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Completed

NCT Number: NCT03243227

Effectiveness of Neurodynamic Techniques for the Treatment of Carpal Tunnel Syndrome

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.

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Key information

Conditions

Carpal Tunnel Syndrome Cumulative Trauma Disorders Median Neuropathy Mononeuropathies Nerve Compression Syndromes Nervous System Diseases Neuromuscular Diseases Peripheral Nervous System Diseases Sprains and Strains Wounds and Injuries

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The University of Jordan

Amman, 11942, Jordan

About this study

  • 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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Neurodynamic techniques

Other

4 sessions of Neurodynamics treatment will be provided by and 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.

Exercise therapy

Other

AROM exercise stretching exercise strengthening exercise 4 sessions

Primary outcomes

  1. Change in Boston Carpal Tunnel Questionnaire score

    Time frame: Baseline, 1 month, 6 months

    BCTS is a patient-based outcome measure used for patients with CTS. It includes two distinct scales, the Symptom Severity Scale (SSS) which has 11 questions and uses a five-point rating scale and the Functional Status Scale (FSS) containing 8 items which have to be rated for degree of difficulty on a five-point scale. Each scale generates a final score (sum of individual scores divided by number of items) which ranges from 1 to 5, with a higher score indicating greater disability.

Secondary outcomes

  1. The Disabilities of the Arm, Shoulder and Hand (DASH) Score

    Time frame: Baseline, 1 month, 6 months

    DASH is a patient-based outcome measure used to assess function in patients with arm or hand pain. it includes two components: the disability/symptom

  2. Pain severity scale

    Time frame: Baseline,1 month , 6 months

    subjective rating of pain severity is specified by patient as a number from 0-10. the higher the number the greater level of pain

  3. Wrist ROM

    Time frame: Baseline, 1 month , 6 months

    Range of movement of the wrist joint is measured using universal goniometer. All wrist joint movements will be measured actively and passively.

  4. Grip strength

    Time frame: Baseline, 1 month, 6 months

    Hand grip strength is measured using a hand held dynamometer device. Reading is taken in pounds.

  5. Surgery

    Time frame: 6 months

    whether or not the patient decided to undergo median nerve decompression surgery

Sponsors and collaborators

Lead sponsor

University of Jordan

Other

Registry information

Important dates

Study start
2017
Primary completion
2019
Study completion
2019
First posted
Aug 8, 2017
Registry last updated
Sep 20, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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