Carpal Tunnel Syndrome (CTS)
Conditions
Keywords
Carpal Tunnel Syndrome, Exercise, Hand Grip Strength, Servicothoracic Exercises, Wrist Pain
Brief summary
This randomized, parallel-group controlled clinical trial evaluated the effects of adding cervicothoracic exercises to conventional physiotherapy on symptoms, functional status, pain, grip strength, and wrist range of motion in individuals with carpal tunnel syndrome (CTS). Seventy adults diagnosed with CTS were randomly allocated to two groups: conventional physiotherapy (n=35) or cervicothoracic exercises combined with conventional physiotherapy (n=35). The conventional physiotherapy program included transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, median nerve mobilization, wrist range-of-motion exercises, and strengthening exercises. The intervention group received the same conventional physiotherapy program together with cervicothoracic exercises targeting cervical mobility, cervical muscle control, scapular stabilization, and thoracic mobility. Both groups received treatment five days per week for six weeks. Outcomes were assessed at baseline, at the end of the six-week intervention, and approximately three months after each participant completed the intervention. In this updated record, the Boston Carpal Tunnel Questionnaire (BCTQ) is designated as the primary outcome measure. Its Symptom Severity Scale and Functional Status Scale are scored and reported separately, with higher scores indicating greater symptom severity and functional limitations. The primary assessment time point is the end of the six-week intervention. Secondary outcome measures include pain intensity assessed using the Visual Analog Scale (VAS), upper extremity function assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, grip strength measured using a Jamar hand dynamometer, and wrist range of motion measured using a goniometer. All outcome measures were repeated at the three-month follow-up. The final post-intervention assessment was completed on 31 May 2026, and the final follow-up assessment was completed on 1 September 2026.
Interventions
OTHERCervicothoracal Exercise Group
Participants will receive cervicothoracic exercises in addition to the same conventional physiotherapy program. The cervicothoracic exercise program will include cervical mobility exercises, scapular stabilization, and thoracic spine mobility exercises designed to improve proximal neural mechanics and upper limb function. All interventions will be supervised by a physiotherapist and applied five days per week for six weeks.
Participants will receive a conventional physiotherapy program consisting of transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, median nerve mobilization, wrist range-of-motion exercises, and hand strengthening exercises. TENS will be applied using sensory-level stimulation without muscle contraction. Therapeutic ultrasound will be delivered over the carpal tunnel region using standard clinical parameters. Median nerve mobilization and wrist exercises will be performed under physiotherapist supervision. The treatment will be administered five days per week for six weeks.
Sponsors
Medipol University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
The registered primary assessment time point was the end of the 6-week intervention. All outcome measures were also reassessed approximately 3 months after each participant completed the intervention. The final post-intervention assessment was completed on 31 May 2026, and the final follow-up assessment was completed on 1 September 2026. The 3-month follow-up time point was not included in the initial registry entry and is being documented in this update.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age over 18 * Symptom duration of at least 12 weeks, * Information about carpal tunnel syndrome received from a physician, * Positive Tinel or Phalen test in carpal compression test, * Pain intensity, Visual Analog Scale, at least 40 mm out of 100 mm
Exclusion criteria
* Any sensory or motor deficit in the ulnar or radial nerve * History of previous surgery or injection in the wrist * Trauma to the neck, shoulder, or upper extremity * Pregnancy * Concurrent cervical radiculopathy or polyneuropathy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Boston Carpal Tunnel Syndrome Questionnaire | Assessment will be taken initially and after the intervention (for 6 weeks, 5 days a week). | This questionnaire will be used to measure hand and wrist symptom and function scores in carpal tunnel syndrome. The scale consists of two sub-sections: Symptom Severity and Functional Status. The Symptom Severity Scale evaluates symptoms such as pain, numbness, tingling, and nighttime awakenings, while the Functional Status Scale measures difficulties in daily living activities such as writing, grasping, and carrying objects. Each item is scored between 1 (no complaints) and 5 (very severe complaints); higher scores indicate more symptoms and functional limitations. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disabilities of the Arm Shoulder and Hand (DASH) | Assessment will be taken initially and after the intervention (for 6 weeks, 5 days a week). | The questionnaire will be used to assess the upper extremity function of the participants. The questionnaire consists of a 30-item scale, and each item is scored between 1 (no difficulty) and 5 (very great difficulty). The total score is converted into a score between 0 and 100; higher scores indicate more functional limitations and symptoms. |
| Jamar Hydraulic Hand Dynamometer (Hand Grip Strength) | Assessment will be taken initially and after the intervention (for 6 weeks, 5 days a week). | Hand grip strength will be measured using a Jamar hydraulic hand dynamometer. Procedure: The patient will be seated upright, with shoulders in a natural position and adduction, and elbows at 90° flexion, when the measurement will be taken with the Jamar dynamometer. Three repetitions will be performed for the measurement, and the average will be taken. |
| Visual Analog Scale | Assessment will be taken initially and after the intervention (for 6 weeks, 5 days a week). | The Visual Analog Scale will be used to assess pain. The Visual Analog Scale is a measurement tool that allows individuals to subjectively assess the intensity of their pain, defined by endpoints of "0 = no pain" and "10 = unbearable pain" on a 10 cm long horizontal line. Participants are asked to mark the point on this line that corresponds to the intensity of the pain they feel. A higher score indicates more severe pain. |
| Goniometer (Wrist Range of Motion) | Assessment will be taken initially and after the intervention (for 6 weeks, 5 days a week). | Wrist joint range of motion (ROM) will be measured with a goniometer, assessing flexion, extension, ulnar deviation, and radial deviation. The participant will be seated with the forearm pronated and supported on a table. For flexion and extension, the pivot will be placed on the ulnar styloid process, the fixed arm aligned with the ulna, and the movable arm along the 5th metacarpal. For ulnar and radial deviation, the pivot will be positioned proximal to the third metacarpal, the fixed arm aligned with the forearm, and the movable arm parallel to the third metacarpal. The fixed arm will remain stationary, each movement will be measured three times, and the average value will be used for analysis. |
Countries
Turkey (Türkiye)
Outcome results
None listed