Efficacy of neurodynamic techniques in conservative treatment of carpal tunnel syndrome (CTS).

Arm. 1 - Group 1 (neurodynamic techniques treatment) - gliding and tension neurodynamic techniques of median nerve, one-direction proximal and distal glide mobilisation and one-direction proximal and distal tension mobilisation. a. neurodynamic techniques for medial nerve – position supine, neurodynamic sequence: arm adduction 90 degrees and external rotation, wrist and finger extension, forearm supination, elbow extension; one-direction proximal glide mobilisation (movement – elbow extension –large amplitude of motion), one-direction distal glide mobilisation (movement – wrist extension –large amplitude of motion), one-direction proximal tension mobilisation (movement – elbow extension –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – wrist extension – small amplitude of motion et the end of the movement). Standard protocol consisted of three series of 60 repetitions of glide and tension neurodynamic techniques separated by inter-series intervals of 15 s, twice a week for 10 sessions. The therapy will be performed by physiotherapists with more than 10 years of experience in neurodynamic techniques. The study will be performed in 2 medical clinics in the Silesia province of Poland. Approximate duration of each session – 15 minutes. Arm. 2 - Group 2 (placebo treatment) – sham gliding and tension neurodynamic techniques of median nerve, one-direction proximal and distal glide mobilisation and one-direction proximal and distal tension mobilisation. a. neurodynamic techniques for medial nerve – position supine, without neurodynamic sequence – upper extremity in neutral position; one-direction proximal glide mobilisation (movement – elbow extension –large amplitude of motion), one-direction distal glide mobilisation (movement – wrist extension –large amplitude of motion), one-direction proximal tension mobilisation (movement – elbow extension –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – wrist extension – small amplitude of motion et the end of the movement). Standard protocol consisted of three series of 60 repetitions of glide and tension neurodynamic techniques separated by inter-series intervals of 15 s, twice a week for 10 sessions. The therapy will be performed by physiotherapists with more than 10 years of experience in neurodynamic techniques. The study will be performed in 2 medical clinics in the Silesia province of Poland. Approximate duration of each session – 15 minutes.