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. 2023 Feb 27;2023(2):CD010003. doi: 10.1002/14651858.CD010003.pub2

Eraslan 2014.

Study characteristics
Methods Study design: 2‐arm quasi‐randomised trial
Setting: unclear
Participants Details of sampling frame:
Total n eligible = not reported
Total n excluded pre‐randomisation = not reported
Total n randomised = 30 participants (47 wrists)
Total n available for follow‐up = 30 
Total n analysed = 30
Intervention group 1 (splint) n = 15
Intervention group 2 rigid taping) = 15
Gender distribution
Intervention group 1 (splint): 2 male, 13 females
Intervention group 2 (rigid taping): 2 male, 13 females
Mean ± SD (range) age:
Intervention group 1 (splint): 43.5 ± 13
Intervention group 2 (rigid taping): 48.9 ± 12
Total mean: 46.2 (aged between 21 and 71 years)
Mean ± SD (range) duration of symptoms, months
Not reported
Inclusion criteria:
CTS according to the electroneuromyography (ENMG) and American Association of Electrodiagnostic Medicine criteria 
Exclusion criteria:

  1. Trauma history like distal radius fracture

  2. Connective tissue diseases

  3. Malign tumours

  4. Cervical degenerative disc diseases and fibromyalgia

  5. People with CTS according to ENMG but having negative Tinel's sign and Phalen's test


CTS diagnostic criteria (case definition):
Not reported
CTS severity: 
Not reported
Protocol violators:
None
Interventions Group 1 ‐ splint: On the 6th day of the treatment, participants were recommended night splint without thumb support. While allowing pronation and supination of the wrist, a neutral positioned splint with volar support was used, which would not allow flexion, extension and deviation. The participants were advised to use their splints for an average of 8 hours each night.
Group 2 ‐ rigid taping: Rigid taping was applied by stretching the carpometacarpal joint with the anchor tie around the thumb, relaxing the flexor retinaculum, and finally stretching the metacarpophalangeal joint and closing it with the last anchor tie on the thumb. 
Both groups: physical therapy programme consisting of 21 sessions of hot application‐ultrasound‐TENS. Hot application for 20 minutes, ultrasound for 4 minutes (1.5 W/cm2 for 2 minutes in each hand), and 20 minutes of TENS (continuous mode) were applied once a day, 6 sessions a week. In the first 6 days of treatment, the participants were recommended to restrict excessive hand and wrist activities. On the 6th day of the treatment, both groups were given tendon shifting, median nerve shifting, strengthening exercises for the wrist, strengthening exercises for the intrinsic muscles, especially strengthening and stretching exercises for the thumb (abductor pollicis muscle) and median nerve stretching. 
Outcomes Outcomes were collected at baseline and at the 21st day of the treatment

  1. BCTQ symptom severity score (1 to 5; higher is worse)

  2. BCTQ functional status score (1 to 5; higher is worse)

  3. VAS for pain at rest, activity and night (0 to 10; higher score indicates more pain)

  4. VAS for paraesthesia (0 to 10; higher score indicates more paraesthesia)
Funding Not reported
COI Not reported
Notes Article in Turkish, translation used 
Results from BCTQ not reported in scale 1 to 5. We assumed that total sum was reported and divided symptom score by 11 and functional score by 8 (as per instructions of the scale).
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk Quote from translation: "Patients were allocated to two treatment groups as night splint and rigid taping. The first patient assigned to a group according to the coin toss method. The following patients were grouped considering the arrival order."
Comment: Only the first participant was randomised and the rest were sequentially allocated, which is not true randomisation.
Allocation concealment (selection bias) High risk Quote from translation: "Patients were allocated to two treatment groups as night splint and rigid taping. The first patient assigned to a group according to the coin toss method. The following patients were grouped considering the arrival order."
Comment: No true randomisation and the sequence was not concealed from the investigators.
Blinding of participants and personnel (performance bias)
All outcomes High risk Comment: Not reported, but due to the nature of the interventions (splint versus taping), it is likely that participants were aware of their allocated treatment.
Incomplete outcome data (attrition bias)
3 months or less Low risk Comment: Data given for all participants in the table
Selective reporting (reporting bias) Unclear risk Comment: No protocol available to confirm the planned outcomes, therefore the risk was unclear. BCTQ reported fully for both groups 
Other bias Low risk Comment:
1) The BCTQ scores were reported in a modified way. The standard method is to divide by the number of questions (scale 1 to 5) but the authors reported the total score (scale probably 19 to 95). However, this did not cause bias because both groups were reported similarly.
2) The level of analysis was the participant, therefore clustering should not affect the analysis.