Effects of Whole Wrist Versus Specific Carpal Bone Mobilization in the Patients of Carpel Tunnel Syndrome

NCT07724717 | Completed

• 1 other identifier: REC/RCR & AHS/25/0149
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 2

Brief Summary

The study was conducted to compare the effectiveness of Whole Wrist Mobilization versus Specific Carpal Bone Mobilization in reducing symptoms and improving function in patients with Carpal Tunnel Syndrome (CTS).

Conditions

Carpal Tunnel Syndrome

Keywords

Carpal Tunnel Syndrome; Manual Therapy; Range of Motion; Specific Carpal Bone Mobilization; Wrist Mobilization

Outcome Measures

Primary Outcomes (6)

• Numeric Pain Rating Scale

  The Numeric Pain Rating Scale (NPRS) was used to assess pain intensity, with participants rating their pain from 0 (no pain) to 10 (worst possible pain). It provided a quantitative measure to track pain changes over time.

  From enrollment to the end of treatment at 4 weeks

• Boston Carpal Tunnel Questionnaire

  The Boston Carpal Tunnel Questionnaire (BCTQ) is a recommended tool for assessing the functional status and severity of symptoms in CTS patients.

  From enrollment to the end of treatment at 4 weeks

• ROM Wrist Flexion

  Changes in wrist flexion ROM at baseline and 4th week of intervention was measured using goniometer.

  From enrollment to the end of treatment at 4 weeks

• ROM Wrist Extension

  Changes in wrist extension ROM at baseline and 4th week of intervention was measured using goniometer.

  From enrollment to the end of treatment at 4 weeks

• ROM Wrist Radial Deviation

  Changes in wrist radial deviation ROM at baseline and 4th week of intervention was measured using goniometer.

  From enrollment to the end of treatment at 4 weeks

• ROM Wrist Ulnar Deviation

  Changes in wrist ulnar deviation ROM at baseline and 4th week of intervention was measured using goniometer.

  From enrollment to the end of treatment at 4 weeks

Study Arms (2)

Specific Bone Mobilization

EXPERIMENTAL

Other: Specific Bone Mobilization; Other: Standardized Physiotherapy Treatment

Whole Wrist Mobilization

ACTIVE COMPARATOR

Other: Whole Wrist Mobilization; Other: Standardized Physiotherapy Treatment

Interventions

Specific Bone Mobilization OTHER

Scaphoid Mobilization: The therapist applied anterior-posterior mobilization on the scaphoid while the patient's wrist was in slight flexion. It was held for 5 seconds and repeated for 10 repetitions. Lunate Mobilization: The therapist performed lateral and medial mobilization of the lunate while stabilizing the forearm. It was held for 5 seconds and repeated for 10 repetitions. Triquetrum Mobilization: With the wrist in a neutral position, the therapist applied gentle mobilization to the triquetrum. It was held for 5 seconds and repeated for 10 repetitions.

Specific Bone Mobilization

Whole Wrist Mobilization OTHER

Distal Radioulnar Joint Mobilization: To perform mobilizations at the distal radioulnar joint, the therapist stabilized the patient's hand and radiocarpal region, then provided anteroposterior glide and medial and lateral rotary joint play movements of the distal ulna. Radiocarpal Joint - Dorsal Palmar Glide: The mobilization involved moving the row of carpal bones either dorsally to promote wrist extension or palmary to promote wrist flexion. Radiocarpal Joint - Ulnar and Radial Glide: Ulnar glide was performed to increase radial deviation, while radial glide was performed to increase ulnar deviation of the wrist joint. Mid-Carpal Joint Mobilization: The mobilization involved moving the row of carpal bones either dorsally to promote wrist extension or palmary to promote wrist flexion.

