Effectiveness of Tendon and Nerve Gliding Exercises in the Treatment of Patients With Mild Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial

Hand ◽  
2021 ◽  
pp. 155894472110068
Author(s):  
Hossein Ali Abdolrazaghi ◽  
Mahmoud Khansari ◽  
Maryam Mirshahi ◽  
Mahin Ahmadi Pishkuhi
Keyword(s):  
Treatment Group ◽  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Treatment Options ◽  
Pinch Strength ◽  
Control Group ◽  
Tunnel Syndrome ◽  
Wrist Splint

Background There is limited evidence regarding the efficacy of different treatment options in patients with carpal tunnel syndrome (CTS). This study aimed at assessing the effectiveness of nerve and tendon gliding exercises in the treatment of patients with mild CTS. Methods The current prospective, randomized trial with pretest-posttest design was conducted on 80 patients with mild CTS randomly assigned to 2 groups. The treatment group was instructed to perform gliding exercises in addition to the wrist splint use. The control group only used the wrist splint. All the patients were instructed to use the splint at night and during the day if required. Patients were evaluated in terms of clinical parameters (ie, grip and pinch strength). The severity of symptoms and functional status was also determined using the Boston Carpal Tunnel Syndrome Questionnaire. The subjects were followed up for 6 weeks. Results There were no significant differences in all parameters between groups. The pretest-posttest analysis showed a statistically significant improvement in subjective and objective parameters in the treatment group. However, in the control group, only a significant improvement was observed in grip strength. Wrist splint use led to a significant change in the severity of symptoms only over the second week. Conclusions Both gliding exercise and wrist splint groups showed some improvement in the severity of symptoms and functional status scores. However, the gliding exercises did not offer additional benefit compared with wrist splint alone.

Evaluation of the Efficacy of Ultrasound Therapy in the Treatment of Patients with Carpal Tunnel Syndrome

2019 ◽  
Vol 11 (1) ◽  
pp. 24-27
Author(s):  
Nadia Siddiquee ◽  
Farzana Akonjee Mishu ◽  
Monzur Ahmed ◽  
Shaila Sharmin Shahnewaz ◽  
Hashina Bilkish Banu ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Ultrasound Therapy ◽  
Symptom Severity Scale ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Wrist Splint

This randomized controlled trial was conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhaka during the period from March 2014 to August 2014 to evaluate the effect of ultrasound therapy (UST) on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly divided in two groups by lottery. Group-A was treated with UST, Exercise, Wrist splint, non steroidal anti inflammatory drugs (NSAIDs) and group-B received Exercise, Wrist splint and NSAIDs. Treatment continued for a period of 6 weeks. Group-A were compared to group B by both Visual Analog Scale (VAS) and Levine Symptom severity scale(LSSS) after 3 weeks and 6weeks of treatment. The result showed mean VAS at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3) In Group-A was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W6) after 6 weeks. Mean LSSSat pretreatment (W0),1st follow up after 3 weeks (W 3), 2nd follow up (W 6) after 6 weeksin group-A was 31.64±1.55, 14.32 ± 2.29 and 14.31 ±1.12 respectively,and in group-B was 31.3±0.74,18.51±0.92and 18.31 ± 0.42 respectively.This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 24-27

scholarly journals Comparison of the efficacy of a neutral wrist splint and a wrist splint incorporating a lumbrical unit for the treatment of patients with carpal tunnel syndrome

2016 ◽  
Vol 40 (5) ◽  
pp. 617-623 ◽  
Author(s):  
Batol Golriz ◽  
Monireh Ahmadi Bani ◽  
Mokhtar Arazpour ◽  
Mahmood Bahramizadeh ◽  
Sarah Curran ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
T Test ◽  
Pinch Strength ◽  
Before And After ◽  
Quasi Experimental ◽  
Tunnel Syndrome ◽  
Wrist Splint

