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| The effectiveness of mobilization with movement on patients with mild and moderate carpal tunnel syndrome: a single-blinded, randomized controlled study [with consumer summary] |
| Ceylan I, Buyukturan O, Aykanat O, Buyukturan B, Sas S, Ceylan MF |
| Journal of Hand Therapy 2023 Oct-Dec;36(4):773-785 |
| clinical trial |
| 6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; 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* |
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STUDY DESIGN: Single-blinded, randomized controlled study. INTRODUCTION: Carpal tunnel syndrome (CTS) causes pain and loss of function in the affected hand. The mobilization with movement (MWM) technique is a manual therapy method applied to correct joint movement limitation and to relieve pain and functional disorders. PURPOSE OF THE STUDY: This study aimed to examine the effectiveness of MWM technique on pain, grip strength, range of motion, edema, hand reaction, nerve conduction, and functional status in patients with CTS. METHODS: A total of 45 patients enrolled in the study. The MWM group (n = 18) completed a 4-week combined conservative physiotherapy and MWM program, whereas the control group (n = 18) received only the 4 weeks of conservative physiotherapy. Pain severity according to the numerical rating scale was used as primary outcome. RESULTS: We found an improvement within the subjects in resting pain (MWMG 5.1 +/- 3.6 versus 1.1 +/- 2.4, Effect Size (ES) 1.3; CG 4.5 +/- 3.3 versus 1.0 +/- 2.2, ES 1.1), in activity pain (MWMG 6.5 +/- 3.7 versus 1.1 +/- 2.4, ES 1.5; CG 4.8 +/- 3.4 versus 2.2 +/- 2.3, ES 1) and in night pain (MWMG 5.9 +/- 3.2 versus 1.8 +/- 2.5, ES 1.2; CG 5.3 +/- 4.2 versus +/- 2.3 +/- 3.5, ES 0.9). For between the groups, a statistical difference was found for the activity pain, Disabilities of the Arm Shoulder and Hand Questionnaire score (MWMG 52.2 +/- 23.8 versus 27 +/- 24.7, ES 1.3; CG 47.0 +/- 24.8 versus 41.5 +/- 22.1, ES 0.2), Michigan Hand Outcomes Questionnaire (MHQ-1), (MWMG 44.4 +/- 23.7 versus 74.7 +/- 24.5, ES 1.3; CG 44.8 +/- 17.4 versus 57.4 +/- 21.7, ES 0.9) and MHQ-5 (MWMG 68.8 +/- 13.1 versus 82.5 +/- 11.5, ES 0.9; CG 63.4 +/- 26.7 versus 59.3 +/- 25.8, ES 0.1) parameters in favour of MWM group. DISCUSSION: This study showed that MWM compared to conservative physiotherapy might be more effective in reducing perceived symptoms in mild and moderate CTS patients. CONCLUSIONS: MWM produced a small benefit to recovery of activity pain and upper extremity functionality level outcomes of patients with mild to moderate CTS when added to a traditional CTS physical therapy program.
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