Effects of Sensory Reeducation Programs on Functional Hand Sensibility after Median and Ulnar Repair: A Systematic Review

IntroductionThis is the first systematic review looking at the effectiveness of sensory re-education programmes on functional sensibility which focuses purely on clinical trials of adult patients with median and ulnar nerve injuries.MethodsA literature search of AMED, CINAHL, Embase and OVID Medline (from inception to July 2011) was undertaken. Studies were selected if they met the following inclusion criteria: controlled trials (with or without randomization) of sensory re-education, including early and late phase, in adults with median and/or ulnar nerve repair. Two independent assessors rated study quality and risk of bias using the 24 point MacDermid Evaluation Tool.ResultsA total of seven articles met the inclusion criteria representing five separate studies Study quality ranged from 13 to 33 out of 48 points on the Evaluation Tool. Due to heterogeneity of the interventions and outcomes assessed it was not possible to pool the results from all studies. There is limited evidence to support the use of early and late SR programmes.ConclusionFurther trials are needed to evaluate the effect of early and late sensory re-education which are adequately powered, include validated and relevant outcomes and which are reported according to CONSORT (Consolidated Standards of Reporting Trials) guidelines.Level of Evidence2b.