EXERCISE AND MOBILISATION INTERVENTIONS FOR CARPAL TUNNEL SYNDROME PDF

Cochrane Database Syst Rev. Exercise and mobilisation interventions for carpal tunnel syndrome. However, the effectiveness and duration of benefit from exercises and mobilisation for this condition remain unknown. We collected data on adverse events from included studies. Two compared a mobilisation regimen to a no treatment control, three compared one mobilisation intervention for example carpal bone mobilisation to another for example soft tissue mobilisation , nine compared nerve mobilisation delivered as part of a multi-component intervention to another non-surgical intervention for example splint or therapeutic ultrasound , and three compared a mobilisation intervention other than nerve mobilisation for example yoga or chiropractic treatment to another non-surgical intervention. The risk of bias of the included studies was low in some studies and unclear or high in other studies, with only three explicitly reporting that the allocation sequence was concealed, and four reporting blinding of participants.

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Abstract Background Non-surgical treatment, including exercises and mobilisation, has been offered to people experiencing mild to moderate symptoms arising from carpal tunnel syndrome CTS. However, the effectiveness and duration of benefit from exercises and mobilisation for this condition remain unknown.

Objectives To review the efficacy and safety of exercise and mobilisation interventions compared with no treatment, a placebo or another non-surgical intervention in people with CTS. Selection criteria Randomised or quasi-randomised controlled trials comparing exercise or mobilisation interventions with no treatment, placebo or another non-surgical intervention in people with CTS.

Data collection and analysis Two review authors independently assessed searches and selected trials for inclusion, extracted data and assessed risk of bias of the included studies. We collected data on adverse events from included studies. Main results Sixteen studies randomising participants with CTS were included in the review. Two compared a mobilisation regimen to a no treatment control, three compared one mobilisation intervention for example carpal bone mobilisation to another for example soft tissue mobilisation , nine compared nerve mobilisation delivered as part of a multi-component intervention to another non-surgical intervention for example splint or therapeutic ultrasound , and three compared a mobilisation intervention other than nerve mobilisation for example yoga or chiropractic treatment to another non-surgical intervention.

The risk of bias of the included studies was low in some studies and unclear or high in other studies, with only three explicitly reporting that the allocation sequence was concealed, and four reporting blinding of participants.

The studies were heterogeneous in terms of the interventions delivered, outcomes measured and timing of outcome assessment, therefore, we were unable to pool results across studies.

Only four studies reported the primary outcome of interest, short-term overall improvement any measure in which patients indicate the intensity of their complaints compared to baseline, for example, global rating of improvement, satisfaction with treatment, within three months post-treatment. However, of these, only three fully reported outcome data sufficient for inclusion in the review. One very low quality trial with 14 participants found that all participants receiving either neurodynamic mobilisation or carpal bone mobilisation and none in the no treatment group reported overall improvement RR Another very low-quality trial with 26 participants found that more CTS-affected wrists receiving nerve gliding exercises plus splint plus activity modification had no pathologic finding on median and ulnar nerve distal sensory latency assessment at the end of treatment than wrists receiving splint plus activity modification alone RR 1.

However, a unit of analysis error occurred in this trial, as the correlation between wrists in participants with bilateral CTS was not accounted for. Only two studies measured adverse effects, so more data are required before any firm conclusions on the safety of exercise and mobilisation interventions can be made.

People with CTS who indicate a preference for exercise or mobilisation interventions should be informed of the limited evidence of effectiveness and safety of this intervention by their treatment provider. Plain language summary Exercise and mobilisation interventions for carpal tunnel syndrome Carpal tunnel syndrome is a common condition where one of two main nerves in the wrist is compressed, resulting in pain to the hand, wrist and sometimes arm, numbness and tingling in the thumb, index and long finger.

In advanced cases the muscles of the hand can become weak. The condition affects approximately three per cent of the population, more commonly women. While carpal tunnel syndrome can be treated with surgery, people with mild to moderate symptoms are sometimes offered non-surgical interventions such as exercises or mobilisation. Based on the 16 studies identified, there is limited and very low quality evidence of benefit for all of a diverse collection of exercise and mobilisation interventions for improving symptoms, functional ability for example hand grip strength , quality of life, and neurophysiologic parameters, and for minimising adverse effects and the need for surgery in people with carpal tunnel syndrome.

More research is needed to investigate the effectiveness of exercises and mobilisation for people with carpal tunnel syndrome, especially the sustainability and long-term effects of this treatment. Related posts:.

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Exercise and mobilisation interventions for carpal tunnel syndrome.

Coronavirus COVID resources Exercise and mobilisation interventions for carpal tunnel syndrome Carpal tunnel syndrome is a common condition where one of two main nerves in the wrist is compressed, resulting in pain to the hand, wrist and sometimes arm, numbness and tingling in the thumb, index and long finger. In advanced cases the muscles of the hand can become weak. The condition affects approximately three per cent of the population , more commonly women. While carpal tunnel syndrome can be treated with surgery, people with mild to moderate symptoms are sometimes offered non-surgical interventions such as exercises or mobilisation. Based on the 16 studies identified, there is limited and very low quality evidence of benefit for all of a diverse collection of exercise and mobilisation interventions for improving symptoms, functional ability for example hand grip strength , quality of life, and neurophysiologic parameters, and for minimising adverse effects and the need for surgery in people with carpal tunnel syndrome. More research is needed to investigate the effectiveness of exercises and mobilisation for people with carpal tunnel syndrome, especially the sustainability and long-term effects of this treatment.

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