Soft Tissue Massage Along With Mobilization Technique on Symptoms and Functional Status of Carpal Tunnel Syndrome

NCT05466162 | Unknown

• 1 other identifier: HamnaS
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this experimental study is to determine the effect of soft tissue massage along with mobilization technique on intensity of pain by visual analog scale and functional status by using Jamar hand-held dynamometer, Pinch Gauge and Boston Scale for carpal tunnel syndrome questionnaire in Carpal tunnel syndrome patients. It is being conducted on patients with Carpal tunnel syndrome at Sindh Institute of Physical Medicine and Rehabilitation, Karachi and Neurological outpatient department of Dr. Ruth K. M. Pfau, Civil Hospital Karachi among Sixty participants with mild and moderate severity of Carpal Tunnel Syndrome will be randomly allocated in two groups after initial screening by a consultant physiatrist according to CTS-6 scale. Written informed consent will be taken from each participant. Group A will be treated with soft tissue massage (Medenci hand massage technique) along with joint (radiocarpal and inter-carpal) and median nerve mobilization slider technique while group B will be treated with joint (radiocarpal and inter-carpal) and median nerve mobilization slider technique only. Participant will be evaluated by visual analog pain scale, Boston scale of carpal tunnel syndrome, dynamometer and -pinch gauge, Center for Epidemiologic Studies Depression Scale and Pain Anxiety Symptoms Scale on day 1 and last treatment session.

Conditions

Carpal Tunnel Syndrome

Keywords

peripheral neuropathy; compression neuropathy; entrapment neuropathy; soft tissue massage; manual therapy; massage therapy; Median neuropathy

Outcome Measures

Primary Outcomes (4)

• Change in pain intensity on Visual Analog Scale in centimeter after sixth week

  Visual Analog Scale can be defined as a subjective psychometric response scale used to measure distinct behavioral or physiological phenomena based on linear numerical gradient in pain intensity measurement. The patients rate their pain intensity on 0 to 10 cm where 0 cm refers 'no pain' and 10 cm refers 'most excruciating pain'. Increase in number of cm suggests worst pain.

  At baseline and after completion of study at after sixth week

• Change in symptoms severity and functional status on scale of Boston Carpal Tunnel Questionnaire in scores

  It is a self-administered likert scale, containing two parts, namely the symptom severity scale and the functional status scale. It is used to assess the severity of symptoms and evaluate the difficulty in implementing the designated task. Symptom severity scale contains 11 items and the functional status scale contans 8 items. Higher the score in both scales indicating higher severity and more difficulty in performing the task. Scoring for Symptoms severity scale: Less than 11 or 11 = Asymptomatic, 12 to 22 = Mild, 23-33 = Moderate, 24-44 = Severe, 45-55 = Very Severe Scoring for Functional status scale: less than 8 or 8 = Asymptomatic, 9-16 = Mild, 17-24 = Moderate, 25-32 = Severe, 33-40 = Very Severe The total score of both scale is calculated as the mean of the scores for the total items of scale.

  At baseline and after completion of study at after sixth week

• Change in hand grip strength by using Jamar dynamometer

  Hand grip strength is quantify in kilogram by using Jamar dynamometer. Measurements was taken three times of each individuals and then calculated mean of these readings.

  At baseline and after completion of study at sixth week

• Change in pinch strength by using Pinch Gauge

  Pinch grip strength is measured in kilogram by using Pinch Gauge. Measurements was taken three times of each individuals and then calculated mean of these readings.

  At baseline and after completion of study at sixth week

Other Outcomes (2)

• Change on Pain Anxiety Symptoms Scale-20

  At baseline and after completion of study at sixth week

• Change on Center for Epidemiological Studies-Depression scale in scores

  At baseline and after completion of study at sixth week

Study Arms (2)

Soft tissue mobilization + joint and nerve Mobilization

EXPERIMENTAL

Soft tissue massage therapy includes Madenci hand massage technique initiate with 30-second (sec) effleurage, followed by 60- sec friction, 30-sec petrissage, 30-sec shaking, and ends with 30-sec effleurage. It takes totally of 3 min Passive mobilizations of the wrist : radio-carpal joint in flexion and extension, maintained hand in traction. (30 oscillations, 5 sets and 30 secs interval between each step) Inter-carpal horizontal flexion and extension. (30 oscillations, 5 sets and 30 secs interval between each step) . Nerve Mobilization treatment( Slider technique) followed by Shoulder will be in depression, abduction on gleno-humeral joint and rotated externally, forearm will be in a supination, elbow flexion and wrist, elbow extension and wrist, thumb, and finger flexion Treatment sessions: 3set, 10 reps, with hold for 10 secs.

