scholarly journals Effect of Persian manual therapy (Fateh technique) on patients with mild and moderate carpal tunnel syndrome: a clinical trial

2021 ◽  
Vol 7 (4) ◽  

Objective: Various non-surgical treatments are used to treat Carpal tunnel syndrome, including hand therapy. In this study, the effect of Fateh Iranian hand therapy on this disease has been investigated for the first time. Method: In this controlled clinical trial, 58 female patients (78 hands) eligible for carpal tunnel syndrome were divided into two groups of intervention (splint, Fateh hand therapy, and exercise) and the control group (splint only). Each person in the intervention group received about 7 minutes of soft tissue manipulation for 6 sessions and performed two active exercises at home daily. Symptom severity and functional capacity were assessed with the Boston questionnaire, pain intensity, and electrodiagnostic findings at the beginning and tenth week, and patient satisfaction in the tenth week of the experiment. Results: Data of 51 patients, all-female (68 hands), were analyzed. The age distribution was the same in both groups. In the intervention group, we saw a significant improvement in symptom severity and functional capacity compared to the control group (P-value<0.05). In addition, pain changes in the intervention group were significantly more than in the control group (P-value<0.05). The values ​​of electrodiagnostic variables at the beginning and end of the design were not significantly different between the two groups (P-value>0.05). Comparison of changes in these values ​​did not show a significant difference between the two groups (P-value>0.05). Satisfaction in the intervention group was significantly higher (P-value<0.05). Conclusion: Fateh method is effective in reducing the symptoms of mild to moderate carpal tunnel syndrome.

2015 ◽  
Vol 123 (5) ◽  
pp. 1230-1237 ◽  
Author(s):  
Daniele Vanni ◽  
Francesco Saverio Sirabella ◽  
Renato Galzio ◽  
Vincenzo Salini ◽  
Vincenzo Magliani

OBJECT The purpose of this study was to assess the effectiveness and safety of an alternative minimally invasive technique for the treatment of carpal tunnel syndrome (CTS). METHODS This was designed as a prospective, randomized, open-label, blinded end point evaluation (PROBE) study. The active comparison was double tunnels technique (DTT) (Group A, 110 patients) versus standard open decompression of the median nerve (control [Group B], 110 patients). Patient recruitment started in January 2011. The primary outcomes were the functional Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores and visual analog scale (VAS) scores for pain (pVAS) at Weeks 2 and 4, and at Months 3, 6, and 12. The secondary outcome was the aesthetics (aVAS) score at Weeks 2 and 4, and at Months 3, 6, and 12. RESULTS The Student t-test and ANOVA were used, and the results were considered statistically significant if the p value was ≤ 0.05 for continuous variables. The DTT is a tissue-sparing approach that allows the surgeon to limit the length of the incision (0.6 ± 0.05 cm) and to respect the palmar fascia and the subcutaneous tissue. Recovery from wrist pain, night pain, numbness, stiffness, and weakness was achieved more effectively and quickly compared with the standard approach. Better BCTSQ, pVAS, and aVAS scores were observed in Group A. CONCLUSIONS The DTT is a safe and effective approach for the treatment of CTS. This technique entails faster recovery times, better aesthetic outcomes, and lower risks of complications.


2021 ◽  
Vol 6 (4) ◽  
pp. 89-96
Author(s):  
Jehan Zeb ◽  
Muhammad Ullah ◽  
Muhammad Shoaib ◽  
Syed Shah ◽  
Walayat Shah ◽  
...  

