Diagnósticos e desfechos dos ensaios clínicos randomizados sobre a síndrome do túnel do carpo utilizando a classificação internacional de funcionalidade, incapacidade e saúde (CIF) como referência – revisão sistemática.
Data
2023-05-15
Autores
Sousa, Rafael Luz [UNIFESP]
Orientadores
Belloti, João Carlos [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Embora a síndrome do túnel do carpo (STC) seja a neuropatia periférica mais prevalente no mundo, ainda falta de uniformidade entre qual método diagnóstico empregar e como avaliar os
desfechos do tratamento cirúrgico.
Objetivo: Identificar métodos diagnósticos e de desfechos em ensaios clínicos randomizados (ECRs)
sobre STC, sistematizando-os de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF).
Métodos: Cochrane Library, Pubmed e Embase foram pesquisadas com filtro para
ECRs com intervenção cirúrgica para STC. De forma duplicada, extraíuse os métodos diagnósticos e de desfechos dos ECRs.
Resultados: Dos 582 estudos selecionados, 35 foram incluídos nesta revisão sistemática. Parestesia associada ao teste de Phalen (18 estudos; 51%) e a eletroneuromiografia (31 estudos; 88%) foram os métodos diagnósticos mais prevalentes. O domínio Função Corporal, da CIF, foi o que teve
maior quantidade de desfechos classificados, sendo a utilização do Questionário Túnel do Carpo de Boston (QTCB) o desfecho mais utilizado (18 estudos; 51%), seguido por força de preensão manual (14
estudos; 40%).
Conclusão: Cerca de metade dos estudos não alicerçam o método diagnóstico por meio de critérios clínicos estruturados. A maioria dos estudos utilizam a eletroneuromiografia como exame complementar. Baseando-se na CIF, houve predomínio de avaliação da deficiência corporal por meio da maior prevalência de desfechos englobados no domínio Função Corporal.
Introduction: Although carpal tunnel syndrome (CTS) is the most prevalent peripheral neuropathy in the world, there is still a lack of uniformity between which diagnostic method to use and how to assess the outcomes of surgical treatment. Objective: To identify diagnostic and outcome methods in Randomized Clinical Trials (RCTs) on CTS, systematizing them according to the International Classification of Functioning, Disability and Health (ICF). Methods: Cochrane Library, Pubmed, and Embase were searched with a filter for RCTs with surgical intervention for CTS. In duplicate, diagnostic methods and outcomes were extracted from the RCTs. Results: Of the 582 selected studies, 35 were included in this systematic review. Paresthesia associated with Phalen's test (18 studies; 51%) and electroneuromyography (31 studies; 88%) were the most prevalent diagnostic methods. The Body Function domain of the ICF had the highest number of outcomes classified, with the use of the Boston Carpal Tunnel Questionnaire (BCTQ) being the most used outcome (18 studies; 51%), followed by handgrip strength ( 14 studies; 40%). Conclusion: About half of the studies do not support the diagnostic method using structured clinical criteria. Most studies use electroneuromyography as a complementary exam. Based on the ICF, there was a predominance of assessment of body deficiency through the higher prevalence of outcomes encompassed in the Body Function domain.
Introduction: Although carpal tunnel syndrome (CTS) is the most prevalent peripheral neuropathy in the world, there is still a lack of uniformity between which diagnostic method to use and how to assess the outcomes of surgical treatment. Objective: To identify diagnostic and outcome methods in Randomized Clinical Trials (RCTs) on CTS, systematizing them according to the International Classification of Functioning, Disability and Health (ICF). Methods: Cochrane Library, Pubmed, and Embase were searched with a filter for RCTs with surgical intervention for CTS. In duplicate, diagnostic methods and outcomes were extracted from the RCTs. Results: Of the 582 selected studies, 35 were included in this systematic review. Paresthesia associated with Phalen's test (18 studies; 51%) and electroneuromyography (31 studies; 88%) were the most prevalent diagnostic methods. The Body Function domain of the ICF had the highest number of outcomes classified, with the use of the Boston Carpal Tunnel Questionnaire (BCTQ) being the most used outcome (18 studies; 51%), followed by handgrip strength ( 14 studies; 40%). Conclusion: About half of the studies do not support the diagnostic method using structured clinical criteria. Most studies use electroneuromyography as a complementary exam. Based on the ICF, there was a predominance of assessment of body deficiency through the higher prevalence of outcomes encompassed in the Body Function domain.
Descrição
Citação
SOUSA, Rafael. Diagnósticos e desfechos dos ensaios clínicos randomizados sobre a síndrome do túnel do carpo utilizando a Classificação internacional de funcionalidade, incapacidade e saúde (CIF) como referência – revisão sistemática. 2023. Dissertação (Mestrado em Cirurgia Translacional) - Escola Paulista de Medicina, Universidade Federal de São Paulo, 2023