Other: Soft tissue mobilization; Other: Joint and nerve mobilization

joint and nerve mobilizations

ACTIVE COMPARATOR

Inter-carpal horizontal flexion and extension. (30 oscillations, 5 sets and 30 secs interval between each step) . Nerve Mobilization treatment( Slider technique) followed by Shoulder will be in depression, abduction on gleno-humeral joint and rotated externally, forearm will be in a supination, elbow flexion and wrist, elbow extension and wrist, thumb, and finger flexion Treatment sessions: 3set, 10 reps, with hold for 10 secs

Other: Joint and nerve mobilization

Interventions

Soft tissue mobilization OTHER

Soft tissue massage therapy includes Madenci hand massage technique initiate with 30-second (sec) effleurage, followed by 60- sec friction, 30-sec petrissage, 30-sec shaking, and ends with 30-sec effleurage. It takes totally of 3 min Passive mobilizations of the wrist : radio-carpal joint in flexion and extension, maintained hand in traction. (30 oscillations, 5 sets and 30 secs interval between each step) Inter-carpal horizontal flexion and extension. (30 oscillations, 5 sets and 30 secs interval between each step) . Nerve Mobilization treatment( Slider technique) followed by Shoulder will be in depression, abduction on gleno-humeral joint and rotated externally, forearm will be in a supination, elbow flexion and wrist, elbow extension and wrist, thumb, and finger flexion Treatment sessions: 3set, 10 reps, with hold for 10 secs

Also known as: Nerve mobilization( Slider technique), Joint mobilization

Soft tissue mobilization + joint and nerve Mobilization

Joint and nerve mobilization OTHER

Passive mobilizations of the wrist : radio-carpal joint in flexion and extension, maintained hand in traction. (30 oscillations, 5 sets and 30 secs interval between each step) Inter-carpal horizontal flexion and extension. (30 oscillations, 5 sets and 30 secs interval between each step) Nerve Mobilization treatment( Slider technique) followed by Shoulder will be in depression, abduction on gleno-humeral joint and rotated externally, forearm will be in a supination, elbow flexion and wrist, elbow extension and wrist, thumb, and finger flexion Treatment sessions: 3set, 10 reps, with hold for 10 secs.

Soft tissue mobilization + joint and nerve Mobilization; joint and nerve mobilizations

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Consultant Physiatrist will be diagnosed patients of carpal tunnel syndrome on electro diagnostic test i.e. Nerve Conduction Studies.
• Mild and moderate severity of Carpal tunnel syndrome.
• Age: 18-50 years
• Both gender patients with unilateral involvement of the hand

You may not qualify if:

• In electro diagnostic test, either motor or sensory deficit in the ulnar nerve and radial nerve.
• Other Neurological problems ( cervical myelopathy, motor neuron disease like amyotrophic lateral sclerosis
• Neoplasm around the affected arm
• Presence of other musculoskeletal problems of upper quadrant (for example: rheumatoid arthritis or fibromyalgia, cervical radiculopathy)
• Any recent history of trauma of upper extremity on affected side

Sponsors & Collaborators

• Dow University of Health Sciences: lead

Study Sites (1)

Sindh Institute of Physical Medicine and Rehabilitation

Karachi, Sindh, Pakistan

RECRUITING

Related Publications (24)

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MeSH Terms

Conditions

Carpal Tunnel Syndrome; Peripheral Nervous System Diseases; Tomaculous neuropathy; Charcot-Marie-Tooth Disease; Median Neuropathy

Condition Hierarchy (Ancestors)

Mononeuropathies; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Wounds and Injuries; Hereditary Sensory and Motor Neuropathy; Nervous System Malformations; Heredodegenerative Disorders, Nervous System; Neurodegenerative Diseases; Polyneuropathies; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Genetic Diseases, Inborn

Study Officials

• Hamna Syed, DPT

  Dow University of Health Sciences

  PRINCIPAL INVESTIGATOR

• Dr. Syed Imran Ahmed, MBBS,FCPS

  Sindh Institute of Physical Medicine and Rehabilitation

  STUDY DIRECTOR

• Dr, Naila Naeem Shahbaz, MBBS,FCPS

  Dr. Ruth K.M. Pfau Civil Hospital, Karachi

  STUDY DIRECTOR

• Aftab Ahmed Mirza Baig, DPT,MSAPT

  Sindh Institute of Physical Medicine and Rehabilitation

  STUDY DIRECTOR

Central Study Contacts

Hamna Syed, DPT

CONTACT

+923043257150; hamnasyyd6@gmail.com

Dr.Syed Imran Ahmed, MBBS,FCPS

CONTACT

03002120661; syedimran77@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The interventions assigned to individual participants will be kept hidden from the outcome assessors in the clinical trial.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Hamna Syed

Model Details: It is a randomized controlled trial. Total 60 patients will be recruited, 30 in each group that includes There will be one interventional group and one control group. Treatment will be allocated by using a random number sheet generated by SPSS software version 21. Participants are assigned to one of two groups in parallel for the duration of the study.

Study Record Dates

• First Submitted: April 9, 2022
• First Posted: July 20, 2022
• Study Start: September 21, 2021
• Primary Completion: August 1, 2022
• Study Completion: August 1, 2022
• Last Updated: July 20, 2022

Record last verified: 2022-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)