Purpose: To determine the outcome of microscopic carpal tunnel release in patients with carpal tunnel syndrome who failed to respond to conservative treatment. Methodology: This descriptive case series was carried at Department of Neurosurgery, D.H.Q Hosptial Charsadda over 1 year from Jan 2019 to Dec 2020, indicate the sampling method used to select the study participants involving 94 patients; both men and women with ages in the range 30-70 years diagnosed of carpal tunnel syndrome who failed to respond to conservative treatment and were planned for surgical release. Microscopic CTS release was performed and outcomes were assessed in terms of improvement in VAS score for wrist pain, symptom severity score and function status scale 3 and 6 months after the surgery. Recurrence of symptoms was also noted. A written informed consent was obtained from every patient. Indicate the method of data collection and data analysis Findings: The mean age of the patients with carpal tunnel syndrome was 41.6±7.9 years. There was slight female predominance with male to female ratio of 1:2.1. History of diabetes was recorded in 29 (31.0%) patients while 34 (37.0%) patients were obese. Right hand was more frequently involved (53.0%) than the left hand (47.0%). The mean VAS score for wrist pain reduced from 7.9±1.2 at baseline to 1.8±0.7 3 months after the surgery (p- value<0.001). Similar improvements were also noted in symptom severity score (3.8±0.8 to 1.6±0.8; p- value<0.001) and function status scale (2.7±0.8 to 1.5±0.8; p-value<0.001) at the end of 3 months after the surgery. Recurrence was not observed in any patient at the end of 6 months follow-up. Recommendation: Microscopic carpal tunnel release was found to relieve patient’s symptoms and improve wrist function yet with minimal scarring and without recurrence which advocates its preferred use in future practice provided necessary surgical skills and hardware are available.


2018 ◽  
Vol 33 (3) ◽  
pp. 408-417 ◽  
Author(s):  
Tomasz Wolny ◽  
Pawel Linek

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.


Author(s):  
Mariana Sutopo ◽  
Yudy Goysal ◽  
David Gunawan Umbas ◽  
Susi Aulina ◽  
Louis Kwandou ◽  
...  

     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


2021 ◽  
Vol 12 ◽  
Author(s):  
Margreet Meems ◽  
Myrthe G. B. M. Boekhorst ◽  
Victor J. M. Pop

Background: For patients with carpal tunnel syndrome (CTS), the only long-term effective treatment option is carpal tunnel release surgery. Up to one-third report recurrent symptoms, and 12% needs repeated surgery. This study aimed to evaluate the long-term effects of mechanical traction as a non-invasive treatment option for CTS compared to care as usual.Methods: Patients with electrodiagnostically confirmed CTS [N = 181; mean age, 58.1 (13.0) years; 67% women] were recruited from an outpatient neurology clinic in the Netherlands. Patients completed baseline questionnaires and randomized to the intervention group (12 treatments with mechanical traction, twice a week for 6 weeks) or care as usual. The primary clinical outcome measure was surgery during the 12-month follow-up. Secondly, we assessed symptom severity with the Boston Carpal Tunnel Questionnaire (BCTQ) at baseline and at the 12-month follow-up. Changes in CTS symptom severity between baseline and the 12-month follow-up were analyzed between groups using t-tests and a multiple linear regression analyses, adjusting for duration of complaints, age, gender, and symptom severity at baseline.Results: At the 12-month follow-up, 35 of 94 (37%) patients in the intervention group had surgery, compared to 38 of 87 (44%) in the care-as-usual group (χ12 = 0.78, p = 0.377). Symptom severity and functional status scores did not significantly differ between the intervention (n = 81) and care-as-usual group (n = 55) at follow-up. For patients who did not have surgery, BCTQ scores decreased significantly more from baseline to the 12-month follow-up in the intervention group (n = 53) compared to patients in the care-as-usual group (n = 25). For patients who did not have surgery, belonging to the intervention group and a higher BCTQ score at baseline were related to a greater decrease in BCTQ scores from baseline to the 12-month follow-up, as well as symptom severity and functional status.Conclusions: Mechanical traction is effective in reducing symptom severity compared to current conservative treatment options in standard care and can therefore benefit the large number of patients that prefer conservative treatment for CTS.Clinical Trial Registration: Clinical Trials NL44692.008.13. Registered 19 September 2013, https://clinicaltrials.gov/ct2/show/NCT01949493


