal tunnel syndrome: splinting, ultrasound, and low-level laser therapies.", "creators": [ { "creatorType": "author", "firstName": "U", "lastName": "Dincer" }, { "creatorType": "author", "firstName": "E", "lastName": "Cakar" }, { "creatorType": "author", "firstName": "MZ", "lastName": "Kiralp" }, { "creatorType": "author", "firstName": "H", "lastName": "Kilac" }, { "creatorType": "author", "firstName": "H", "lastName": "Dursun" } ], "abstractNote": "OBJECTIVE: The objective of this study was to investigate the effectiveness of splinting, ultrasound (US), and low-level laser (LLL) in the management of carpal tunnel syndrome (CTS).BACKGROUND DATA: CTS is the entrapment mononeuropathy most frequently seen in clinical practice, caused by compression of the median nerve at the wrist. Although several treatment modalities are routinely in use, there is no consensus about the best way to manage CTS.MATERIALS AND METHODS: In our study, patients were randomly allocated to three groups that received the following treatment protocols: splinting only, splinting plus US, and splinting plus LLL therapy. Patients were assessed with the Boston Questionnaire, patient satisfaction inquiry, visual analogue scale for pain, and electroneuromyography.RESULTS AND CONCLUSION: The study was completed with a total of 100 hands of 50 women patients with bilateral CTS at 3 mo after treatment. At the end of the follow-up period, each of the groups had improvements to varying degrees. It appeared that the combinations of US or LLL therapy with splinting were more effective than splinting alone in treating CTS. However, LLL therapy plus splinting was more advantageous than US therapy plus splinting, especially for the outcomes of lessening of symptom severity, pain alleviation, and increased patient satisfaction.", "publicationTitle": "Photomedicine and laser surgery", "publisher": "", "place": "", "date": "2009", "volume": "27", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "119-25", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "The effectiveness of conservative treatments of carpal tunnel syndrome", "language": "", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.", "extra": "", "tags": [ { "tag": "SR-NEUROMUSC", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2015-10-12T23:20:28Z", "dateModified": "2015-10-12T23:20:28Z" } }, { "key": "CTJG72G7", "version": 21, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/CTJG72G7", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/CTJG72G7", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/411551/items/HNTACTI5", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } } }, "data": { "key": "CTJG72G7", "version": 21, "parentItem": "HNTACTI5", "itemType": "attachment", "linkMode": "imported_url", "title": "Cochrane Snapshot", "accessDate": "2015-10-12T23:19:43Z", "url": "http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/131/CN-00908131/sect0.html", "note": "", "contentType": "text/html", "charset": "utf-8", "filename": "sect0.html", "md5": "79a850b4d4c813f2cf520da94a53a025", "mtime": 1444691983221, "tags": [], "relations": {}, "dateAdded": "2015-10-12T23:19:43Z", "dateModified": "2015-10-12T23:19:43Z" } }, { "key": "HNTACTI5", "version": 20, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/HNTACTI5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/HNTACTI5", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } }, "creatorSummary": "Saeed F-U-R et al.", "parsedDate": "2012", "numChildren": 1 }, "data": { "key": "HNTACTI5", "version": 20, "itemType": "journalArticle", "title": "The effects of laser and ultrasound therapy on carpal tunnel syndrome.", "creators": [ { "creatorType": "author", "name": "Saeed F-U-R" }, { "creatorType": "author", "firstName": "S", "lastName": "Hanif" }, { "creatorType": "author", "firstName": "M", "lastName": "Aasim" } ], "abstractNote": "Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of upper limb and one of the causes of disability. The conservative management of CTS includes splints, intracarpal steroids and ultrasound therapy. Recently Low-energy Laser Therapy has been popularized in the treatment various treatment including carpal tunnel syndrome. We compared the effects of both of these therapies in a randomized trial. Objectives: To compare the effects of laser versus ultrasound therapy on carpal tunnel syndrome Methods: A total of hundred patients of unilateral carpal tunnel syndrome diagnosed clinically and electro physiologically were included in the study and divided in two equal groups. One group was treated by Ultra sound Ttherapy (1MHz, 1.0 Watt/cm 2 ) and the other group by Low Level Laser Therapy (830 nm infrared ). Patients were blinded to