Carpal tunnel syndrome: mobilization and segmental stabilization

David Fedrigo Moraes,Andréa Licre Pessina Gasparini,Tamiris Cassin Mainardi,Luciane Fernanda Rodrigues Martinho Fernandes,Marco Aurélio Sertório Grecco,Nathalia Helen Neves Almeida

doi:10.1590/1980-5918.029.003.ao15

David Fedrigo Moraes, Andréa Licre Pessina Gasparini + Show 4 more

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https://doi.org/10.1590/1980-5918.029.003.ao15

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Abstract

Abstract Introduction: Carpal tunnel syndrome is a compressive neuropathy, frequently seen in women. Conservative treatment for carpal tunnel syndrome focuses on control of symptoms and the nervous path, due to the possibility of double compression. Objective: To assess whether a protocol with emphasis on motor control techniques, including segmental cervical stabilization and neural mobilization, has better results in mechanical reorganization and reduction of symptoms when compared with classic therapeutic exercise techniques in the conservative treatment of carpal tunnel syndrome. Methods: This pilot study was a randomized, double-blind clinical trial, involving 11 women with an average age of 54 (± 6) years, allocated to either a classical kinesiotherapy group (CG) or experimental group (EG). The intervention spanned 12 weeks, with assessments prior to and following therapy, using the monofilament test, handgrip dynamometer, and BCTQ, DASH, and PRWE questionnaires. All normally distributed data was analysed with Student's T-tests. Results: Both groups exhibited an increase in grip strength and relief of symptoms with improved functionality. There was a significant reduction in sensitivity noted in the CG group, and a significant increase in grip strength observed in the EG group. Conclusion: The experimental protocol group exhibited better results in mechanical reorganization, reflected in increased strength, sensitivity, and improved functionality, when compared to the group with conventional therapeutic exercise, but without the same symptomatic reduction.

Highlights

Carpal tunnel syndrome is a compressive neuropathy, frequently seen in women
Conservative treatment for Carpal tunnel syndrome (CTS) emphasises control of symptoms with use of orthotics to preserve the carpal tunnel volume [4] and nervous path, a product of the hypothesis established by Upton and McComas [5], which suggests that axons that are suffering in a region are more likely to suffer in another region
This pilot study was a randomized, double-blind clinical trial conducted between January and June 2015, including 15 women diagnosed with carpal tunnel syndrome who were submitted to conservative treatment

Summary

Introduction

Carpal tunnel syndrome is a compressive neuropathy, frequently seen in women. Conservative treatment for carpal tunnel syndrome focuses on control of symptoms and the nervous path, due to the possibility of double compression. Objective: To assess whether a protocol with emphasis on motor control techniques, including segmental cervical stabilization and neural mobilization, has better results in mechanical reorganization and reduction of symptoms when compared with classic therapeutic exercise techniques in the conservative treatment of carpal tunnel syndrome. Conclusion: The experimental protocol group exhibited better results in mechanical reorganization, re lected in increased strength, sensitivity, and improved functionality, when compared to the group with conventional therapeutic exercise, but without the same symptomatic reduction. Incidence of CTS has quadrupled over the past decade, occurring in approximately 3.4 new cases per thousand inhabitants, per year [2] Individuals suffering from this disorder have both nocturnal and daytime symptoms, manifesting as pain and numbness in the territory of the median nerve; including burning pain, numbness and sharp sensations related to oedema. As a product of this, a need exists to establish a physical therapy protocol aimed at conventional CTS, and the nerve root

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