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Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial [with consumer summary]
Wolny T, Linek P
Clinical Rehabilitation 2019 Mar;33(3):408-417
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The aim of this study was to evaluate the efficacy of manual therapy based on neurodynamic techniques in conservative treatment of carpal tunnel syndrome. DESIGN: Randomized controlled trial. SETTING: Several medical outpatient clinics in the south of Poland. PARTICIPANTS: The study included 103 patients with mild and moderate carpal tunnel syndrome (mean age 53.95, SD 9.5) years, who were randomly assigned to a neurodynamic techniques group (experimental group n = 58) or a group without treatment (control group n = 45). INTERVENTION: Neurodynamic techniques were used in the experimental group. Treatment was conducted twice weekly (20 sessions). Control group did not receive treatment. MAIN MEASURES: Nerve conduction study, pain, symptom severity and functional status of Boston Carpal Tunnel Questionnaire, and strength of cylindrical and pincer grips were assessed at baseline and immediately after treatment (nerve conduction study one month after treatment). RESULTS: Baseline assessment revealed no group differences in any assessed parameters (p > 0.05). There were significant differences between groups after treatment, including nerve conduction (eg, sensory conduction velocity experimental group 38.3 m/s, SD 11.1 versus control group 25.9 m/s, SD 7.72, p < 0.01). Significant changes also occurred in pain (experimental group 1.38, SD 1.01 versus control group 5.46, SD 1.05, p < 0.01), symptom severity (experimental group 1.08, SD 0.46 versus control group 2.87, SD 0.68, p < 0.01), and functional status (experimental group 1.96, SD 0.64 versus control group 2.87, SD 1.12, p < 0.01). There were no group differences in strength (p > 0.05). CONCLUSION: The use of neurodynamic techniques in conservative treatment for mild to moderate forms of carpal tunnel syndrome has significant therapeutic benefits.

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