Effect of Manual Lymph Drainage on Carpal Tunnel Syndrome, Ultrasound Evaluation of the Effect of Manual Lymph Drainage
Conditions
Keywords
ultrasonographic evaluation, carpal tunnel syndrome, manual lymph drainage, edema, pain
Brief summary
Carpal tunnel syndrome (CTS) occurs as a result of compression of the median nerve under the transverse ligament along the carpal tunnel. The main cause of median nerve compression and carpal tunnel syndrome is increased volume in the carpal tunnel. The pressure that edema puts on the nerve must be controlled in the early period. Edema that persists beyond the inflammatory process can contribute to the fibrotic stage, delay healing, and even cause complications such as pain and stiffness. Manual lymphatic drainage (MLD) is a specialized technique that involves gentle massage techniques and follows lymphatic pathways from proximal to distal and then from distal to proximal. On the basis of this concept; Increasing circulation by stimulating the lymph system, removing biochemical residues, reducing edema and pain, and regulating sympathetic and parasympathetic system responses. It is known that MLD rapidly regulates lymphatic circulation by creating a change in interstitial fluid pressure, thus preventing even arthrofibrotic tissue that may form after a traumatic situation, reducing edema that predisposes to pain, and increasing mobility. Nerve gliding exercises are another method used in treatment. By providing a sliding movement of the tendons and median nerve in the distal-proximal direction, mobilization of the surrounding soft tissues is achieved and dynamic ischemia is terminated. The aim of this study is to determine the effectiveness of manual lymphatic drainage and nerve mobilization on clinical and ultrasonographic findings in carpal tunnel syndrome.
Interventions
OTHERManual lymphatic drainage
Manual lymphatic drainage will be applied 5 days a week for about 15 minutes every day for 4 weeks.
DEVICEsplint
In splint treatment, a volar-supported splint that keeps the wrist in a neutral position will be preferred and it will be recommended to both groups to be used only at night for 4 weeks.
OTHERNerve gliding
Median nerve gliding exercises as a home exercise program will be performed by the patient 5 days a week for 4 weeks. It will be performed in 6 different consecutive positions of the hand and wrist.
Sponsors
Selcuk University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of mild to moderate carpal tunnel syndrome on electrodiagnostic examination * Being between 20-55 years old * Volunteering to participate in the treatment to be given
Exclusion criteria
* Have a systemic inflammatory disease * Having any disease that may cause polyneuropathy, such as diabetes mellitus * Cognitive impairment * Receiving psychotherapy * Having a pacemaker * illiterate * Having a disease affecting the central nervous system * Having a hearing problem * Any skin disease that would contraindicate manual lymphatic drainage * Arterial or venous circulatory disorders that would contraindicate manual lymphatic drainage * NSAID drug use
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ultrasonographic Evaluation | 20 minutes | Median nerve diameter measurements and depths of the participants will be made by USG with a multifrequency (7-15 MHz) linear probe. With USG, the median CBF and its depth will be measured distally from the level of the scaphoid bone (wrist; carpal tunnel level) and the midpoint of the forearm. |
| Evaluation of symptom severity and functional status | 10 minutes | It will be assessed with the Boston Carpal Tunnel Questionnaire (BCTQ). 1. The symptom severity scale (BCTQSS) has 11 items that evaluate pain, paresthesia, and weakness. 2. The functional status scale (BCTQ-FS) evaluates the ability to perform manual activities with 8 items. Each item evaluates the increasing severity of symptoms or difficulty with a higher score. |
Countries
Turkey (Türkiye)
Outcome results
None listed