Effect of Myofascial Release Versus Acupressure on Carpal Tunnel Syndrome in Postnatal Period

Обзор

This study will be conducted to compare the effect of myofascial release and acupressure on postnatal carpal tunnel syndrome.

Подробное описание

Various factors, such as an increase in body mass index (BMI), hormones (relaxin), fluid redistribution, and maternal age, are involved in the etiology of pregnancy related carpal tunnel syndrome (CTS). In terms of prognosis, although it has been reported that pregnancy related CTS generally regresses completely spontaneously or with conservative treatment methods after birth, residual symptoms and neurophysiological findings that require surgical decompression up to a year after birth have also been reported.

In clinical practice guidelines, conservative treatment is recommended for mild and moderate cases, while a surgical approach is recommended for patients with severe CTS . Some clinical conditions such as hormonal alteration and edema for menopause and pregnancy due to alteration of the fluid balance in the body.

Myofascial release is considered a safe, non-invasive, and simple method for decreasing pain intensity and numbness sensation severity and for improving hand function in pregnant women with CTS.

Acupressure is the supportive therapies based on Chinese medicine. Pressure is applied to the affected areas without the use of needles. PC7 or the Daling point is especially considered when managing CTS; it was found to cause an increase of endomorpin-1, beta-endorphin, serotonin, dopamine, and enkephalin levels in the brain tissues and plasma. Acupressure was found to be more effective compared to the placebo and splints re- garding the functional status and nerve conduction studies.

Вмешательства

• Другое Night splint
  All participants will be treated conservatively by wrist splint in a neutral position.
• Другое Myofascial release technique
  The participant will receive myofascial release using M2T blade. It will be applied on the carpal tunnel over and above the wrist creases on the ventral aspect of the forearm for 15 minutes, 3 sessions weekly for 6 weeks (total of 18 sessions).
• Другое Acupressure
  It will be applied on the pericardium 6 point (PC-6) for 3 minutes, three times per week for 6 weeks (total of 18 sessions). It is located on the palm side of the wrist a couple of inches toward the body in between the two tendons (palmaris longus \& flexor carpi radialis) that run approximately down the center of the forearm.
• Другое Home advice
  The participants will be asked to follow important advices like supporting the wrists during activity and ensuring proper posture, avoiding wrist flexion and extension, avoiding hard clutches, holding or carrying objects for a long time, catching with fingers, repetitive hand and wrist movement such as knitting or sewing, driving, activities and hobbies such as golf, tennis, table tennis.

Первичные конечные точки

• Pain intensity [Срок оценки: 6 weeks]
• Sensory conduction velocity [Срок оценки: 6 weeks]
• Sensory distal latency [Срок оценки: 6 weeks]
• Median nerve amplitude [Срок оценки: 6 weeks]

Вторичные конечные точки (1)

• Assessment of severity of carpal tunnel syndrome symptoms [Срок оценки: 6 weeks]

Критерии участия

Критерии включения

• Postpartum women with mild to moderate carpal tunnel syndrome (CTS).
• Their ages will range from 25 to 35 years old.
• Their body mass index (BMI) will range from 25 to 30 Kg/m2.
• The electrophysiological evidence of mild or moderate median nerve lesion at wrist (mild: sensory nerve conduction velocity slow on finger/wrist measurement, sensory nerve latency >3.5 ms, normal terminal motor latency; moderate: sensory potential preserved with motor slowing, distal motor latency to abductor pollicis brevis (APB) < 6.5 ms)
• Positive phalen's test.
• Positive tinel's test.
• Unilateral or bilateral carpal tunnel affection will be included.

Критерии исключения

• History of brachial plexopathy or malignancy.
• Radial, ulnar neuropathy, proximal median neuropathy or polyneuropathy.
• Previous wrist surgery or steroid injection for CTS.
• History of trauma, fracture, deformity or inflammation in the wrist, such as rheumatoid arthritis.
• Coagulation abnormalities, pregnancy, fever and infections.
• Skin disease and skin cancer.
• Spots, birthmarks or tattoos over the work points.
• Pacemaker and implementable medical devices.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Египет · 1 центр

• Amr Kamal Abd El-Aal — Cairo

Идентификаторы

NCT: NCT07086846 · 012/005373

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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