Author(s):  
Atefeh Aminian-Far ◽  
Dariush Pahlavan ◽  
Fatemeh Maleki Kohnegi

BACKGROUND: Carpal tunnel syndrome (CTS) is one of the most common forms of peripheral neuropathies due to median nerve compression. Occupational factors, such as repetitive hand motions are believed to be associated with this condition. OBJECTIVE: This clinical trial assessed the effect of Kinesio taping (KT) of hand flexor muscles on the management of mild to moderate CTS in Iranian manual laborers. METHODS: Thirty manual laborers with mild to moderate CTS participated in this clinical trial. They were assigned to an intervention or a control group. The treatment consisted of a 2-week KT followed by a 4-week follow-up. The control group received sham KT without tension applied. Boston Carpal Tunnel Questionnaire scores, pinch and grip force tests, and electrophysiological examination of the median nerve were performed for each participant at baseline, 24 to 48 hours, and two to four weeks of follow-up. The statistical analysis of variance was performed five times for all participants, comparing differences in the data within and between the two groups. RESULTS: The baseline assessment revealed no inter-group differences in the clinical outcomes (P⩽ 0.05). Comparisons of the changes in the electro-physiological and functional variables indicated significantly greater improvement in the KT group than in the sham counterpart (P< 0.05). No statically significant improvement was evident by the electrodiagnostic criteria in the sham-KT group (P⩽ 0.05). CONCLUSIONS: KT is an effective, safe, reliable, and conservative therapeutic choice for the management of patients with CTS. The treatment does not restrict the daily activities of patients nor has it any side effects.


Pain Medicine ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1668-1675 ◽  
Author(s):  
Chih-Ya Chang ◽  
Liang-Cheng Chen ◽  
Yu-Ching Chou ◽  
Tsung-Ying Li ◽  
Tsung-Yen Ho ◽  
...  

Abstract Objectives To evaluate the combination effect of platelet-rich plasma (PRP) and extracorporeal shock wave therapy (ESWT) for moderate carpal tunnel syndrome (CTS), compared with PRP alone. Design A randomized, double-blinded, placebo-controlled trial. Setting A single medical center in Taiwan. Patients Patients diagnosed with moderate CTS. Interventions All subjects were administered one dose of ultrasound-guided PRP injection at baseline. After two weeks, one session of rESWT was completed in the intervention group, whereas the control group received one session of sham rESWT. Evaluations were performed at baseline and one, three, and six months post–PRP injection. Outcome Measures The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was measured as the primary outcome. Electrophysiological study and cross-sectional area (CSA) of the median nerve were used as secondary outcomes. Results All 40 enrolled subjects (male/female: 4/36) completed the study, resulting in an analysis of 32 wrists per group (total: N = 64 wrists). Compared with the control group, the intervention group did not show statistically significantly superior outcomes, except in BCTQs at one month (mean change ± SE = –11.47 ± 1.18 vs –7.06 ± 1.26, P = 0.013) and distal motor latency at three months (mean change ± SE = –0.59 ± 0.09 vs –0.30 ± 0.09, P = 0.031). Conclusions Combined PRP and one-session rESWT was not superior to PRP alone in treating moderate CTS. Further studies with multiple sessions of ESWT and longer follow-up periods are needed to verify the clinical efficacy of ESWT.


2021 ◽  
Vol 19 (7) ◽  
pp. 149-155
Author(s):  
Shatha Mohammed Abdulmunem ◽  
Hanan L. Al-Omary

Carpal tunnel syndrome is a neurological disease that presented with paresthesias, pain, and numbness in the hand's median nerve compression. Vitamin D was assumed to affect both electrophysiological &clinical gradings, the study aims to assess the correlation between the deficiency of vitamin D and both electrophysiological and clinical gradings. This study was conducted in Ghazi Alhariri Hospital during the period from the first of November/2020 to the twenty-eighth of February/2021, fifty five individuals were referred to as Carpal tunnel syndrome patients, and compared to (55) control individuals, blood samples were withdrawn from the patients (3ml), centrifuged and kept in the freezer (-20°C) until the time of analysis of vitamin D3, Sensory and motor nerve conduction studies of both median and ulnar nerve were done bilaterally. patients were classified electrophysiologically and clinically into two subgroups (mild to moderate) and (severe) groups. The result showed that the differences are not significant in the gender, BMI and vitamin D of the patients versus the control group (p>0.05), the difference of the electrophysiological parameters was not significant between patients with low vitamin D versus those with normal vitamin D (p value>0.05), there was a significant association between the electrophysiological and clinical grading in addition to a significant association between vitamin D level and the clinical grading. Vitamin D deficiency does not affect the electrophysiological parameters while the clinical grading becomes worse with the decrease in its level. The electrophysiological grading is associated with clinical grading.


