Linking hand therapy outcome measures used after carpal tunnel release to the International Classification of Functioning, Disability and Health: A systematic review.

INTRODUCTION: The goal of hand therapy after carpal tunnel release (CTR) is restoration of function. Outcome assessment tools that cover the concepts contained in the International Classification of Functioning, Disability and Health (ICF), a framework for describing functioning and disability, are appropriate for hand therapy treatment of this diagnosis.

PURPOSE OF THE STUDY: To identify and review outcome measures used in studies on rehabilitation after CTR and link these to the concepts contained in the ICF.

METHODS: A comprehensive literature search was conducted. Outcome measures in the included studies were linked to the ICF. For data calculation purposes, outcome measures were linked to the specific ICF category, which matched the majority of assessment items if there were components that fit into more than 1 category. The quality of the studies was evaluated, and effect sizes for the treatment interventions were calculated for a comprehensive systematic review.

RESULTS: Seven studies met the inclusion criteria. Eleven outcomes (68.75%) were linked to body function, 1 (6.25%) to body structure, 3 (18.75%) to activity and participation, and 1 (6.25%) to environmental factors. No outcomes were associated with environmental factors or personal factors. Structured Effectiveness for Quality Evaluation of Study scores of the included studies ranged from 23 to 43/48.

DISCUSSION: The predominant outcome tools in the current research on rehabilitation after CTR are impairment measures and are linked to the category of body structures and body functions.

CONCLUSIONS: Functional measures, associated with the activity and participation category, are only modestly represented, and there is a lack of representation of environmental and personal factors for outcome measures used following CTR.