Combined Effects of Neurodynamics With PNF on Pain and ROM in Patients With CTS.

NCT07573878 | Completed DMC

• 1 other identifier: REC/RCR & AHS/24/0293
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to determine the combined effects of neurodynamics with proprioceptive neuromuscular facilitation technique on reducing pain and improving range of motion in patients with carpal tunnel syndrome. This study evaluates whether neurodynamics combined with PNF is an effective approach in treating CTS compared to baseline treatment, as both techniques are well known for their individual effects. This treatment is given for 2 weeks, 5 days per week with 10 repetitions for each exercise.

Conditions

Carpal Tunnel Syndrome (CTS)

Keywords

Carpal tunnel syndrome; Median nerve; Neurodynamic; PNF; Range of motion

Outcome Measures

Primary Outcomes (2)

• Quick DASH Questionnaire

  Changes from Baseline Quick DASH questionnaire (Quick Disabilities of the Arm, Shoulder, and Hand) is a concise version of the DASH questionnaire. It consists of 11 items, with each item scored from 1 (no difficulty) to 5 (unable to perform), assessing daily activities, pain, and social functioning, along with optional modules for work or sports/performing arts. The total score ranges from 0 to 100, where 0 indicates no disability and 100 indicates the most severe disability. Score Ranges: 0-20: Minimal disability 21-40: Mild to moderate disability 41-60: Moderate to severe disability 61-100: Extreme disability The score is calculated by summing responses, dividing by the number of items (n), subtracting 1, and multiplying by 25.

  2nd week

• Visual Analog Scale

  The Visual Analog Scale (VAS) is a frequently utilized tool in clinical and research settings to measure subjective experiences like pain. It was first developed in 1921 by psychologists Mary H.S. Hayes and Donald G. Paterson as a "graphic rating" method for subjective assessments, later adopted and adapted for measuring pain and clinical symptoms in the 1960s. It consists of a 10 cm line where patients spot their pain intensity, from 0 "no pain" at one end to 10 "unbearable pain" at the other.

  2nd week

Study Arms (2)

Neurodynamic with PNF

EXPERIMENTAL

PNF technique include Rhythmic Initiation along with agonistic reversals. Neurodynamics includes the distal nerve tension technique along with nerve sliding.

Other: Neurodynamic and PNF

Baseline treatment

ACTIVE COMPARATOR

Wrist splint along with ultrasound therapy, cold therapy, and medication like NSAIDs.

Other: Baseline Treatment

Interventions

Neurodynamic and PNF OTHER

These 2 exercises were provided in 10 repetitions for 2 weeks (duration), 5 days per week (frequency). i) PNF techniques used in carpal tunnel treatment includes 1. Rhythmic Initiation 2. Agonistic Reversals. ii) For Neurodynamic (1) Distal nerve tension technique :Hand was placed in six different positions each position maintained for 7 second and have 5 repetitions for each step this is done in median nerve tension technique (2) nerve slide

Also known as: Neurodynamic, Proprioceptive Neuromuscular Facilitation technique

Neurodynamic with PNF

Baseline Treatment OTHER

They were provided with common conservative physical therapy treatment for 2 weeks, 5 days per week, following carpal tunnel syndrome. These treatments included use of a wrist splint, especially at night, along with 10-15 min of cold and ultrasound therapy. Medications like NSAIDs were given for 5 days.

Also known as: medication, wrist splint, Ultrasound therapy, Cold therapy

Baseline treatment

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosed cases of carpal tunnel syndrome.
• Patients having positive Tinel's test and Phalen's test.
• Symptoms persisted for at least 4 weeks.
• Availability and motivation of patients to participate in a 2-week program.

You may not qualify if:

• Patient with contraindications to rehabilitation treatment.
• Patients with a history of previous upper limb surgery.
• Patient received steroid injection or have any systemic disease that can influence condition.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Bahawal Victoria Hospital

Chak Four Hundred Fifty-four, Punjab Province, 63100, Pakistan

Location

Related Publications (5)

• Shabbir S, Naeem F, Aroob A. Comparative Effects of Neurodynamics With and Without Wrist Splint in patients with Carpal Tunnel Syndrome. Pakistan Journal of Medical & Health Sciences. S Shabbir, F Naeem, A Aroob Pakistan Journal of Medical and Health Sciences, 2022•academia.edu

  BACKGROUND

• Aditi, K., Manish, J. K., Vaibhav, A., & Yadav, N. Analysing the Effects of Neuro-dynamics in Carpal Tunnel Syndrome in Pain and Disability: A Randomized Control Trial.

  BACKGROUND

• Zaheer SA, Ahmed Z. Neurodynamic Techniques in the Treatment of Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis. J Clin Med. 2023 Jul 25;12(15):4888. doi: 10.3390/jcm12154888.

  PMID: 37568290 BACKGROUND

• Nunez de Arenas-Arroyo S, Cavero-Redondo I, Torres-Costoso A, Reina-Gutierrez S, Alvarez-Bueno C, Martinez-Vizcaino V. Short-term Effects of Neurodynamic Techniques for Treating Carpal Tunnel Syndrome: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2021 Dec;51(12):566-580. doi: 10.2519/jospt.2021.10533. Epub 2021 Nov 16.

  PMID: 34784245 BACKGROUND

• Hamzeh H, Madi M, Alghwiri AA, Hawamdeh Z. The long-term effect of neurodynamics vs exercise therapy on pain and function in people with carpal tunnel syndrome: A randomized parallel-group clinical trial. J Hand Ther. 2021 Oct-Dec;34(4):521-530. doi: 10.1016/j.jht.2020.07.005. Epub 2020 Jul 30.

  PMID: 32893098 BACKGROUND

Related Links

• Comparative Effects of Neurodynamics With and Without Wrist Splint in patients with Carpal Tunnel Syndrome
• Effectiveness of proprioceptive neuromuscular facilitation pattern on upper extremity and scapula in patients with adhesive capsulitis: a single-centre assessor-blinded randomised controlled trial (RCT)
• Comparison of Two Different Applications of Proprioceptive Neuromuscular Facilitation Techniques to Increase Upper-Extremity Muscle Strength Bezmialem Science 2021;9(2):190-197 DOI: 10.14235/bas.galenos.2020.3854
• Changes in Median Nerve Excursion with Neurodynamic techniques in patients with carpal tunnel syndrome and healthy adults: influencing factors H Farghaly, H Rashed, H Elgendy, A Mohamed Egyptian Journal of Physical Therapy, 2023•ejpt.journals.ekb.eg
• Effect of Neurodynamic Technique on Carpal Tunnel Syndrome" Single Case Report"
• Comparison of Two Different Applications of Proprioceptive Neuromuscular Facilitation Techniques to Increase Upper-Extremity Muscle Strength Bezmialem Science 2021;9(2):190-197

MeSH Terms

Conditions

Carpal Tunnel Syndrome

Interventions

Dosage Forms; Ultrasonic Therapy; Cryotherapy

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)

Pharmaceutical Preparations; Technology, Pharmaceutical; Investigative Techniques; Diathermy; Hyperthermia, Induced; Therapeutics

Study Officials

• Arnab Altaf, ppdpt

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: March 27, 2026
• First Posted: May 7, 2026
• Study Start: January 1, 2025
• Primary Completion: October 1, 2025
• Study Completion: October 1, 2025
• Last Updated: May 7, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)