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Telerehabilitation in Carpal Tunnel Syndrome

Not Applicable
Completed
Conditions
Carpal Tunnel Syndrome
Interventions
Other: Unimodal treatment
Other: Multimodal treatment
Registration Number
NCT05184413
Lead Sponsor
Hospital Clínico La Florida
Brief Summary

Carpal tunnel syndrome (CTS) is a compressive peripheral neuropathy characterized by pain, tingling sensation and paresthesia in the territory of the median nerve. These symptoms cause significant functional impairment that affects patients' quality of life. Pain neuroscience education (PNE) combined with therapeutic exercise (TE) has shown good results in patients with chronic pain, but the effects of this multimodal treatment via telerehabilitation have not been studied in patients with CTS. Telerehabilitation has demonstrated clinical and functional outcomes as effective as face-to-face interventions, being a good alternative to improve accessibility to rehabilitation care in a context of pandemic and social distancing. The purpose of this study is to provide coordinated, patient-centered care by implementing a Telerehabilitation model for patients with severe CTS. The objective of this study was to compare the effectiveness of a multimodal therapy program (TE plus PNE) versus a unimodal treatment (TE) in patients with CTS.

A Randomized Controlled Trial, simple-blind and multicenter study will be conducted. Patients will be randomly assigned to the multimodal treatment group (TE plus PNE) or to the unimodal treatment group (TE). At admission, an investigator blinded to treatment assignment will conduct data collection. The measurements will be the following outcomes: a) Pain Catastrophizing Scale; b) Tampa Scale for Kinesiophobia-11; c) Numerical Rating Scale (NRS); d) Boston Carpal Tunnel Questionnaire; e) Hospital Anxiety and Depression Scale; f) Quality of Life, using the EQ-5D instrument; g) Patient's global impression of change; h) Katz Diagram; These evaluations will be performed again at week 6 and 12.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Over 20 years of age, severe CTS medical diagnosis, duration of symptoms for more than three months, access to a smartphone with internet, and acceptance to participate in the study.
Exclusion Criteria
  • Inability to understand instructions, non-controlled mental health pathology, cognitive problems and previous surgery in the upper limb.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Unimodal treatmentUnimodal treatmentTherapeutic Exercise
Multimodal treatmentMultimodal treatmentTherapeutic Exercise plus Pain Neuroscience Education
Primary Outcome Measures
NameTimeMethod
Change from Baseline Tampa Scale for Kinesiophobia-11 (TSK-11) at 6 and 12 weeksBaseline (0 weeks), 6 weeks and 12 week

Kinesiophobia will be evaluated by Tampa Scale for Kinesiophobia (TSK-11SV) (Spanish adaptation. Gómez-Pérez, López-Martínez y Ruiz-Párraga, 2011). Scoring: Items are summed, with a total score from 11-44 and higher values represent a worse outcome (more pain interference in behavior).

Change from Baseline Numerical rating scale (NRS) at 6 and 12 weeksBaseline (0 weeks), 6 weeks and 12 week

The patient must rate his or her pain on a defined scale from 0 to 10, where 0 is no pain and 10 is the worst pain imaginable.

Change from Baseline Pain Catastrophizing Scale (PCS) at 6 and 12 weeksBaseline (0 weeks), 6 weeks and 12 week

To assess catastrophic thinking as a response to pain through 13 statements with 4 possible options from 1 "not at all" to 4 "all the time". a higher score indicates a higher catastrophic thinking

Secondary Outcome Measures
NameTimeMethod
Change from Baseline Hospital Anxiety and Depression Scale (HAD) at 6 and 12 weeksBaseline (0 weeks), 6 weeks and 12 week

Patient's emotional state will be evaluated by Hospital Anxiety and Depression Scale (HAD), which assess the level of anxiety and depression. Subscales and score range are Anxiety (0-21) and Depression (0-21). Scoring: items of each subscale are summed, indicating: 0-7 normality, 8-10 probably case, 11-21 anxiety or depression clinical case. Higher values represent a worse outcome.

Change from Baseline EQ-5D at 6 and 12 weeksBaseline (0 weeks), 6 weeks and 12 week

The EQ-5D is a self-assessed health-related quality of life questionnaire. The EQ-5D consists essentially of 2 pages: the EQ-5D description system and the visual analog scale (EQ VAS).

Change from Baseline Boston Carpal Tunnel Questionnaire (BCTQ) at 6 and 12 weeksBaseline (0 weeks), 6 weeks and 12 week

The BCTQ measures self-reported functional status (BCTQ-F) and severity (BCTQ-S). The BCTQ-S consists of 11 questions, each question provides 5 response choices, from 1 (no symptoms) to 5 (most severe/often). The BCTQ-F includes 8 questions assessing difficulty with daily tasks. These responses are also scored on a 5-point scale (1-5).

Change from Baseline Muscular endurance at 6 and 12 weeksBaseline (0 weeks), 6 weeks and 12 week

Maximum number of repetitions of rapid opening and closing of the hand until fatigue.

Hand diagramsBaseline (0 weeks)

To define total area marked for pain and numbness. The areas of the hand are marked by the patient and the marked area is quantified in square centimeters.

Patient Global Impression of Change Scale (PGICS)12 weeks

The PGICS consists of two subscales, one categorical and one quantitative. The categorical scale is a 7-point verbal scale with the options "I have improved a lot" = 7, "I have improved a lot" = 6, "I have improved a little" = 5, "I am the same" = 4, "I have gotten a little worse" = 3, "I have gotten a lot worse" = 2, "I have gotten a lot worse" = 1.205-207 And, the quantitative scale consists of a line from 0 to 10, where 0 = much better and 10 = much worse.

Trial Locations

Locations (1)

Hospital la Florida

🇨🇱

Santiago, Chile

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