Carpal Tunnel Syndrome (CTS)
Conditions
Keywords
Carpal tunnel syndrome, Neural mobilization, Diagnostic ultrasound, Median nerve, Handheld dynamometer, Boston Carpal Tunnel Questionnaire
Brief summary
The study group (G1) consisted of 15 patients treated by neural mobilization techniques targeting the median nerve, in addition to a selected physical therapy program including transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, and strengthening exercises for the wrist and hand muscles. The control group (G2) consisted of 15 patients treated only by the same selected physical therapy program as in G1, without neural mobilization. All outcome variables (median nerve cross-sectional area, flattening ratio, and flexor retinaculum bowing measured by diagnostic ultrasound; hand grip strength measured by handheld dynamometer; and symptom severity and functional status measured by the Boston Carpal Tunnel Questionnaire) were assessed pre-treatment and after 6 weeks of intervention, for comparison within and between groups.
Detailed description
The study group (G1) consisted of 15 patients treated by neural mobilization techniques targeting the median nerve, in addition to a selected physical therapy program including transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, and strengthening exercises for the wrist and hand muscles. The control group (G2) consisted of 15 patients treated only by the same selected physical therapy program as in G1, without neural mobilization. All outcome variables (median nerve cross-sectional area, flattening ratio, and flexor retinaculum bowing measured by diagnostic ultrasound; hand grip strength measured by handheld dynamometer; and symptom severity and functional status measured by the Boston Carpal Tunnel Questionnaire) were assessed pre-treatment and after 6 weeks of intervention, for comparison within and between groups.
Interventions
OTHERNeuromobilization
Neuromobilization (also called Neural Mobilization or Neurodynamic Techniques) is a conservative physiotherapy intervention that aims to restore the normal mechanical movement of the median nerve through the carpal tunnel and surrounding tissues.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
45 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Female patients diagnosed with carpal tunnel syndrome (CTS) confirmed by electrophysiological nerve conduction study Age range: 45-55years Unilateral or bilateral CTS (mild to moderate severity) Symptom duration of at least 3 months (chronic cases) No previous surgical intervention for CTS Willing to participate and sign informed consent
Exclusion criteria
* Severe CTS requiring surgical intervention Previous wrist surgery or fracture history Cervical radiculopathy or thoracic outlet syndrome (double crush syndrome)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in pain intensity measured by the Visual Analogue Scale (VAS) | Baseline and after 6 weeks of treatment | Pain intensity was assessed using the 0-10 cm Visual Analogue Scale (0 = no pain, 10 = worst imaginable pain). Higher scores indicate greater pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in symptom severity measured by the Symptom Severity Scale (SSS) of the Boston Carpal Tunnel Questionnaire (BCTQ) | Baseline and after 6 weeks of treatment | Symptom severity was assessed using the SSS of the BCTQ (11 items, each scored 1-5; higher mean score indicates more severe symptoms). |
| Change in functional status measured by the Functional Status Scale (FSS) of the Boston Carpal Tunnel Questionnaire (BCTQ) | Baseline and after 6 weeks of treatment | Functional status was assessed using the FSS of the BCTQ (8 items, each scored 1-5; higher mean score indicates greater functional impairment). |
| Change in hand grip strength measured by a handheld dynamometer | Baseline and after 6 weeks of treatment | Maximum hand grip strength was measured using a handheld dynamometer (in kg). |
| Change in median nerve cross-sectional area (CSA) measured by diagnostic ultrasound | Baseline and after 6 weeks of treatment | CSA of the median nerve at the carpal tunnel inlet was measured by diagnostic ultrasonography (in mm²). |
| Change in median nerve flattening ratio measured by diagnostic ultrasound | Baseline and after 6 weeks of treatment | The flattening ratio of the median nerve was measured by diagnostic ultrasonography. |
| Change in flexor retinaculum (palmar) bowing measured by diagnostic ultrasound | Baseline and after 6 weeks of treatment | Palmar bowing of the flexor retinaculum was measured by diagnostic ultrasonography (in mm). |
Countries
Egypt
Outcome results
None listed