The Effectiveness of Neurodynamic Mobilization in Carpal Tunnel Syndrome

NCT06882707 | Completed

• 1 other identifier: MedianNerveMobilization
• Study Type: interventional
• Target: 86
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized, clinical, single-blinded, controlled study will initially planned to include 86 patients diagnosed with carpal tunnel syndrome who applied to Kütahya Health Sciences University, Evliya Çelebi Training and Research Hospital, Physical Medicine and Rehabilitation outpatient clinic and Kutahya City Hospital.Patients aged 20-55 years who were diagnosed with mild and moderate carpal tunnel syndrome by electromyography (EMG) in the last 6 months were included in the study. The patients were randomized into two groups using the computer-assisted randomization method. Median nerve mobilization and ultrasound therapy will be given to the study group, and only ultrasound therapy will be given to the control group. All the patients were evaluated with the Visual Analog Scale (VAS), Hand and Pinching Grip Test, Boston Carpal Tunnel Questionnaire (BCTQ) and Median Nerve and Abductor Pollicis Brevis Muscle ultrasonography before the intervention and at the third week of intervention.

Conditions

Carpal Tunnel Syndrome (CTS); Median Nerve

Keywords

carpal tunnel syndrome; median nerve mobilization; abductor pollicis brevis; boston carpal tunnel questionnaire; hand grip; ultrasonography

Outcome Measures

Primary Outcomes (1)

• Ultrasound assessment

  The Median nerve's diameter will be evaluated bilaterally by another researcher blinded to interventions and experienced in musculoskeletal ultrasonography, using ultrasound with a 6-18 Mhz linear probe (Mindray-UMT 200, USA). During the examination, patients will be seated on a stretcher, while the examiner sat on a higher stool. The Median nerve will be evaluated by measuring the circumference of the nerve at the location where the nerve entered the carpal tunnel. The ultrasound probe will be positioned above the epicondylus lateralis. The nerve cross-sectional area (CSA) will be recorded in the carpal tunnel while it was perpendicular to the wrist at 90 degrees on the Median nerve trace. The nerve diameter will be measured from the circumference of the epineurium.

  Change from Baseline at 3th weeks

Secondary Outcomes (2)

• Hand and pinching grip measurement

  Change from Baseline at 3th weeks

• Symptom severity and functional status

  Change from Baseline at 3th weeks

Study Arms (2)

Median nerve mobilization in addition to ultrasound therapy

EXPERIMENTAL

In addition nerve mobilization, ultrasound therapy will be applied to all patient in experimental group via methods explained below.

Other: Median Nerve Mobilization; Other: Ultrasound therapy

Ultrasound therapy

ACTIVE COMPARATOR

In control group, patients will received only ultrasound therapy.

Other: Ultrasound therapy

Interventions

Median Nerve Mobilization OTHER

Passive neuromobilisation of the median nerve and functional self-exercises. The procedure started with the patient in the supine position. The following steps were taken in sequence: shoulder girdle depression; slight abduction of the elbow extension with arm lateral rotation and forearm supination; wrist, finger and thumb extensions were added; and the shoulder was taken into further extension. To apply maximum stretch opposite cervical side flexion was done, and, in the end, the wrist was repeatedly moved into and out of stretch by performing a few degrees of flexion and extension at the wrist. This mobilization technique will be performed by an experienced physician/physiotherapist three times a week for 3 weeks, and the patients will be given 3 sets of 15 cycles with a 1-minute rest period in each set.

Median nerve mobilization in addition to ultrasound therapy

Ultrasound therapy OTHER

In control group, patients will received only ultrasound therapy. The patient will be in a sitting position with his/her face facing the physiotherapy technician, elbow in 90 degree flexion, forearm in supination, wrist in neutral position and supported by placing a towel under the patient's extremity and will be applied in Us intermittent mode with an intensity of 0.8 W/cm2 in 1 MHZ frequency in 1:4 mode for 10 minutes, moving in a way to draw an infinity sign for 10 seconds. Treatment will be given 5 days a week for 3 weeks and a total of 15 sessions.

Median nerve mobilization in addition to ultrasound therapy; Ultrasound therapy

Eligibility Criteria

• Age: 20 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosed with mild-to-moderate CTS on the dominant hand, based on the electrodiagnostic examination.
• Aged 20-55 years.
• Consent to receive the described treatment.
• Lasting symptoms at least 3 months

You may not qualify if:

• A systemic inflammatory disease.
• Any disease that can cause polyneuropathy, for example, diabetes mellitus.
• A cognitive disorder.
• Receiving psychotherapy.
• A pacemaker.
• Any disease that can affect the central nervous system.
• Carpal tunnel syndrome surgery history

Sponsors & Collaborators

• Kutahya Health Sciences University: lead

Study Sites (1)

Kutahya Health Sciences University

Kütahya, Turkey, 43050, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Carpal Tunnel Syndrome

Interventions

Ultrasonic 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)

Diathermy; Hyperthermia, Induced; Therapeutics

Study Officials

• Merve Akdeniz LEBLEBİCİER, MD

  Kutahya Health Sciences University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: March 12, 2025
• First Posted: March 18, 2025
• Study Start: March 15, 2025
• Primary Completion: June 15, 2025
• Study Completion: August 15, 2025
• Last Updated: January 15, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)