Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods

Abstract

The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient's outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master's degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.

Keywords: Italian survey; care management; carpal tunnel syndrome; physiotherapy; rehabilitation.

Figure 1

Clinical management for orthotics, instrumental therapies and neuro/tendons glides techniques. Tabled as percentage of respondent (n = 508). Q: question. Q19: Orthotic; Q20: Instrumental Therapies; Q21: Neurodynamic/tendons glides techniques.

Figure 2

Most frequent treatment strategy for carpal tunnel syndrome. A: Massage therapy, instrumental therapy; B: Education, manual therapy, myofascial therapy, therapeutic exercise; C: Joint mobilization of the radiocarpal joint, stretching; D: None of the previous answers; E: Missing values.

Figure 3

Inferences between educational qualifications and correct answers (Q12, Q18, Q22, Q23). Acronyms: Q: question. Bold values outside the box are the ones with statistical significance in the residual p-values. Tabled as percentage of respondent (n = 508).

Figure 4

Inferences between places of professional activity and correct answers (Q12 and Q24). Acronyms: Q, question. Bold values outside the box are the ones with statistical significance in the residual p-values. Tabled as percentage of respondent (n = 508).