NEURODYNAMIC TECHNIQUES VERSUS “SHAM” THERAPY IN THE TREATMENT OF CARPAL TUNNEL SYNDROME; A RANDOMIZED PLACEBO-CONTROLLED TRIAL

Review written by Todd Hargrove info

BACKGROUND & OBJECTIVE

Carpal tunnel syndrome (CTS) is the most frequently diagnosed peripheral neuropathy. It is thought to involve compression of the median nerve by the carpal tunnel, leading to nerve slide impairment. Many studies have assessed the effectiveness of neurodynamic techniques in treating CTS, but the results are not definitive. This study compared neurodynamic techniques to “sham” therapy in the treatment of mild and moderate CTS.

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The treatment group improved significantly more than the placebo group in all measures except grip strength.

METHODS

150 patients diagnosed with CTS were divided into two groups. One group received therapy with neurodynamic techniques, which consisted of various joint mobilizations, applied by a physiotherapist, and designed to slide or tension the median nerve. The second group received “sham” therapy, which involved a similar set of passive joint mobilizations done in a manner that would not slide or tension the median nerve. Twenty minutes of therapy was done twice weekly for 10 weeks.

The researchers assessed the following before and immediately following treatment: pain; two-point discrimination; strength; and symptom severity and functional impairment according to the Boston Carpal Tunnel Questionnaire.

RESULTS

A baseline assessment revealed no differences between the two groups in any measure. After therapy, the treatment group improved significantly more than the placebo group in all measures except grip strength. Only the treatment group experienced any significant improvement in

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