Background: Different types of splints have been used as a conservative intervention to improve symptoms in patients with Carpal tunnel syndrome (CTS). Although a number of studies have been undertaken to compare different splints, information and understanding of the influence of these interventions are lacking. Objectives: The purpose of this study was to compare the effect of a classic thermoplastic wrist splint or a wrist splint with an additional metacarpophalangeal unit on pain, function, grip strength, and pinch strength in patients with mild-to-moderate carpal tunnel syndrome. Study design: Quasi experimental design. Methods: A total of 24 patients received conservative treatment using either the classic wrist splint or the wrist splint with the metacarpophalangeal unit for a period of 6 weeks. Primary outcome measures were pain, function, grip strength, and pinch strength. Data were collected immediately before and after using the two types of splints at baseline (0 weeks) and 6 weeks. Statistical analysis was performed using the paired t-test and an independent t-test. Results: Compared to baseline, both the classic thermoplastic wrist splint and the wrist splint with a metacarpophalangeal unit significantly decreased pain and increased function, pinch strength, and grip strength. Comparisons of the two types of splints for grip strength ( P = 0.675) and pinch strength ( P = 0.650) revealed that there were no significant differences between the two after 6 weeks of wear. However, there were significant differences in pain levels ( P = 0.022) and the Disability of the Arm, Shoulder, and Hand score ( P = 0.027) between the two types of splints from baseline to 6 weeks. Conclusion: The wrist splint with a metacarpophalangeal unit was more effective than the classic thermoplastic wrist splint in pain reduction and improvement of function. Clinical relevance A wrist splint with a metacarpophalangeal unit may be an appropriate conservative treatment in the rehabilitation of patients with mild-to-moderate carpal tunnel syndrome.

scholarly journals Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial

2018 ◽  
Vol 33 (3) ◽  
pp. 408-417 ◽  
Author(s):  
Tomasz Wolny ◽  
Pawel Linek
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Nerve Conduction ◽  
Controlled Trial ◽  
Group Differences ◽  
Control Group ◽  
Randomized Controlled ◽  
Tunnel Syndrome ◽  
Experimental Group

Objective: The aim of this study was to evaluate the efficacy of manual therapy based on neurodynamic techniques in conservative treatment of carpal tunnel syndrome. Design: Randomized controlled trial. Setting: Several medical outpatient clinics in the south of Poland. Participants: The study included 103 patients with mild and moderate carpal tunnel syndrome (mean age = 53.95, SD = 9.5) years, who were randomly assigned to a neurodynamic techniques group (experimental group, n = 58) or a group without treatment (control group, n = 45). Intervention: Neurodynamic techniques were used in the experimental group. Treatment was conducted twice weekly (20 sessions). Control group did not receive treatment. Main measures: Nerve conduction study, pain, symptom severity and functional status of Boston Carpal Tunnel Questionnaire, and strength of cylindrical and pincer grips were assessed at baseline and immediately after treatment (nerve conduction study one month after treatment). Results: Baseline assessment revealed no group differences in any assessed parameters ( P > 0.05). There were significant differences between groups after treatment, including nerve conduction (e.g. sensory conduction velocity: experimental group: 38.3 m/s, SD = 11.1 vs control group: 25.9 m/s, SD = 7.72, P  < 0.01). Significant changes also occurred in pain (experimental group: 1.38, SD = 1.01 vs control group: 5.46, SD = 1.05, P < 0.01), symptom severity (experimental group: 1.08, SD = 0.46 vs control group: 2.87, SD = 0.68, P < 0.01), and functional status (experimental group: 1.96, SD = 0.64 vs control group: 2.87, SD = 1.12, P < 0.01). There were no group differences in strength ( P > 0.05). Conclusion: The use of neurodynamic techniques in conservative treatment for mild to moderate forms of carpal tunnel syndrome has significant therapeutic benefits.

scholarly journals Intralesional steroid and ultrasound therapy in patients with carpal tunnel syndrome

2019 ◽  
Vol 12 (4) ◽  
pp. 177-181
Author(s):  
Md. Israt Hasan ◽  
Syed Mozaffar Ahmed
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Naproxen Sodium ◽  
Ultrasound Therapy ◽  
Severity Scores ◽  
Intralesional Steroid ◽  
Tunnel Syndrome ◽  
Wrist Splint

The study aimed to compare the effects of intralesional steroid injection and ultrasound therapy for the treatment of carpal tunnel syndrome. A total 130 patients divided into 2 groups: a) One group (n=65) received intralesional corticosteroid injection along with wrist splint, exercise, naproxen sodium 500 mg tablet and omeprazole 20 mg capsule twice daily for 2 weeks; b) Another group received (n=65) ultrasound therapy (10 min/day, 3 days/week for 4 weeks) along with  Wrist splint for 4 weeks, exercises for 4 weeks, naproxen sodium 500 mg tablet and omeprazole 20 mg capsule twice daily for 2 weeks. The patients were followed-up 2 weekly for 4 weeks. The visual analogue score, symptom severity scores and functional status scores were significantly improved within each group at week 2 (p<0.05) and week 4 (p<0.05) except for the symptom severity score at (p>0.05). The improvement in symptom severity scores and functional status scores in the intralesional steroid group was more than in the ultrasound therapy group after 4 weeks.

scholarly journals A Prospective, Randomized Trial Comparing Open and Endoscopic Carpal Tunnel Release Within the Same Patient

