Effects of Neurodynamic and Carpal Bone Mobilization in Mild-to-Moderate Carpal Tunnel Syndrome

Official title

Clinical and Morphological Effects of Neurodynamic Mobilization and Carpal Bone Mobilization Techniques in Patients With Mild-to-Moderate Carpal Tunnel Syndrome

Overview

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

• Other Neurodynamic mobilization
  Median nerve neurodynamic mobilization exercises performed 5 sessions per week for 4 weeks.
• Other Carpal bone mobilization
  Manual carpal bone mobilization techniques applied 5 sessions per week for 4 weeks.
• Other Splint
  Neutral-position wrist splint used during night-time for 4 weeks.

Primary outcome measures

• Boston Carpal Tunnel Questionnaire (BCTQ) Total Score [Time frame: Baseline to 4 weeks]

Secondary outcome measures (7)

• Visual Analog Scale (VAS) [Time frame: Baseline to 4 weeks]
• Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) [Time frame: Baseline to 4 weeks]
• Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) [Time frame: Baseline to 4 weeks]
• Grip Strength [Time frame: Baseline to 4 weeks]
• Pinch Strength [Time frame: Baseline to 4 weeks]
• Pressure Pain Threshold [Time frame: Baseline to 4 weeks]
• Median Nerve Cross-Sectional Area [Time frame: Baseline to 4 weeks]

Eligibility criteria

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

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Turkey (Türkiye) · 1 center

• Kutahya Health Sciences University Yoncalı Physical Therapy and Rehabilitation Hospital — Kütahya

Identifiers

NCT: NCT07359274 · Neurodynamic and Carpal Mobs

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