Whole Wrist Mobilization

Standardized Physiotherapy Treatment OTHER

Hot Pack: A hot pack was applied to the wrist and forearm for 10 minutes to help relax the muscles and improve circulation around the carpal tunnel. Transcutaneous Electrical Nerve Stimulation: TENS was applied with a frequency of 2 Hz and a pulse duration of 200 µs for 10 minutes over the wrist area to reduce pain and discomfort. Wrist Flexion and Extension: With the arm supported, the patient actively flexed and extended the wrist through a full range of motion. This was repeated for 10 repetitions. Radial and Ulnar Deviation: With the arm supported, the patient actively moved the wrist side to side (radially and ulnarly). Wrist Circles: The patient performed circular motions with the wrist in both clockwise and counterclockwise directions. This was repeated for 10 repetitions. Wrist Flexor Stretch: The arm was extended in front with the palm facing up, and the fingers were gently pulled back to stretch the wrist flexors. The stretch was held for 30 seconds and repeated 3 times.

Specific Bone Mobilization; Whole Wrist Mobilization

Eligibility Criteria

• Age: 30 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants aged 30 to 60 years old
• Both male and female participants
• CTS for at least 2 months
• Pain levels on the Numeric Pain Rating Scale (NPRS) between 3 and 7
• Limited range of motion and wrist pain
• Patient with positive PHALEN and TINEL test

You may not qualify if:

• Prior traumatic injury of wrist
• History of wrist surgery
• Diagnoses of polyneuropathy, cervical radiculopathy, myelopathy, inflammatory arthritis, diabetes, thyroid disease
• Presence of abnormal sensation in the wrist region
• Hemorrhagic tendency and/or current anticoagulation treatment
• History of whiplash injury

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (2)

Riphah Rehabilitation Clinic

Lahore, Punjab Province, Pakistan

Location

Umaid Qaseem Hospital and Chest Clinic

Lahore, Punjab Province, Pakistan

Location

Related Publications (5)

• Sault JD, Jayaseelan DJ, Mischke JJ, Post AA. The Utilization of Joint Mobilization As Part of a Comprehensive Program to Manage Carpal Tunnel Syndrome: A Systematic Review. J Manipulative Physiol Ther. 2020 May;43(4):356-370. doi: 10.1016/j.jmpt.2020.02.001. Epub 2020 Aug 26.

  PMID: 32861521 BACKGROUND

• Liew BXW, de-la-Llave-Rincon AI, Scutari M, Arias-Buria JL, Cook CE, Cleland J, Fernandez-de-Las-Penas C. Do Short-Term Effects Predict Long-Term Improvements in Women Who Receive Manual Therapy or Surgery for Carpal Tunnel Syndrome? A Bayesian Network Analysis of a Randomized Clinical Trial. Phys Ther. 2022 Apr 1;102(4):pzac015. doi: 10.1093/ptj/pzac015.

  PMID: 35194646 BACKGROUND

• Ceylan I, Buyukturan O, Aykanat O, Buyukturan B, Sas S, Ceylan MF. The effectiveness of mobilization with movement on patients with mild and moderate carpal tunnel syndrome: A single-blinded, randomized controlled study. J Hand Ther. 2023 Oct-Dec;36(4):773-785. doi: 10.1016/j.jht.2023.02.004. Epub 2023 Aug 11.

  PMID: 37573157 BACKGROUND

• Dilvesi D, Jelaca B, Knezevic A, Zivanovic Z, Pantelic V, Golubovic J. Evolution of Carpal Tunnel Syndrome Treatment: A Narrative Review. NeuroSci. 2026 Jan 12;7(1):10. doi: 10.3390/neurosci7010010.

  PMID: 41562834 BACKGROUND

• Masiero S, Arcuri P, Boccolari P, Zorzi E, Vio A, Fairplay T, Zanin D, Vita F, Donati D, Tedeschi R. Surgical Versus Conservative Management for Carpal Tunnel Syndrome: An Updated Systematic Review of Randomised Trials. Brain Sci. 2026 Apr 8;16(4):399. doi: 10.3390/brainsci16040399.

  PMID: 42041808 BACKGROUND

MeSH Terms

Conditions

Carpal Tunnel Syndrome

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

Study Officials

• Ali Raza, MS-OMPT

  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: July 21, 2026
• First Posted: July 24, 2026
• Study Start: December 1, 2025
• Primary Completion: May 30, 2026
• Study Completion: May 30, 2026
• Last Updated: July 24, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (2)