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 322-326 ◽  
Author(s):  
Brett M. Michelotti ◽  
Kavita T. Vakharia ◽  
Diane Romanowsky ◽  
Randy M. Hauck
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Carpal Tunnel Release ◽  
Demographic Data ◽  
Pinch Strength ◽  
Postoperative Time ◽  
Tunnel Syndrome ◽  
A Prospective Study

Background: Surgical management of carpal tunnel syndrome includes performing an endoscopic (ECTR) or open (OCTR) carpal tunnel release. Several studies have shown less postoperative pain and improvement in grip and pinch strength with the endoscopic technique. The goal of this study was to prospectively examine outcomes, patient satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient. Methods: This was a prospective study in which patients with bilateral carpal tunnel syndrome underwent surgical release with both techniques, with initial operative approach randomized in the more symptomatic hand. Demographic data and functional outcomes were recorded, including the pain score, 2-point discrimination, Semmes-Weinstein monofilament testing, thenar strength testing, grip strength, carpal tunnel syndrome functional status score, carpal tunnel syndrome symptom severity score, and overall satisfaction. Results: Thirty patients completed the study; there were no significant differences in any measure at any of the postoperative time points. Symptom severity and functional status scores were not significantly different between groups at any evaluation. Subjectively, 24 of 30 patients did state they preferred the ECTR, mostly citing less pain as their primary reason, although pain scores were not significantly different. Differences in overall satisfaction were also not significant. Conclusions: Both techniques are well tolerated with no differences in outcomes. With the added cost and equipment associated with ECTR, and no added benefit, the usefulness of ECTR is questionable.

scholarly journals PENGARUH TEKNIK INJEKSI STEROID DENGAN TUNTUNAN ULTRASONOGRAFI TERHADAP LUARAN KLINIS PASIEN CARPAL TUNNEL SYNDROME

2018 ◽  
Vol 36 (1) ◽  
Author(s):  
Mariana Sutopo ◽  
Yudy Goysal ◽  
David Gunawan Umbas ◽  
Susi Aulina ◽  
Louis Kwandou ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Ultrasound Guidance ◽  
Steroid Injection ◽  
Control Group ◽  
Severity Scale ◽  
Symptom Severity Scale ◽  
Tunnel Syndrome

     EFFECT OF STEROID INJECTION TECHNIQUE WITH ULTRASOUND GUIDANCE ON CLINICAL OUTCOMES IN CARPAL TUNNEL SYNDROME PATIENTSABSTRACTIntroduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper extremity and one of the diseases that causes disability, thereby reducing productivity. This study purpose is to determine the effect of steroid injection techniques with and without ultrasound guidance on clinical outcomes in patients with CTS.Method: This study was a clinical trial with a non-randomized pretest-posttest-control group design. This study subjects were 36 patients with CTS, consisting of 18 wrists receiving steroid injection with ultrasound guidance and 18 wrists without ultrasound guidance.Results: The results showed a significant change in the Symptom Severity Scale (SSS) and Functional Status Scale (FSS) (p<0.05) after treatment in the steroid injection group with and without ultrasound guidance. The results of the unpaired t-test on changes in the SSS between the groups who received steroid injection with ultrasound guidance and without ultrasound guidance showed no significant difference (p>0.05). The results of the Mann-Whitney test on changes in FSS scores between groups who received steroid injections with and without ultrasound guidance showed no significant differences (p>0.05).Discussion: Decrease in Boston SSS and FSS after steroid injections in both groups were in accordance with theory that steroid injection can quickly bind directly to nerve cell receptors and inhibit production of proinflammatory mediators. Whereas results of the study comparing effectiveness of steroid injection techniques with ultrasound guidance and without ultrasound guidance were not significant because observations were only made for 1 week.Keywords: Carpal tunnel syndrome, functional status scale, steroid injection, symptom severity scale, USG-guidedABSTRAKPendahuluan: Carpal tunnel syndrome (CTS) adalah neuropati jebakan yang paling sering pada ekstremitas atas dan merupakan salah satu penyakit yang menyebabkan disabilitas, sehingga menurunkan produktivitas. Penelitian ini bertujuan mengetahui pengaruh teknik injeksi steroid dengan dan tanpa tuntunan ultrasonografi terhadap luaran klinis pada pasien carpal tunnel syndrome.Metode: Penelitian ini adalah uji klinis dengan rancangan non-randomized pretest-posttest-control-group. Penelitian ini dilakukan terhadap 36 pasien CTS, terdiri dari 18 pergelangan tangan yang mendapat injeksi steroid dengan tuntunan USG dan 18 pergelangan tangan tanpa tuntunan USG.Hasil: Hasil penelitian menunjukkan adanya perubahan Symptom Severity Scale (SSS) dan Functional Status Scale (FSS) yang bermakna (p<0,05) setelah perlakuan pada kelompok injeksi steroid dengan dan tanpa tuntunan USG. Hasil uji-t tidak berpasangan terhadap perubahan SSS antara kelompok yang mendapat injeksi steroid dengan tuntunan USG dan tanpa tuntunan USG menunjukkan perbedaan tidak bermakna (p>0,05). Hasil uji Mann-Whitney terhadap perubahan skor FSS antara kelompok yang mendapat injeksi steroid dengan tuntunan USG dan tanpa tuntunan USG menunjukkan perbedaan tidak bermakna (p>0,05).Diskusi: Penurunan SSS dan FSS kuesioner Boston setelah dilakukan injeksi steroid pada kedua kelompok ini sesuai dengan teori bahwa injeksi steroid dapat dengan cepat berikatan langsung dengan reseptor sel saraf. Ikatan steroid dengan reseptor di sel saraf dapat menghambat produksi mediator proinflamasi. Sedangkan hasil penelitian yang membandingkan efektivitas teknik injeksi steroid dengan tuntunan USG dan tanpa tuntunan USG tidak bermakna karena pengamatan hanya dilakukan selama 1 minggu.Kata kunci: Carpal tunnel syndrome, functional status scale, injeksi steroid, symptom severity scale, USG-guided

