Effectiveness of Neurodynamic Techniques for the Treatment of Carpal Tunnel Syndrome

University of Jordan

Status: Completed

Conditions: Carpal Tunnel Syndrome

Treatments: Other: Exercise therapy; Other: Neurodynamic techniques

Study type: Interventional

Funder types: Other

Identifiers

NCT03243227

47/2016/2256

Details and patient eligibility

About

Carpal tunnel syndrome CTS is the most common peripheral neuropathy seen in clinic. It results in marked functional limitations of patients. Most patients undergo surgical release which places a heavy burden on health system. Neurodynamic exercise is claimed to be an effective physiotherapy treatment for these patients. It is a practical and complications-free treatment which can be used as a home exercise program. This study aims to investigate the effect of median nerve gliding exercise on symptoms severity and functional limitation in CTS patients.

Full description

• Design: Two groups randomized controlled trial
• Participants: 50 subjects diagnosed with CTS will be recruited from JUH physical medicine and rehabilitation department, diagnosis will be confirmed by a physician clinically and using nerve conduction test. Subjects will be randomized into treatment and control groups.
• Procedures: Participants will be recruited from the physical medicine department at JUH and the diagnosis and initial assessment will be performed by a physician. Baseline outcomes will be measured by an experienced physiotherapist.

Treatment Group: Neurodynamics evaluation and treatment will be provided by an experienced physiotherapist. Each treatment session involves both manual therapy and median nerve mobilization exercise following the neurodynamics concept. Four 60 minutes sessions over a period of four weeks will be performed for each patient. Median nerve mobilization exercise will be continued as home exercise program and will be monitored by the treating physiotherapist using exercise diary.

Control group: four sessions of exercise will be given to participants. CTS standard exercise brochure will be given for the patients to follow over 4 weeks. The brochure will include wrist joint strengthening, stretching and AROM exercise.

Outcomes will be measured at the end of the 4 weeks treatment, 6 weeks and 6 months post treatment.

• Data analysis: Microsoft Excel and SPSS will be used for data entry and analysis.

Descriptive analysis: All obtained data will be tabulated, means, standard deviations and differences will be measured.

Inferential analysis: Two way repeated measure ANOVA will be used to measure differences between the groups.

Enrollment: 53 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Confirmed CTS diagnosis

Exclusion criteria

Previous trauma or surgery involving the upper extremities known neurological condition pregnancy history of radiating neck or back pain in the previous 3 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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53 participants in 2 patient groups

Neurodynamic techniques

Experimental group

Description:

4 sessions of Neurodynamics treatment will be provided by an experienced physiotherapist. It will include manual therapy, median nerve gliding exercise, median nerve tension exercise. patients will continue the exercises as home exercise program during and after the treatment period.

Treatment:

Other: Neurodynamic techniques

Exercise

Active Comparator group

Description:

Exercise therapy 4 sessions of exercise treatment will be provided by an experienced physiotherapist. It will include active range of motion, stretching, and strengthening exercise. patients will be given a brochure to continue the exercises as home exercise program during and after the treatment period.

Treatment:

Other: Exercise therapy