Graded Motor Imagery in Carpal Tunnel Syndrome

NCT07800260 | Not Yet Recruiting

• 1 other identifier: Graded Motor Imagery in CTS
• Study Type: interventional
• Target: 46
• Locations: 0 countries
• Sites: N/A

Brief Summary

The aim of this study is to investigate whether the addition of Graded Motor Imagery (GMI) to progressive neurodynamic exercises is more effective than progressive neurodynamic exercises alone in individuals with carpal tunnel syndrome (CTS). The objectives are to reduce pain and symptom severity, improve pain, sensorimotor function, physical performance, and grip strength through the addition of GMI.

Conditions

Carpal Tunnel Syndrome (CTS)

Keywords

carpal tunnel syndrome; wrist joint; exercise; hand strength; physical functional performance

Outcome Measures

Primary Outcomes (2)

• Disabilities of the Arm, Shoulder, and Hand (DASH)

  DASH is a 30-item self-report tool assessing upper-extremity disability and symptoms, including daily activities, pain, numbness, joint stiffness, weakness, sleep issues, and psychological effects. Examples include turning a doorknob, changing a light bulb, and cutting food. Scores range from 0 to 100; higher scores indicate more severe symptoms and impairment.

  Baseline

• Disabilities of the Arm, Shoulder, and Hand (DASH)

  DASH is a 30-item self-report tool assessing upper-extremity disability and symptoms, including daily activities, pain, numbness, joint stiffness, weakness, sleep issues, and psychological effects. Examples include turning a doorknob, changing a light bulb, and cutting food. Scores range from 0 to 100; higher scores indicate more severe symptoms and impairment.

  After the 6-week intervention

Secondary Outcomes (12)

• Mini Mental State Examination

  Baseline

• Mini Mental State Examination

  After the 6-week intervention

• Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)

  Baseline

• Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)

  After the 6-week intervention

• The Semmes-Weinstein Monofilament Test

  Baseline

Study Arms (2)

Graded Motor Imagery

EXPERIMENTAL

Each patient in the Graded Motor Imagery group will receive a treatment protocol consisting of Graded Motor Imagery, progressive neurodynamic exercises, and nighttime resting splints.

Other: Graded Motor Imagery (GMI); Other: Progressive Neurodynamic Exercise; Other: Nighttime Resting Splint

Progressive Neurodynamic Exercises

ACTIVE COMPARATOR

Each patient in the progressive neurodynamic exercises group will receive a treatment protocol consisting of progressive neurodynamic exercises and nighttime resting splints.

Other: Progressive Neurodynamic Exercise; Other: Nighttime Resting Splint

Interventions

Nighttime Resting Splint OTHER

The night splint was fitted with a wrist splint that keeps the wrist in a neutral position, permits finger flexion, maintains the wrist within a 0°-5° extension range, and ends just distal to the distal palmar crease.

Graded Motor Imagery; Progressive Neurodynamic Exercises

Progressive Neurodynamic Exercise OTHER

The progressive neurodynamic exercises involved holding each position for 5 seconds. Each session included two sets of 10 repetitions (2×10). The treatment lasted for 30-minute sessions, conducted twice weekly over a total of 6 weeks.

Graded Motor Imagery; Progressive Neurodynamic Exercises

Graded Motor Imagery (GMI) OTHER

GMI includes three stages. GMI program will span over 6 weeks. The first 2 weeks will focus on lateralization, followed by 2 weeks of motor imagery, and the final 2 weeks will involve mirror therapy. Lateralization: Patients will be asked to differentiate whether the hands shown in the Recognise™ Hand application belongs to the right or left side of their body. Motor Imagery: Patients will be instructed to imagine slowly and smoothly moving their affected extremities to the posture depicted in the photos in the Recognise™ Hand application and then returning to the starting position. Mirror Therapy: Using a mirror measuring 300 x 300 x 300 mm³ placed between the upper extremities, patients will be instructed to progressively move only their unaffected extremity, then their affected extremity, and finally both extremities.

Graded Motor Imagery

Eligibility Criteria

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

You may qualify if:

• mild to moderate unilateral CTS based on the Bland classification of electrodiagnostic testing ;
• positive Phalen or Tinel tests;
• symptoms such as paresthesia and pain associated with CTS that last longer than 3 months;
• patients aged 30-60 years (when CTS becomes more prevalent);
• patients who achieved a minimum score of 24 on the Mini-Mental State Examination (MMSE).

You may not qualify if:

• bilateral CTS;
• history of prior CTS surgery;
• clinical indicators of cervical radiculopathy or polyneuropathy;
• pregnancy or cognitive impairment;
• the presence of orthopedic, neurological, or functional problems on the unaffected side that could affect hand function (e.g., history of trauma or surgery, peripheral nerve injury, tendinopathy, tenosynovitis, trigger finger, arthritis, sequelae of a fracture, etc.);
• receipt of any conservative treatment for CTS within the last month.

Sponsors & Collaborators

• Artvin Coruh University: lead

MeSH Terms

Conditions

Carpal Tunnel Syndrome; Motor Activity

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; Behavior

Study Officials

• Zeynep Yıldız Kızkın

  Artvin Coruh University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Zeynep Yıldız Kızkın

CONTACT

+905346945085; pt.zeynepyildiz@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcomes assessor will be blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Model Details: In this prospective study, two treatment groups will be formed: a GMI group and a control group. Both groups will receive progressive neurodynamic exercises and a nighttime resting splint, while the GMI group will additionally receive Graded Motor Imagery.

Study Record Dates

• First Submitted: August 30, 2026
• First Posted: September 2, 2026
• Study Start (Estimated): March 1, 2027
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): December 30, 2027
• Last Updated: September 2, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share