scholarly journals A prospective comparative study of surgical release of carpal tunnel syndrome with and without flexor tenosynovectomy

2022 ◽  
Vol 13 (1) ◽  
pp. 146-151
Author(s):  
Niraj Ranjeet ◽  
Pabin Thapa ◽  
Krishna Sapkota ◽  
Pratyenta Raj Onta ◽  
Upendra Jung Thapa ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Satisfaction Score ◽  
Pinch Strength ◽  
Patient Satisfaction Score ◽  
Tunnel Syndrome ◽  
Surgical Release

Background: Carpal tunnel syndrome (CTS) is a common condition causing hand pain and numbness. The rationale of tenosynovectomy is to remove the flexor tenosynovium that is contributing to increased volume within the carpal canal, thus removal of this tenosynovium should give more space for the median nerve and there by relief from symptoms. Aims and Objectives: The main objective of our study was to assess the role of routine flexor tenosynovectomy in the treatment of CTS. Materials and Methods: Eighty-six hands with CTS were randomized into two groups, either to carpal tunnel release with or without flexor tenosynovectomy. All patients were requested to fill up the self-administered questionnaire for the assessment of symptom severity and functional status, examined for 2-point discrimination, grip and pinch strength, scar tenderness and patient satisfaction score preoperatively, 2 weeks, 1 month, and 6 months follow-up. Results: After the surgical release, both groups improved significantly with respect to symptom severity and functional status, 2-point discrimination, grip and pinch strength, scar tenderness and patient satisfaction score but there was no significant difference between the two groups. There were two cases of post-operative wound infection and one case of mild reflex sympathetic dystrophy. Conclusion: We conclude that routine flexor tenosynovectomy during surgical release of carpal tunnel in patients with CTS does not provide any added benefit nor does it increase any morbidity.

scholarly journals The experience of using anti-adhesion gel in the surgery for carpal tunnel syndrome

2021 ◽  
Vol 23 (3) ◽  
pp. 39-47
Author(s):  
A. S. Nikitin ◽  
I. B. Aleynikova
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Control Group ◽  
Study Group ◽  
Clinical Relapse ◽  
Study Objective ◽  
Boston Carpal Tunnel Questionnaire ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

The study objective is to evaluate the effectiveness of anti‑adhesion gel by using in carpal tunnel syndrome surgery.Materials and methods. A prospective study was carried out among 55 patients with carpal tunnel syndrome. All patients were underwent open decompression of the carpal tunnel. Patients of study group (n = 25) got an carboxymethylcellu‑ lose anti‑adhesion gel, which was applied to the nerve before suturing the wound. Patients from control group (n = 30) were underwent surgery without using an anti‑adhesive gel. Before surgery, all patients underwent a clinical neurological examination with an assessment of symptoms according to the Boston Carpal Tunnel Questionnaire, which includes 2 scales: the scale and the functional status scale. The Boston Carpal Tunnel Questionnaire was reevaluated 2.5 years after surgery.Results. In study group the mean symptom severity decreased by 59.5 %, functional status improved by 55.1 %, in control group these indicators were 48.3 and 47.6 %. Clinical relapse of the disease was noted in 8 % of patients of study group and in 20 % of patients of control group.Conclusion. Intraoperative using of an anti‑adhesion gel allows to reduce the frequency of recurrence of carpal tunnel syndrome after surgical decompression.

Sign in / Sign up

Export Citation Format

Share Document