Comparative Effects of Sensory Re-education and Neural Mobilization in CTS Patients
NCT ID: NCT06686212
Last Updated: 2024-11-13
Study Results
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Basic Information
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NOT_YET_RECRUITING
NA
48 participants
INTERVENTIONAL
2024-11-10
2025-07-30
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Group A: Sensory re-education program, strengthening exercises and kinesio taping
The patient will be given a session of 60 minutes 3 days in a week which includes : Splinting (15 minutes), Topical anesthesia spray (10 minutes ) and wrist massage (10 minutes).
* PNF using upper extremity (D2) pattern (5 minutes).
* Strengthening exercises (20 minutes) and Kinesio taping for 12 weeks.
Sensory re-education+ strengthening exercises+ kinesio taping
Sensory re-education. Splinting: as constant maintained touch with wrist holding in neutral position for 15 minutes.
Topical anesthesia spray on affected area for 10 minutes. Massage: apply massage over sensitive areas with same speed and pressure, then the light pressure with cotton, velvet, terry cloth, polyester and wool over sensitive area for 10 minutes.
PNF using upper extremity (D2) pattern including shoulder extension, adduction, internal rotation, wrist and fingers flexed and wrist ulnar deviated. 10-15 repetitions for 5 minutes.
Strengthening exercises: wrist flexion and extension, supination and pronation, opposition, gripping, ball squeeze and fingers pinching against resistance. 10-15 repetitions of each exercise for 20 minutes.
Kinesio taping: Taping will be applied twice a week for 12 weeks.
Group B:Neural mobilization of median nerve, strengthening exercises and kinesio taping.
The patient will be given a session of 60 minutes 3 days in a week which includes: ,Median nerve mobilization through various steps of gliding. (30 minutes).
* Free the bird exercise. (10 minutes).
* Strengthening exercises (20 minutes) and kinesio taping for 12 weeks.
Neural mobilization+ Strengthening exercises+ Kinesio taping.
The median nerve is mobilized through wrist flexion and extension with elbow straight and palm facing up.
Wrist flexion and extension with elbow flexed to 90 degrees with palm facing up 10-15 repetitions.
Wrist flexors stretch with extended arm and palm facing down 10-15 repetitions. Straight fist: hold your hand up with fingers straight. Full fist: bend your fingers to form a full fist. Median nerve stretch and wrist extension exercises for 30 minutes. Free the bird exercises, busy bee flexion shape of Z exercises and wall stretch exercise. (10-15 repetitions) for 10 minutes.
Strengthening exercises: wrist flexion and extension, supination and pronation, opposition, gripping, ball squeeze and fingers pinching against resistance. 10-15 repetitions each for 20 minutes.
Kinesio taping: The taping will be applied twice a week for 12 weeks.
Interventions
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Sensory re-education+ strengthening exercises+ kinesio taping
Sensory re-education. Splinting: as constant maintained touch with wrist holding in neutral position for 15 minutes.
Topical anesthesia spray on affected area for 10 minutes. Massage: apply massage over sensitive areas with same speed and pressure, then the light pressure with cotton, velvet, terry cloth, polyester and wool over sensitive area for 10 minutes.
PNF using upper extremity (D2) pattern including shoulder extension, adduction, internal rotation, wrist and fingers flexed and wrist ulnar deviated. 10-15 repetitions for 5 minutes.
Strengthening exercises: wrist flexion and extension, supination and pronation, opposition, gripping, ball squeeze and fingers pinching against resistance. 10-15 repetitions of each exercise for 20 minutes.
Kinesio taping: Taping will be applied twice a week for 12 weeks.
Neural mobilization+ Strengthening exercises+ Kinesio taping.
The median nerve is mobilized through wrist flexion and extension with elbow straight and palm facing up.
Wrist flexion and extension with elbow flexed to 90 degrees with palm facing up 10-15 repetitions.
Wrist flexors stretch with extended arm and palm facing down 10-15 repetitions. Straight fist: hold your hand up with fingers straight. Full fist: bend your fingers to form a full fist. Median nerve stretch and wrist extension exercises for 30 minutes. Free the bird exercises, busy bee flexion shape of Z exercises and wall stretch exercise. (10-15 repetitions) for 10 minutes.
