Singleton Contrast Bath

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Contrast Bath:

Contrast Bath Physical Agent Modalities Fall 2015 Bryan K. Singleton

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome :

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome Full Citation: Janssen, R. G., Schwartz, D. A., & Velleman, P. F. (2009). A randomized controlled study of contrast baths on patients with carpal tunnel syndrome. Journal for Hand Therapy, 22 (3), 200-208. doi:10.1016/j.jht.2009.02.001 Level of Evidence: Level I-Randomized Control Trial Methodology: This research project consisted of people who were selected after having such tests as the electromyograph performed on them as well as being assessed and were all identified as having carpal tunnel syndrome. All of them were patients from the same medical facility who had had surgery or were going to have surgery due to this condition and were chosen because there was such an ample selection of them. Some of the people following their surgical procedures were shown to have issues with increased hand volume. In addition, a certain type of surgical procedure was implemented on all of them during their surgery for this condition (Janssen, Schwartz, & Velleman, 2009, p. 201).

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome :

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome Hypothesis: “The null hypothesis is that there will be no significant increase or decrease in hand volumes using any of three treatment protocols described below regardless of whether the treatment occurred pre- or postoperatively” (Janssen et al., 2009, p. 201). Inclusion Criteria: There was no inclusion criteria mentioned in this research study. Exclusion Criteria: This consisted of people who had already had surgery for carpal tunnel syndrome, other types of hand complaints in addition to their carpal tunnel syndrome, and those who had “…systemic or neurological conditions…” (Janssen et al., 2009, p. 201).

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome :

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome Intervention: Contrast baths given before testing for hand volumetry pre surgery-3-5 days prior post surgery-10-14 later One control group and two treatment groups treatment groups-contrast baths control group-just exercise Hand volume assessed-contrast baths and exercise (composite fist)-first treatment group Hand volume assessed-contrast baths and no exercise-second treatment group Hand volume assessed-exercise and hand poses but no contrast baths-third group or control group Finger exercises-extension and flexion-total 11 minutes-hot water 1 minute cold water 1 minute Hands in cold water first then finishing in same cold water-normal sequence Hands in hot water first then final placement in same hot water for this research investigation Total of 6 seconds-exercises of complete extension and flexion of subjects’ fingers conducted (Janssen et al., 2009, p.201)

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome :

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome Outcomes of Interest: Objective The major outcome of interest with its objective evaluations that also has favorable inter-rater reliability as well as validity was the hand volumeter. This is a tool that calculates and documents in milliliters the amount of water that has moved after a subject places his hands in water (Janssen et al., 2009, p. 202). Sta tis tical Tests: ANOVA Regression

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome :

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome Findings: Statistically significant: Yes there were statistical significances with hand volume even though it barely elevated in the control group and both of the treatment groups (Janssen et al., 2009 p. 204). Clinically significant: These elevations were not significantly different clinically, despite having statistical significances (Janssen et al., 2009, p.204). Author's Conclusions: The author’s conclusion was that, “Contrast baths as described are not clinically effective in changing hand volume in pre- and postoperative Carpal Tunnel Release patients” (Janssen et al., 2009, p. 206).

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome:

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome What are the strengths of the study? The authors noted that with the interpretations of the power ANOVA that was conducted with this study being accurate when determining effect size in relation to hand volume, that even though the sample size was somewhat less than what i s usually needed for a study to be considered noteworthy, it was not an issue. Because of this reasoning, other people who have had surgery for Carpal Tunnel Syndrome or those who are going to have it can have the outcomes of this study applied to them as well, although not if they also have different hand issues or other complicating conditions (Janssen et al., 2009, p. 205). What are the limitations of the study? The subjects for this research analysis were recruited by convenience sampling, which can cause a limitation to the study. It was easy to find the subjects for this study because all of them had had their carpal tunnel work conducted at the same facility (Janssen et al., 2009, p. 205).

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome :

A randomized controlled study of contrast baths on patients with carpal tunnel syndrome How do the results of this study apply to our practice?: After reviewing this research article, coming to the conclusion that contrast baths have very little affect on hand volume, and while they might still be beneficial with some clients to some degree, it would probably be advisable to not use this modality for this particular condition. Action plan (how do I plan to use these results?): I plan to use the results of this research article with some hesitation. Depending on the client’s diagnosis, if a contrast bath modality would be appropriate and helpful then I would consider using it. However , if there is research that demonstrates another modality that would be more advantageous for a particular client, then I would choose the latter.

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