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| The impact of lymphatic drainage and nerve mobilization techniques on nerve morphology in mild-to-moderate carpal tunnel syndrome: a randomized controlled trial [with consumer summary] |
| Cihan E, Akdeniz Leblebicier M, Sahbaz Pirincci C, Yaman F, Ture A, Ari B, Yamuc B |
| Clinical Rehabilitation 2024 Dec;38(12):1633-1644 |
| clinical trial |
| 6/10 [Eligibility criteria: No; 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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OBJECTIVE: To investigate whether nerve mobilization related to nerve mobility or the removal of edema using lymphatic drainage affects the cross-sectional area of the nerve, hand function, and symptom severity in carpal tunnel syndrome. DESIGN: The study is a prospective randomized controlled trial. Data were analyzed between groups using ANOVA, Chi-squared test, and Kruskal-Wallis test. SETTING: Treatment lasted 4 weeks. Splint group wore the splint daily. Splint plus manual lymphatic drainage received lymphatic drainage 5 days a week. Splint plus nerve mobilization performed neuromobilization exercises as home exercises 5 days a week. Evaluations were conducted before and after 4 weeks of treatment. PARTICIPANTS: The study included 80 patients with mild-to-moderate carpal tunnel syndrome. INTERVENTIONS: The patients were randomly divided into three groups: splint (n = 27), splint plus manual lymphatic drainage (n = 27), or the splint plus nerve mobilization (n = 26). MAIN OUTCOME MEASURES: The main outcome measures were ultrasound assessments and the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Boston Functional Status Scale). RESULTS: Compared to the other groups, the nerve cross-sectional area decreased at both the carpal tunnel (p = 0.003) and mid-forearm (p = 0.014) levels in the drainage group. Nerve mobilization did not result in a significant change in the nerve cross-sectional area. All groups showed significant improvements in both symptom severity and functional status scores (p < 0.001). CONCLUSION: The reduction of edema through lymphatic drainage contributes to a decrease in the cross-sectional area of the median nerve. Additionally, all three methods appear to positively impact the functional capacity of the hand and alleviate symptoms.
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