Strengthening exercises: wrist flexion and extension, supination and pronation, opposition, gripping, ball squeeze and fingers pinching against resistance. 10-15 repetitions each for 20 minutes.
Kinesio taping: The taping will be applied twice a week for 12 weeks.
Eligibility Criteria
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Inclusion Criteria
* Patients having positive score on CTS specific test (Phalen's test and Tinel's test).
* Patients with pain, paresthesia and hyperesthesia at the course of median nerve.
* Patients that are clinically diagnosed with carpal tunnel syndrome by physician. Patients having BMI \>25 (kg/m2).
Exclusion Criteria
* Patients with carpal tunnel syndrome due to any systemic illness (diabetes mellitus, thyroid diseases and R.A).
Patients having cervical radiculopathy.
Patients with history of wrist fracture.
Patients getting steroid injections and after CTS surgery.
Obese and pregnant female with carpal tunnel syndrome.
Patients with any cognitive or neurological problems are excluded from study.
20 Years
50 Years
ALL
No
Sponsors
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Riphah International University
OTHER
Responsible Party
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Principal Investigators
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Muhammad Kashif, Phd
Role: STUDY_CHAIR
Riphah International University Lahore Punjab, Pakistan
Central Contacts
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References
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Sheereen FJ, Sarkar B, Sahay P, Shaphe MA, Alghadir AH, Iqbal A, Ali T, Ahmad F. Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome. Pain Res Manag. 2022 Jun 8;2022:1975803. doi: 10.1155/2022/1975803. eCollection 2022.
Jimenez-Del-Barrio S, Cadellans-Arroniz A, Ceballos-Laita L, Estebanez-de-Miguel E, Lopez-de-Celis C, Bueno-Gracia E, Perez-Bellmunt A. The effectiveness of manual therapy on pain, physical function, and nerve conduction studies in carpal tunnel syndrome patients: a systematic review and meta-analysis. Int Orthop. 2022 Feb;46(2):301-312. doi: 10.1007/s00264-021-05272-2. Epub 2021 Dec 3.
Hassan A, Beumer A, Kuijer PPFM, van der Molen HF. Work-relatedness of carpal tunnel syndrome: Systematic review including meta-analysis and GRADE. Health Sci Rep. 2022 Nov 2;5(6):e888. doi: 10.1002/hsr2.888. eCollection 2022 Nov.
Abdolrazaghi HA, Khansari M, Mirshahi M, Ahmadi Pishkuhi M. Effectiveness of Tendon and Nerve Gliding Exercises in the Treatment of Patients With Mild Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial. Hand (N Y). 2023 Mar;18(2):222-229. doi: 10.1177/15589447211006857. Epub 2021 Apr 15.
Lam NW, Goh HT, Kamaruzzaman SB, Chin AV, Poi PJ, Tan MP. Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population. Singapore Med J. 2016 Oct;57(10):578-584. doi: 10.11622/smedj.2015164. Epub 2015 Nov 13.
Almasi-Doghaee M, Boostani R, Saeedi M, Ebrahimzadeh S, Moghadam-Ahmadi A, Saeedi-Borujeni MJ. Carpal compression, Phalen's and Tinel's test: Which one is more suitable for carpal tunnel syndrome? Iran J Neurol. 2016 Jul 6;15(3):173-4. No abstract available.
Du J, Yuan Q, Wang XY, Qian JH, An J, Dai Q, Yan XY, Xu B, Luo J, Wang HZ. Manual Therapy and Related Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis. J Integr Complement Med. 2022 Dec;28(12):919-926. doi: 10.1089/jicm.2022.0542. Epub 2022 Jul 27.
Ijaz MJ, Karimi H, Ahmad A, Gillani SA, Anwar N, Chaudhary MA. Comparative Efficacy of Routine Physical Therapy with and without Neuromobilization in the Treatment of Patients with Mild to Moderate Carpal Tunnel Syndrome. Biomed Res Int. 2022 Jun 22;2022:2155765. doi: 10.1155/2022/2155765. eCollection 2022.
Other Identifiers
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REC/RCR&AHS/24/0233
Identifier Type: -
Identifier Source: org_study_id
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