2020 ◽  
Author(s):  
Meliha GÜNDAĞ PAPAKER ◽  
Anas ABDALLAH ◽  
Mehmet Hakan SEYİTHANOĞLU ◽  
Engin CAN ◽  
Aygül TANTİK PAK ◽  
...  

Abstract Objective: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment neuropathy and is seen in 3 % of the general population. The aim to this study was examine the relationship between the symptoms of cleaning compulsion with using Moudsley obsessive compulsive inventory ( MOCI ) and patients with CTS. Methods: Sixty patients with CTS and 60 healty controls were evaluated in Bezmialem Vakif University Faculty of Medicine Neurosurgery Clinic. Neurological examination, Electrophysiological findings, the presence of neuropathic pain evaluated by the Leeds assessment of neuropathic symptoms and signs (LANSS) , the symptoms of obsessive- compulsive disorder using with MOCI and anxiety levels assessed by the Beck Anxiety Inventory (BAI) were evaluated. Results: No statistically significant relationship was observed between anxiety levels and CTS (p › 0.005). No statistically significant relationship was found MOCI rumination, control and doubting subscale scores (p › 0.005). Patient group had higher MOCI cleaning subscale scores than the control group and the difference was statistically significant (p=0.008). Patient group had higher MOCI slowness subscale scores than the control group and the difference was statistically significant (p=0.004). Conclusion: Increased wrist movement in people that have the symptoms of compulsive cleaning is associated with the risk of CTS. Our study show that a reduction of high level of wrist flexion-extansion movements may decrease the new CTS cases.


2021 ◽  
Vol 12 ◽  
Author(s):  
Daniel Gregor Schulze ◽  
Kristian Bernhard Nilsen ◽  
Rikke Munk Killingmo ◽  
John Anker Zwart ◽  
Margreth Grotle

Background: Self-reported measures are often used in research and clinical practice to diagnose carpal tunnel syndrome (CTS) and guide therapeutic choices. We aimed to assess the clinical utility of the Norwegian versions of two self-reported outcome measures for symptom severity assessment, the 6-item CTS (CTS-6), and Boston-CTS (BCTQ), and of one diagnostic measure, the hand-diagram, by evaluating measurement properties including discriminative ability for severity assessment (CTS-6, BCTQ), and diagnosis of CTS (hand-diagram).Methods: We performed forward and backward translation and cultural adaptation of the Norwegian CTS-6 and BCTQ. Following COSMIN guidelines, we investigated internal consistency, reliability, construct validity, and discriminative ability for distinguishing between severity levels of CTS in patients with confirmed CTS for the CTS-6 and BCTQ and reliability and discriminative ability for diagnosing CTS for the hand-diagram.Results: Two hundred and fifty-one patients referred for diagnostic work-up for CTS with nerve conduction studies (NCS) participated. The CTS-6 and BCTQ had acceptable internal consistency (Crohnbach's α = 0.82 and 0.86, respectively), reliability (ICC = 0.86 and 0.90; SEM = 0.24 and 0.20; SDC95% = 0.68 and 0.55, respectively), construct validity (all eight pre-defined hypotheses confirmed) and discriminative ability to distinguish between severity levels of CTS [Area under the curve (AUC) = 0.75, 95% CI 0.64–0.85]. The hand-diagram had acceptable reliability (Cohen's kappa = 0.69) and discriminative ability to diagnose CTS (sensitivity = 0.72, specificity = 0.90).Conclusion: Our findings support the clinical utility of the CTS-6 and BCTQ for symptom severity assessment and of the hand-diagram for diagnostic screening.


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