Effect of self-implemented sliding versus tensioning neurodynamic techniques on objective and subjective parameters in adults with carpal tunnel syndrome.

Arm.1 – Group 1 (manual therapy) –carpal tunnel syndrome treatment will use manual therapy based on self-implemented sliding neurodynamic techniques. The therapy will be performed independently by the patient in the form of self-therapy. a. Sliding neurodynamic techniques for median nerve; position supine; neurodynamic sequence: arm adduction 90 degree and external rotation, wrist and finger extension, forearm supination, elbow extension; neurodynamic technique: one-direction proximal slide mobilisation (movement – rhythmically elbow flexion and extension –large amplitude of motion), one-direction distal slide mobilisation (movement – rhythmically wist flexion and extension –large amplitude of motion). Physiotherapist will be providing instructions to enable participants to self-implement the techniques, the level of intensity – moderate, standard protocol consisted of ten series of 60 repetitions neurodynamic techniques separated by inter-series intervals of 1 minute. The duration of one therapy session will be approximately 30 minutes. The session will be performed in the patient’s home. Strategies used to assess or monitor adherence to the intervention – exercise diaries, reminder and telephone check-up by a physiotherapist. The therapy will be administered 5 times a week for 2 weeks (10 therapeutic sessions in total).