the two types of treatment. Treatment Outcome was measured subjectively by Visual analogue scale, functional status scale and Symptom Severity Scale for gravity of symptoms. Objectively outcome was measured electro physiologically before and after the treatment. Results: Improvement was more marked in ultrasound treated group than laser treated group. Pain relief on Visual Analogue Scale, Symptom Severity Scale and Functional Status Scale was 2.30 points, 0.44 and 0.34 points more in Ultrasound treated group as compared to Laser treated group. Electro physiologically improvement in Sensory Latency and Motor Latency was 0.46 ms and 0.62 ms more in ultrasound treated group. P value was less than 0.001 Conclusion: Ultrasound treatment proved to be more effective than Laser treatment.", "publicationTitle": "Pakistan Journal of Medical and Health Sciences", "publisher": "", "place": "", "date": "2012", "volume": "6", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "238-41", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2015-10-12T23:19:43Z", "dateModified": "2015-10-12T23:19:43Z" } }, { "key": "XTUAZMQB", "version": 19, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/XTUAZMQB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/XTUAZMQB", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/411551/items/NIGHNP6U", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } } }, "data": { "key": "XTUAZMQB", "version": 19, "parentItem": "NIGHNP6U", "itemType": "attachment", "linkMode": "imported_url", "title": "Cochrane Snapshot", "accessDate": "2015-10-12T23:19:12Z", "url": "http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/174/CN-00492174/sect0.html", "note": "", "contentType": "text/html", "charset": "utf-8", "filename": "sect0.html", "md5": "1b227f2a18ee26a59e42a22faf475625", "mtime": 1444691952886, "tags": [], "relations": {}, "dateAdded": "2015-10-12T23:19:12Z", "dateModified": "2015-10-12T23:19:12Z" } }, { "key": "NIGHNP6U", "version": 18, "library": { "type": "group", "id": 411551, "name": "GriffelEthan_Assingment1Part2", "links": { "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/411551/items/NIGHNP6U", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/griffelethan_assingment1part2/items/NIGHNP6U", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2667434, "username": "grifetha", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/grifetha", "type": "text/html" } } }, "creatorSummary": "Bakhtiary and Rashidy-Pour", "parsedDate": "2004", "numChildren": 1 }, "data": { "key": "NIGHNP6U", "version": 18, "itemType": "journalArticle", "title": "Ultrasound and laser therapy in the treatment of carpal tunnel syndrome.", "creators": [ { "creatorType": "author", "firstName": "AH", "lastName": "Bakhtiary" }, { "creatorType": "author", "firstName": "A", "lastName": "Rashidy-Pour" } ], "abstractNote": "This study was designed to compare the efficacy of ultrasound and laser treatment for mild to moderate idiopathic carpal tunnel syndrome. Ninety hands in 50 consecutive patients with carpal tunnel syndrome confirmed by electromyography were allocated randomly in two experimental groups. One group received ultrasound therapy and the other group received low level laser therapy. Ultrasound treatment (1 MHz, 1.0 W/cm(2), pulse 1:4, 15 min/session) and low level laser therapy (9 joules, 830 nm infrared laser at five points) were applied to the carpal tunnel for 15 daily treatment sessions (5 sessions/week). Measurements were performed before and after treatment and at follow up four weeks later, and included pain assessment by visual analogue scale; electroneurographic measurement (motor and sensory latency, motor and sensory action potential amplitude); and pinch and grip strength. Improvement was significantly more pronounced in the ultrasound group than in low level laser therapy group for motor latency (mean difference 0.8 m/s, 95% CI 0.6 to 1.0), motor action potential amplitude (2.0 mV, 95% CI 0.9 to 3.1), finger pinch strength (6.7 N, 95% CI 5.0 to 8.2), and pain relief (3.1 points on a 10-point scale, 95% CI 2.5 to 3.7). Effects were sustained in the follow-up period. Ultrasound treatment was more effective than laser therapy for treatment of carpal tunnel syndrome. Further study is needed to investigate the combination therapy effects of these treatments in carpal tunnel syndrome patients.", "publicationTitle": "Australian journal of physiotherapy", "publisher": "", "place": "", "date": "2004", "volume": "50", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "147-51", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "Copyright © 2012 The Cochrane Collaboration. 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