Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome

Background. Carpal tunnel syndrome (CTS) is the symptomatic compression neuropathy of the median nerve at the wrist level that may become a reason for upper limb disability, in the women and men population. Objective. This study aimed to compare the efficacy of the neurodynamic technique (NT) and ca...

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Main Authors: Fauzia Javed Sheereen, Bibhuti Sarkar, Pallavi Sahay, Mohammad Abu Shaphe, Ahmad H. Alghadir, Amir Iqbal, Taimul Ali, Fuzail Ahmad
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2022/1975803
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author Fauzia Javed Sheereen
Bibhuti Sarkar
Pallavi Sahay
Mohammad Abu Shaphe
Ahmad H. Alghadir
Amir Iqbal
Taimul Ali
Fuzail Ahmad
author_facet Fauzia Javed Sheereen
Bibhuti Sarkar
Pallavi Sahay
Mohammad Abu Shaphe
Ahmad H. Alghadir
Amir Iqbal
Taimul Ali
Fuzail Ahmad
author_sort Fauzia Javed Sheereen
collection DOAJ
description Background. Carpal tunnel syndrome (CTS) is the symptomatic compression neuropathy of the median nerve at the wrist level that may become a reason for upper limb disability, in the women and men population. Objective. This study aimed to compare the efficacy of the neurodynamic technique (NT) and carpal bone mobilization technique (CBMT) incorporated with tendon gliding exercises (TGE) as an effect-enhancing adjunct while managing the participants with chronic CTS. Methods. The study followed a two-arm parallel-group randomized comparative design. Thirty participants (aged 30–59 years) with chronic CTS were recruited randomly to both the NT and CBMT groups. In addition to the TGE (a common adjunct), NT and CBMT were performed in the NT and CBMT groups, respectively, for three weeks. The primary outcome measures including pain intensity, functional status, grip strength, and motor nerve conduction study were assessed using a visual analogue scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), hand-held dynamometer, and electromyograph, respectively, at baseline, 3 weeks postintervention, and follow-up at one week post end of the intervention. Paired and unpaired t-test were used to calculate the differences in intervention effects within and between the groups with keeping the level of significance α at 0.05. Results. The data analysis revealed a significant (95% CI, p<0.05) difference for all outcomes within each group compared across different time intervals. Similarly, a significant difference was found for all outcomes except pain and grip strength compared between groups at 3 weeks postintervention and follow-up at one week post end of the intervention. Conclusions. The NT revealed more effectiveness than the CBMT when incorporated with TGE to improve nerve conduction velocity and functional status of the hand. However, both NT and CBMT were equally effective in improving pain and grip strength while managing the participants with chronic CTS. In addition, the TGE contributed as a beneficial, effect-enhancing adjunct to the NT and CBMT differently. Significance. The study will guide the physiotherapist in applying either of the combination techniques suitable for achieving treatment objectives while managing the participants with chronic CTS.
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spelling doaj-art-3572916e1c234213aa377d3bb33fb7d32025-08-20T02:24:07ZengWileyPain Research and Management1918-15232022-01-01202210.1155/2022/1975803Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel SyndromeFauzia Javed Sheereen0Bibhuti Sarkar1Pallavi Sahay2Mohammad Abu Shaphe3Ahmad H. Alghadir4Amir Iqbal5Taimul Ali6Fuzail Ahmad7Department of Cardiothoracic and Vascular SurgeryNational Institute for Locomotor Disabilities (Divyangjan)National Institute for Locomotor Disabilities (Divyangjan)Department of Physical TherapyDepartment of Rehabilitation SciencesDepartment of Rehabilitation SciencesPeerless Hospitex Hospital and Research CenterDepartment of Physical TherapyBackground. Carpal tunnel syndrome (CTS) is the symptomatic compression neuropathy of the median nerve at the wrist level that may become a reason for upper limb disability, in the women and men population. Objective. This study aimed to compare the efficacy of the neurodynamic technique (NT) and carpal bone mobilization technique (CBMT) incorporated with tendon gliding exercises (TGE) as an effect-enhancing adjunct while managing the participants with chronic CTS. Methods. The study followed a two-arm parallel-group randomized comparative design. Thirty participants (aged 30–59 years) with chronic CTS were recruited randomly to both the NT and CBMT groups. In addition to the TGE (a common adjunct), NT and CBMT were performed in the NT and CBMT groups, respectively, for three weeks. The primary outcome measures including pain intensity, functional status, grip strength, and motor nerve conduction study were assessed using a visual analogue scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), hand-held dynamometer, and electromyograph, respectively, at baseline, 3 weeks postintervention, and follow-up at one week post end of the intervention. Paired and unpaired t-test were used to calculate the differences in intervention effects within and between the groups with keeping the level of significance α at 0.05. Results. The data analysis revealed a significant (95% CI, p<0.05) difference for all outcomes within each group compared across different time intervals. Similarly, a significant difference was found for all outcomes except pain and grip strength compared between groups at 3 weeks postintervention and follow-up at one week post end of the intervention. Conclusions. The NT revealed more effectiveness than the CBMT when incorporated with TGE to improve nerve conduction velocity and functional status of the hand. However, both NT and CBMT were equally effective in improving pain and grip strength while managing the participants with chronic CTS. In addition, the TGE contributed as a beneficial, effect-enhancing adjunct to the NT and CBMT differently. Significance. The study will guide the physiotherapist in applying either of the combination techniques suitable for achieving treatment objectives while managing the participants with chronic CTS.http://dx.doi.org/10.1155/2022/1975803
spellingShingle Fauzia Javed Sheereen
Bibhuti Sarkar
Pallavi Sahay
Mohammad Abu Shaphe
Ahmad H. Alghadir
Amir Iqbal
Taimul Ali
Fuzail Ahmad
Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome
Pain Research and Management
title Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome
title_full Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome
title_fullStr Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome
title_full_unstemmed Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome
title_short Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome
title_sort comparison of two manual therapy programs including tendon gliding exercises as a common adjunct while managing the participants with chronic carpal tunnel syndrome
url http://dx.doi.org/10.1155/2022/1975803
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