Investigation of the Effectiveness of Kinesiological Taping in Cubital Tunnel Syndrome

Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey

Status: Enrolling

Conditions: Kinesio Taping; Ulnar Neuropathies; Cubital Tunnel Syndrome

Treatments: Diagnostic Test: Neuropathic pain scale (measured using the DN-4 scale); Other: kinesio taping; Diagnostic Test: the ulnar nerve cross-sectional area measured by ultrasound; Diagnostic Test: SF-12 Quality of Life Scale; Other: Sham (No Treatment); Other: Ulnar nerve mobilization exercise; Diagnostic Test: Grip strength measured with a hand dynamometer; Diagnostic Test: QUICK-DASH; Diagnostic Test: Numeric Rating Scale (NRS)

Study type: Interventional

Funder types: Other

Identifiers

NCT07001111

25-17

Details and patient eligibility

About

This study aims to investigate the effect of kinesiological taping, applied in addition to exercise, on clinical symptoms in patients diagnosed with Cubital Tunnel Syndrome. The patients will be randomized into three groups (exercise, exercise + kinesiological taping, exercise + sham taping) and will be evaluated at the 1st and 3rd months after a 3-week treatment period.

Full description

Cubital Tunnel Syndrome (CuTS), characterized by the compression of the ulnar nerve at the elbow, is a condition that causes symptoms such as pain, numbness, paresthesia, and muscle weakness in the affected limb. Ulnar nerve compression is the second most common entrapment neuropathy after median nerve entrapment . The ulnar nerve can become compressed at various locations, including the elbow and wrist. The nerve is formed by the C8 and T1 spinal nerve roots, which make up the lower trunk and medial cord of the brachial plexus. It travels along the medial aspect of the humerus, passes through Struthers' arcade, the retro-epicondylar groove, and enters the cubital tunnel. The roof of the cubital tunnel is known as the cubital tunnel retinaculum. The ulnar nerve then passes beneath the aponeurosis of the flexor carpi ulnaris muscle and its two heads, where the upper edge of the aponeurosis forms the Osborne ligament, which is likely the most commonly affected area in ulnar nerve entrapment. In the forearm, the ulnar nerve is located beneath the flexor carpi ulnaris muscle and innervates this muscle along with the ulnar half of the flexor digitorum profundus muscle. The nerve then proceeds toward Guyon's canal along with the ulnar artery. Distally, the nerve branches into three divisions: the dorsal sensory branch, the volar superficial sensory branch, and the deep motor branch. The deep motor branch descends into the deep part of the hand beneath the edge of the aponeurosis surrounding the hook of the hamate bone, innervating most of the hypothenar and intrinsic muscles. The dorsal sensory branch leaves the main trunk approximately 5-8 cm proximal to Guyon's canal and innervates the dorsal ulnar portion of the hand .

In patients with Cubital Tunnel Syndrome, pain, numbness, paresthesia in the 4th and 5th fingers, and in advanced stages, muscle weakness leading to atrophy of the hypothenar muscles and claw hand deformity may be observed. The diagnosis is made through electrophysiological studies (EMG/NCS).

Treatment options include both conservative and surgical approaches. Surgical options include cubital tunnel decompression, medial epicondylectomy, and ulnar nerve transposition . Surgical treatment is generally preferred for patients with muscle weakness and atrophy, as well as those who do not respond to conservative treatments. Conservative treatment options include avoiding positions of the elbow that may exacerbate symptoms, splinting, exercise, electrotherapy, and local steroid injections .

Kinesiotaping, developed by chiropractor and acupuncturist Kenzo Kase in the late 1970s, is a commonly used conservative treatment option for musculoskeletal pathologies in physical therapy clinics. The tape is made of cotton, stretches longitudinally up to 40%, is water-resistant, and can stay on the skin for up to 7 days.

Kinesiotaping is believed to support muscles, correct joint movement, enhance blood and lymph circulation, provide proprioceptive input, and reduce pain and muscle spasms . Various physical therapy modalities, steroid injections, and dry needling have been studied for their effects on Cubital Tunnel Syndrome. Kinesiotaping has been shown to be effective in patients with Carpal Tunnel Syndrome. However, there is no study available on the use of kinesiotaping in CuTS patients. This simple, cost-effective treatment modality, commonly used in physical therapy practice for various pathologies, will be investigated for its efficacy in patients with Cubital Tunnel Syndrome.

Enrollment: 36 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged between 18 and 65 years
• Patients with at least 3 points of pain according to the Numeric Rating Scale (NRS)
• Patients diagnosed with Cubital Tunnel Syndrome via Electroneuromyography (ENMG)
• Literate
• Willing to consent to participate in the study

Exclusion criteria

• Having any secondary entrapment neuropathy such as diabetes, inflammatory arthritis, or hypothyroidism
• Pregnancy
• Active cancer presence
• Skin infection, burns, wounds, or scars on the forearm
• History of elbow trauma
• Cervical radiculopathy or brachial plexopathy
• Polyneuropathy
• Having previously undergone Cubital Tunnel decompression surgery
• Having received a corticosteroid injection into the Cubital Tunnel within the last 3 months
• Illiterate
• Not consenting to participate in the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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36 participants in 3 patient groups

Control

Other group

Description:

All patients will be provided with information and an exercise sheet containing pictures on ulnar nerve gliding exercises. To monitor whether patients are performing the exercises correctly, they will be asked to come to the hospital once a week, where they will perform the exercises under the supervision of a physiotherapist. In the exercise program, different positions will be held for 30 seconds, with a 1-minute rest between them, and the exercises will be performed twice a day .

Treatment:

Diagnostic Test: Numeric Rating Scale (NRS)

Diagnostic Test: QUICK-DASH

Diagnostic Test: Grip strength measured with a hand dynamometer

Other: Ulnar nerve mobilization exercise

Diagnostic Test: SF-12 Quality of Life Scale

Diagnostic Test: the ulnar nerve cross-sectional area measured by ultrasound

Diagnostic Test: Neuropathic pain scale (measured using the DN-4 scale)

Kinesio Taping

Active Comparator group

Description:

It will be applied once a week for 3 weeks to the affected elbow by an experienced practitioner. During taping, the space correction technique will be used. In this technique, the kinesiological tape is applied with a hole cut in the center, slightly larger than the area to be treated .

Treatment:

Diagnostic Test: Numeric Rating Scale (NRS)

Diagnostic Test: QUICK-DASH

Diagnostic Test: Grip strength measured with a hand dynamometer

Other: Ulnar nerve mobilization exercise

Diagnostic Test: SF-12 Quality of Life Scale

Diagnostic Test: the ulnar nerve cross-sectional area measured by ultrasound

Other: kinesio taping

Diagnostic Test: Neuropathic pain scale (measured using the DN-4 scale)

Sham Taping

Sham Comparator group

Description:

It will be applied in the same way as kinesiological taping with adhesive tape.

Treatment:

Diagnostic Test: Numeric Rating Scale (NRS)

Diagnostic Test: QUICK-DASH

Diagnostic Test: Grip strength measured with a hand dynamometer

Other: Ulnar nerve mobilization exercise

Diagnostic Test: SF-12 Quality of Life Scale

Diagnostic Test: the ulnar nerve cross-sectional area measured by ultrasound

Other: Sham (No Treatment)

Diagnostic Test: Neuropathic pain scale (measured using the DN-4 scale)