Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: A Randomized Parallel-Group Trial

Fernández‐de‐las‐Peñas, César; Ortega‐Santiago, Ricardo; de-la-Llave-Rincón, Ana I; Martínez-Pérez, Almudena; Díaz, Homid Fahandezh-Saddi; Martínez‐Martín, Javier; Pareja, Juan A.; Cuadrado, María‐Luz

doi:10.1016/j.jpain.2015.07.012

Cited by 72 publications

(75 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A secondary analysis was conducted alongside a randomized clinical trial, performed in a general hospital in Madrid, Spain, to determine the predictive influence of clinical, psychological, and psychophysical variables on long‐term treatment outcomes after the application of physical therapy including desensitization maneuvers of the central nervous system or surgery in women with CTS. Full details of the trial, participants, interventions, and results of the clinical outcomes are reported elsewhere . The design was approved by the Hospital Universitario Fundación Alcorcón (HUFA) Institutional Review Board (PI01223‐HUFA12/14), and the clinical trial was prospectively registered (ClinicalTrials.gov: NCT01789645).…”

Section: Methodsmentioning

confidence: 99%

“…Participants were randomly assigned to undergo either physical therapy or surgery. Details on the randomization procedure have been previously published . Participants allocated to the physical therapy group underwent 3 treatment sessions of physical therapy of 30 minutes duration, which included desensitization maneuvers of the central nervous system, once per week.…”

Section: Methodsmentioning

confidence: 99%

“…Finally, all participants attended an educational session on performing the tendon/nerve gliding exercises as home exercises. A complete description of the intervention can be found elsewhere …”

Section: Methodsmentioning

confidence: 99%

“…Since no evidence supports one particular surgical procedure, surgery was pragmatically applied based on surgeon and patient preferences . Patients allocated to this group also attended the same educational session for performing the tendon and nerve gliding exercises as the physical therapy group …”

Section: Methodsmentioning

confidence: 99%

“…In a recent clinical trial, the effects of physical therapy including a desensitization maneuver of the central nervous system was compared to the effects of surgery in women with CTS. Physical therapy exhibited better short‐term effects and similar long‐term effects on pain and function, providing promising results for the management of CTS . However, depending on the patient's presentation and pain mechanisms driving the painful condition, different results could be expected.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Fernández‐de‐las‐Peñas

de-la-Llave-Rincón

Cescon

et al. 2019

Pain Practice

View full text Add to dashboard Cite

Objective To assess the influence of clinical, psychological, and psychophysical variables on long‐term clinical outcomes after the application of either physical therapy or surgery in women presenting with carpal tunnel syndrome (CTS). Methods A secondary analysis of a randomized trial investigating the efficacy of manual therapy including desensitization maneuvers of the central nervous system against surgery in 120 women with CTS was performed. Clinical outcomes including pain intensity, function, or symptom severity were assessed at 6 and 12 months post‐intervention. Participants completed at baseline several clinical (pain intensity, function, and symptom severity), psychological (depression), and psychophysical (pressure pain thresholds and pain extent) variables, which were included as predictors. Multiple regression analyses were conducted to assess the relationship between baseline variables and clinical outcomes at 6 and 12 months post‐intervention. Results The regression models indicated that higher scores of each clinical outcome (ie, intensity of pain or symptom severity) at baseline predicted better outcomes at 6 and 12 months post‐intervention (from 15% to 65% of variance) in both groups. Lower pressure pain thresholds over the carpal tunnel at baseline predicted poorer clinical outcomes at 6 and 12 months post‐intervention (from 5% to 20% of variance) in the physical therapy group, whereas higher depressive symptoms at baseline contributed to poorer outcomes at 6 and 12 months post‐intervention (from 5% to 15% of the variance) within the surgery group. Conclusion This study found that baseline localized pressure pain sensitivity and depression were predictive of long‐term clinical outcomes in women with CTS following physical therapy or surgery, respectively.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations