Effectiveness of Mirror Therapy in Patients With Carpal Tunnel Syndrome

NCT05115396 | Completed

• 1 other identifier: 221021
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 2

Brief Summary

Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy. CTS presents with motor and sensory disturbances, including pain, paraesthesia, and numbness in the fingers and hand. Therefore, CTS has a great impact on the activities of daily living. There are non-surgical treatments that can be effective in people who experience mild or moderate symptoms derived from CTS. Among them, flexor tendon and median nerve sliding exercises may offer an improvement in pain severity and symptoms, strength, wrist joint range, functionality, and quality of life for people with CTS. However, there are few studies on the effectiveness of treatments focused on the mechanisms of neuroplasticity through techniques aimed at rehabilitating different deficits. Mirror therapy (MT) may be beneficial in musculoskeletal injuries that occur with pain and reduced functionality of a body segment. For example, in people with acute stroke, orthopaedic hand injuries or complex regional pain syndrome type 1. However, its effect has not been studied in patients with CTS in mild or moderate stages. Thus, the objective of this study is to analyze the effectiveness of MT with conventional CTS exercises in symptoms of median nerve compression, pain, mobility, strength and motor functionality in patients with CTS.

Conditions

Carpal Tunnel Syndrome

Outcome Measures

Primary Outcomes (2)

• Pain intensity

  Visual Analog Scale: 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0-100. A higher score indicates greater pain intensity.

  2 minutes

• Symptom severity and functional status

  Boston Carpal Tunnel Syndrome Questionnaire

  5 minutes

Secondary Outcomes (5)

• Upper limb disability

  5 minutes

• Grip and Gripper Strength

  10 minutes

• Sensitivity

  10 minutes

• Muscle activation

  10 minutes

• Perception of change after treatment

  2 minutes

Study Arms (2)

Mirror therapy

EXPERIMENTAL

To perform mirror therapy, the participant shall be seated in a chair with a table in front of him/her. On the table there will be a mirror in the sagittal plane between the two upper limbs. The affected hand will be behind the mirror, without visibility, while the hand without symptoms will be reflected laterally in the mirror. Thus, the mirror will reflect the movements of the unaffected side as if these movements were executed with the affected side. During the intervention, participants will be instructed to concentrate on the hand reflected in the mirror. During MT, they will perform an exercise protocol based on previous studies and the American College of Sports Medicine guidelines. The duration will be 30 minutes.

Other: Mirror therapy

Cross-education treatment

ACTIVE COMPARATOR

Participants will perform the same exercise protocol with the unaffected hand and without the use of a mirror.

Other: Cross-education treatment

Interventions

Mirror therapy OTHER

The patient shall be seated in a chair with a table in front of him/her. On the table there is a mirror in the sagittal plane between the two upper extremities. The affected hand will be behind the mirror, without visibility, while the hand without symptoms will be reflected laterally in the mirror. Thus, the mirror will reflect the movements of the unaffected side as if these movements were executed with the affected side. During the procedure, patients will be instructed to concentrate on the hand reflected in the mirror.

Mirror therapy

Cross-education treatment OTHER

Participants will perform the same exercise protocol with the unaffected hand and without the use of a mirror.

Cross-education treatment

Eligibility Criteria

• Age: 18 Years - 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Being over 18 years of age.
• Being diagnosed with CTS
• Unilateral CTS

You may not qualify if:

• trauma or surgery on the upper limb within the last two years.
• diagnosis of severe CTS.
• pregnancy.
• atrophy of the tenar muscles.
• local corticosteroid injection or physiotherapy for CTS within the last 3 months.
• peripheral nerve damage.
• entrapment neuropathy at the most proximal levels of the upper limb.

Sponsors & Collaborators

• University of Valencia: lead

Study Sites (2)

Faculty of Physiotherapy

Valencia, Valencia / València, 46010, Spain

Location

Faculty of Physiotherapy

Valencia, 46010, Spain

Location

Related Publications (2)

• Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, Dohle C. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev. 2018 Jul 11;7(7):CD008449. doi: 10.1002/14651858.CD008449.pub3.

  PMID: 29993119 BACKGROUND

• Munoz-Gomez E, Aguilar-Rodriguez M, Molla-Casanova S, Sempere-Rubio N, Ingles M, Serra-Ano P. A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome. J Hand Ther. 2024 Oct-Dec;37(4):534-543. doi: 10.1016/j.jht.2024.02.007. Epub 2024 Mar 7.

  PMID: 38458950 DERIVED

MeSH Terms

Conditions

Carpal Tunnel Syndrome

Interventions

Mirror Movement Therapy

Condition Hierarchy (Ancestors)

Median Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Rehabilitation; Therapeutics

Study Officials

• Pilar Serra-Añó, Dr

  Univeristy of Valencia

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 29, 2021
• First Posted: November 10, 2021
• Study Start: December 1, 2021
• Primary Completion: July 26, 2022
• Study Completion: July 26, 2022
• Last Updated: May 15, 2023

Record last verified: 2021-10

Data Sharing

• IPD Sharing: Will not share

Locations

ES (2)