Carpal Tunnel Syndrome, Splints
Conditions
Brief summary
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by compression of the median nerve at the wrist. Conservative interventions such as splinting and manual therapy are frequently used in individuals with mild-to-moderate CTS. Neurodynamic mobilization and carpal bone mobilization aim to improve neural and soft tissue mobility; however, their comparative effects on clinical outcomes and median nerve morphology are not fully understood. This interventional, non-randomized clinical study aims to compare the clinical and ultrasonographic effects of neurodynamic mobilization plus splinting, carpal bone mobilization plus splinting, and splinting alone in patients with mild-to-moderate CTS. Ninety-three participants diagnosed with mild-to-moderate carpal tunnel syndrome based on electrodiagnostic criteria will be included. Participants will be allocated into three parallel groups without randomization. All participants will receive a neutral-position wrist splint as standard conservative care. Two intervention groups will additionally receive either neurodynamic mobilization exercises or carpal bone mobilization techniques administered by a physiotherapist for four weeks. Clinical outcomes and median nerve morphology will be evaluated at baseline and immediately after the intervention period. The primary outcome is the change in the Boston Carpal Tunnel Questionnaire score. Secondary outcomes include pain intensity, neuropathic pain, functional disability, muscle strength, pressure pain threshold, and ultrasonographic measurements of the median nerve.
Interventions
Median nerve neurodynamic mobilization exercises performed 5 sessions per week for 4 weeks.
Manual carpal bone mobilization techniques applied 5 sessions per week for 4 weeks.
OTHERSplint
Neutral-position wrist splint used during night-time for 4 weeks.
Sponsors
Kutahya Health Sciences University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of mild-to-moderate carpal tunnel syndrome confirmed by electrodiagnostic testing * CTS symptoms for at least 3 months * Ability to provide informed consent
Exclusion criteria
* Previous carpal tunnel surgery * Diabetes mellitus or polyneuropathy * Cervical radiculopathy * Pregnancy or breastfeeding * Central nervous system disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Boston Carpal Tunnel Questionnaire (BCTQ) Total Score | Baseline to 4 weeks | Change in Boston Carpal Tunnel Questionnaire (BCTQ) Total Score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) | Baseline to 4 weeks | Pain intensity measured using a 10-cm visual analog scale. |
| Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) | Baseline to 4 weeks | Change in Neuropathic Pain Score Assessed by Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). |
| Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) | Baseline to 4 weeks | Change in Upper Extremity Disability Assessed by Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH). |
| Grip Strength | Baseline to 4 weeks | Change Grip strength measured using a Jamar dynamometer. |
| Pinch Strength | Baseline to 4 weeks | Change in Pinch Strength measured using a Pinchmeter. |
| Pressure Pain Threshold | Baseline to 4 weeks | Change in pressure pain threshold assessed using J -Tech algometer. |
| Median Nerve Cross-Sectional Area | Baseline to 4 weeks | Change in Median Nerve Cross-Sectional Area Assessed by Ultrasonography. |
Countries
Turkey (Türkiye)
Contacts
CONTACTMerve Akdeniz Leblebicier, MD
CONTACTEsengül Alıcı, MD
PRINCIPAL_INVESTIGATORMerve Akdeniz Leblebicier, MD
Kutahya Health Sciences University
Outcome results
None listed