Mobilization With Movement in Carpal Tunnel Syndrome.

NCT ID: NCT04733209

Last Updated: 2021-02-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 45 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-10-28
• Study Completion Date: 2021-01-15

Brief Summary

Peripheral nerve impingement neuropathies are the most common mononeuropathies encountered in clinical practice. Carpal Tunnel Syndrome (CTS) occurs as a result of compression of the median nerve as it passes through the carpal tunnel, a narrow osteofibrous canal. CTS is the most common entrapment neuropathy of the upper extremity, affecting approximately 3% of the general population.

Massage and mobilization techniques are used in the treatment of CTS due to their analgesic effects. The painless mobilization with movement technique (MWM, developed by Brian Mulligan) is a manual therapy method applies to correct the limitation of movement in the joint and to relieve pain and functional disorders. Many studies have shown that MWM technique provides faster and momentary painless joint movement compared to other physical therapy modalities.

The patient group with CTS has a large place in the general population and long treatment processes cause both labour loss and economic loss. In the literature review, there is no study examining the effects of MWM in patients with CTS. Therefore, this study aimed to examine the effectiveness of MWM technique in cases with CTS.

Detailed Description

In this study, 45 CTS patients with age range 18-65 who applied to Kırşehir Ahi Evran University Training and Research Hospital were examined. The individuals included in the study were divided into two groups according to the paired randomization method. These groups were control and intervention groups. Traditional physiotherapy methods were applied to the control group, traditional physiotherapy and MWM techniques were applied to the intervention group. Traditional physiotherapy methods were included; Transcutaneous Electrical Nerve Stimulation (TENS), Ultrasound (US), tendon-nerve gliding exercises, night splint, stretching and strengthening exercises.

For the evaluation of patients; Visual Analogue Scale (VAS), wrist goniometric measurements, grip strength measurement, pinch strength measurement, edema measurement, Electromyography (EMG), Nelson Hand Reaction Test, Upper Limb Disorders Arm Shoulder and Hand Problems Questionnaire (DASH), Boston Carpal The Tunnel Injury Questionnaire and Michigan Hand Result Questionnaire (MHRQ) was used.

Conditions

Pain, Chronic

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Mobilization with movement

Mobilization with movement technique and traditional physiotherapy were applied to the intervention group. For mobilization with movement technique, the patient was asked to actively flex and extend the wrist with the forearm in neutral in a sitting position on a treatment table, and the pain was asked. The painful side was determined according to the patient's statement.

In a patient whose painful side was flexion, the wrist joint was shifted manually (with the help of the web space of both hands of the therapist) to the lateral and medial at the same time while the patient actively flexed the wrist. The treatment was done 3 times a week for 4 weeks.

Group Type: EXPERIMENTAL

TENS, US, exercise

Intervention Type: OTHER

Physiotherapy

Conventional

Traditional physiotherapy techniques were applied to the intervention group. Conventional TENS type was used. Current transition time was set as 50-100 µs. TENS application is performed at a frequency of 100 Hertz for 20 minutes in amplitude that does not cause muscle contraction in the patient and creates a feeling of numbness and tingling. Continuous ultrasound type was applied with full contact technique. Ultrasound treatment was applied over the transverse carpal ligament in the wrist with circular movements towards the proximal and distal at a speed of 1-2.5 cm per second, at a dose of 1 W / cm2, for 6 minutes, with a frequency of 3 MHz. And; tendon-nerve gliding exercises, night splint, stretching and strengthening exercises applied. The treatment was done 3 times a week for 4 weeks.

Group Type: ACTIVE_COMPARATOR

TENS, US, exercise

Intervention Type: OTHER

Physiotherapy

Interventions

TENS, US, exercise

Physiotherapy

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Lasting longer than six weeks in the area associated with the n. medianus; Paresthesia, pain, and vasomotor symptoms.

A positive Phalen, Tinel or carpal compression test on wrist examination. In neurophysiological evaluation mild to moderate severity of the n. medianus lesion

Exclusion Criteria

• • Radial or ulnar nerve sensory-motor findings accompanying the current condition. Under the age of 18 and over the age of 65.

• Having undergone upper extremity surgery or steroid injection for any reason. Having a history of another disease or trauma in the upper extremity.
• Having a history of systemic disease such as diabetes or thyroid disease, which may lead to CTS.

Pregnancy.

• Any contraindications for the patient to exercise,
• The patient has any mental problems.
• In neurophysiological evaluation severe n. medianus lesion severity

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

İSMAİL CEYLAN

OTHER

Sponsor Role: lead

Responsible Party

İSMAİL CEYLAN

Head of hand therapy clinic. PhD.

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

İsmail Ceylan, PhD.

Role: PRINCIPAL_INVESTIGATOR

Kirsehir Ahi Evran Universitesi

Locations

Kırşehir Ahi Evran Üniversitesi

Kırşehir, İç Anadolu, Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Beselga C, Neto F, Alburquerque-Sendin F, Hall T, Oliveira-Campelo N. Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: A randomised controlled trial. Man Ther. 2016 Apr;22:80-5. doi: 10.1016/j.math.2015.10.007. Epub 2015 Oct 31.

Reference Type: RESULT

PMID: 26559319 (View on PubMed)

Cruz-Diaz D, Lomas Vega R, Osuna-Perez MC, Hita-Contreras F, Martinez-Amat A. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial. Disabil Rehabil. 2015;37(7):601-10. doi: 10.3109/09638288.2014.935877. Epub 2014 Jul 3.

Reference Type: RESULT

PMID: 24989067 (View on PubMed)

Ceylan I, Buyukturan O, Aykanat O, Buyukturan B, Sas S, Ceylan MF. The effectiveness of mobilization with movement on patients with mild and moderate carpal tunnel syndrome: A single-blinded, randomized controlled study. J Hand Ther. 2023 Oct-Dec;36(4):773-785. doi: 10.1016/j.jht.2023.02.004. Epub 2023 Aug 11.

Reference Type: DERIVED

PMID: 37573157 (View on PubMed)

Related Links

https://bmulligan.com/

The official international web site

Other Identifiers

1206845174

Identifier Type: -

Identifier Source: org_study_id