Neurodynamic Techniques Versus “Sham” Therapy in the Treatment of Carpal Tunnel Syndrome: A Randomized Placebo-Controlled Trial

Wolny, Tomasz; Linek, Paweł

doi:10.1016/j.apmr.2017.12.005

Cited by 41 publications

(88 citation statements)

References 40 publications

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“…In many cases, despite the absence of changes before and after the therapy cycle, the improvement was recorded in the BCTQ parameters. This indicates that patients improved despite the lack of changes in ENG or USG [5,37,38].…”

Section: Discussionmentioning

confidence: 92%

“…Wolny et al showed how he created a placebo group and what techniques used in this group differ from the true neuromobilization's techniques of the median nerve [5]. It is also important to provide the exact parameters of the treatments being tested in the field of physical therapy [7,14,38].…”

Section: Discussionmentioning

confidence: 99%

“…Between them on the ventral side, the transverse wrist ligament is spread, commonly referred to as the flexor retinaculum [3]. CTS affects the median nerve by adjacent tissues, which in turn reduces its mobility in the canal [4][5][6]. Compression and reduction of lateral and longitudinal sliding of the mdian nerve is a direct cause of hand discomfort [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of physiotherapy in carpal tunnel syndrome (CTS)

Bobowik¹

2019

areh

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Introduction: Carpal Tunnel Syndrome (CTS) is one of the most common peripheral upper limb's neuropathy. It can affect up to 4% of the human population. There is not one specific CTS's reason. Predisposing factors include: injuries and overloading of the wrists, frequently repetitions of the same activities, pregnancy and acromegaly. The ENG and USG are gold standards in the diagnosis of CTS. CTS treatment includes surgical and physiotherapeutic conservative treatment. Physiotherapists uses manual therapy techniques, neuromobilization, fascial manipulation, osteopathy and other kinds of physical therapy. Material and methods: A systematic review of the literature was based on publications from the last 5 years. Articles concerned the physiotherapy of people with carpal tunnel syndrome (CTS). Publications from the PubMed and ScienceDirect scientific databases have been analyzed. The inclusion and exclusion criteria were introduced and based on an analysis of the titles and abstracts related to carpal tunnel syndrome (CTS). Results: Out of over 28,000 CTS articles, 8 were selected to meet all inclusion and exclusion criteria. The publications concerned physiotherapeutic treatment in the conservative treatment of CTS. The analyzed publications examined the effectiveness of wrist manual therapy, median nerve mobilization, kinesiotaping, soft tissue therapy and fascial manipulations as well as other physiotherapy treatments. Conclusions: The reviewed publications show that physiotherapeutic procedures bring significant benefits and improve CTS symptoms within the hand. The development of physiotherapy and research on rehabilitation in the carpal tunnel syndrome (CTS) allow for more effective conservative treatment. This increases the chance of avoiding or delaying surgical intervention.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of physiotherapy in carpal tunnel syndrome (CTS)

Bobowik¹

2019

areh

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“…Frequently, conservative CTS treatment is based on physiotherapeutic management, in which procedures such as laser, ultrasound and manual therapy (including neurodynamic techniques) are applied (Giele, 2001). Recently, two randomised controlled trials have shown that immediately after 10 weeks of treatment (20 sessions), patients who received manual therapy based on neurodynamic techniques had significant improvement immediately after therapy (Wolny & Linek, 2019; Wolny & Linek, 2018). Wolny and Linek (Wolny & Linek, 2019; Wolny & Linek, 2018) showed that neurodynamic techniques positively influenced outcomes, such as nerve conduction, pain, subjective symptoms (SSS) and functional state (FSS) (Boston Carpal Tunnel Questionnaire—BCTQ), and the perception of two-point discrimination (2PD).…”

Section: Introductionmentioning

confidence: 99%

Long-term patient observation after conservative treatment of carpal tunnel syndrome: a summary of two randomised controlled trials

Wolny

Linek

2019

PeerJ

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BackgroundPhysiotherapy of carpal tunnel syndrome (CTS) involves manual therapy based on neurodynamic techniques. Until now, two randomized controlled trials have shown that immediately after therapy, CTS patients who received neurodynamic techniques had significant improvement in nerve conduction, pain, symptom severity (SSS), functional state (FSS), muscle strength (MS) and two-point discrimination (2PD). However, long-term effects seem to be more important, as they are the only ones that can significantly improve the patient’s health and influence economic and social costs. Thus, the objective of this study was to evaluate the long-term (six months) effects of neurodynamic techniques in the conservative treatment of CTS patients.MethodsCarpal tunnel syndrome patients (107) from two previously published randomised clinical trials were observed for six months after the treatment based on neurodynamic techniques.ResultsThe sensory conduction velocity, motor conduction velocity, and motor latency were not subject to statistically significant changes within six months after therapy (p > 0.05). In both groups, there was further pain reduction (p < 0.05). In Group B, the symptom severity improved significantly (p < 0.05), while the functional status in both groups remained unchanged (p > 0.05). In both groups, there was muscle strength improvement (p < 0.05). Two-point discrimination remained unchanged six months after the therapy.ConclusionThe use of manual therapy based on neurodynamic techniques maintains the beneficial effects 6 months after therapy in CTS patients.

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“…The values were in kilograms of strength (kg). The measurement PeerJ reviewing PDF | (2019:07:39930:2:0:NEW 3 Oct 2019)Manuscript to be reviewed was done three times, and the mean value was added to the analysisWolny & Linek, 2018).…”

mentioning

confidence: 99%

Peer Review #1 of "Long-term patient observation after conservative treatment of carpal tunnel syndrome: a summary of two randomised controlled trials (v0.2)"

2019

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Background Physiotherapy of carpal tunnel syndrome (CTS) involves manual therapy based on neurodynamic techniques. Until now, two randomized controlled trials have shown that immediately after therapy, CTS patients who received neurodynamic techniques had significant improvement in nerve conduction, pain, symptom severity (SSS), functional state (FSS), muscle strength (MS) and two-point discrimination (2PD). However, long-term effects seem to be more important, as they are the only ones that can significantly improve the patient' health and influence economic and social costs. Thus, the objective of this study was to evaluate the long-term (six months) effects of neurodynamic techniques in the conservative treatment of CTS patients. Methods Carpal tunnel syndrome patients (107) from two previously published randomised clinical trials were observed for six months after the treatment based on neurodynamic techniques. Results The sensory conduction velocity, motor conduction velocity, and motor latency were not subject to statistically significant changes within six months after therapy (p > 0.05). In both groups, there was further pain reduction (p < 0.05). In group B, the symptom severity improved significantly (p < 0.05), while the functional status in both groups remained unchanged (p > 0.05). In both groups, there was muscle strenght improvement (p < 0.05). Two-point discrimination remained unchanged six months after the therapy. Conclusion The use of manual therapy based on neurodynamic techniques maintains the beneficial effects 6 months after therapy in CTS patients.

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Neurodynamic Techniques Versus “Sham” Therapy in the Treatment of Carpal Tunnel Syndrome: A Randomized Placebo-Controlled Trial

Cited by 41 publications

References 40 publications

Effectiveness of physiotherapy in carpal tunnel syndrome (CTS)

Effectiveness of physiotherapy in carpal tunnel syndrome (CTS)

Long-term patient observation after conservative treatment of carpal tunnel syndrome: a summary of two randomised controlled trials

Peer Review #1 of "Long-term patient observation after conservative treatment of carpal tunnel syndrome: a summary of two randomised controlled trials (v0.2)"

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