From the Editor's Desk

This is the fourth and final issue for this year – a year in which Hand Therapy was relaunched. I hope readers will agree that it is not just a case of ‘Emperor's new clothes’ but that inside those redesigned front and back covers the scientific content has improved and expanded. As Editor, I have noticed an increase in the number of manuscripts submitted for review and from authors all over the world. I am also pleased to be publishing our first ‘Letter to the Editor’ with the authors' response. While I could see this merely as evidence that at least one person read my last Editor's note, I hope it is more of a testament to an increasing and healthy culture of critical enquiry and debate that exists in hand therapy – so keep them coming!

Katherine Hunt and colleagues from the Peninsula Medical School in the UK present a systematic review of chiropractic manipulation for carpal tunnel syndrome (CTS). Their search yielded only one randomized controlled trial, of low quality, which had concluded that there were no significant differences between patients treated by chiropractic, myofascial massage, loading and night splints, and those receiving night splints and a reducing nine-week treatment of ibuprofen (control). However, the authors question these conclusions showing that on re-analysis there were statistically significant differences in mental and physical distress favouring the control group. Aside from the fact that this calls into question the effectiveness of chiropractic in the treatment of CTS, the review also highlights how important it is for authors to follow appropriate methods for reporting and analysing controlled trials and observational studies. Reporting guidelines like CONSORT, PRISMA and STROBE are all designed to improve the quality of reporting of research. Readers may find further information at the Equator-network (www.equator-network.org/home), which also has a wide range of very useful resources for authors, reviewers and editors.

Robyn-Rose Lee and Sara Probert from London describe the development and evaluation of an extended scope practitioner (ESP) clinic to support the National Health Service 18-week waiting list initiative for CTS and first carpometacarpal joint osteoarthritis. Their article highlights not only the increasing skill and professional autonomy that some hand therapists in the UK have been afforded through ESP roles, but also serves as an excellent example of how service developments can be implemented and audited against performance indicators. Service development and service improvement is perhaps the last but also most important part of ensuring that research is used and implemented at the ‘bedside’. More studies such as these need to be undertaken by hand therapists and the results disseminated.

Our third article by Michelle McCarroll and Jennifer Martin from Youngstown, Ohio is a case report in which a technique called extensor tendon acceleration is applied and evaluated after metacarpal fracture.

Finally, let me remind readers and authors that I am always happy to hear from you especially at this time of year when the Editorial Committee prepares for its annual meeting to review progress and plan for the future. I would also like to thank the Editorial Committee, International Editorial Advisors, Corresponding Editor and reviewers and everyone at RSMP for all their hard work and support over the last year.