Investigation of the Efficacy of Extracorporeal Shock Wave Therapy and Kinesiotaping Applied as an Addition to Conservative Treatment in Individuals With Carpal Tunnel Syndrome
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 54
- Locations
- 1
- Primary Endpoint
- Pain Severity
Study Overview
Brief Summary
This study was conducted to compare the effectiveness of different treatment combinations in individuals with carpal tunnel syndrome (CTS). Participants were divided into three groups: The control group received only night splinting and exercise programme, while the second group received extracorporeal shock wave therapy (ESWT) in addition. The third group received kinesiobanding in addition to night splinting, exercise and ESWT. The study evaluates the effect of multimodal conservative treatment approaches on CTS symptoms and aims to demonstrate the additional benefits of ESWT and kinesiobanding in particular. The findings provide important clues for clinical practice.
Detailed Description
Carpal tunnel syndrome (CTS) is a common entrapment neuropathy resulting from compression of the median nerve at the wrist level, with symptoms such as paresthesia, pain and loss of muscle strength. This study comparatively evaluated the effects of different conservative treatment combinations on symptoms and functional status in individuals with CTS. Participants were divided into three groups. The control group received the standard conservative approach of night splinting and exercise programme. Extracorporeal shock wave therapy (ESWT) group received ESWT, which is known to increase tissue regeneration and blood flow, in addition to night splinting and exercise. In the ESWT+Taping group, in addition to night splinting, exercise and ESWT, kinesiobanding, which aims to provide proprioceptive support and reduce oedema, was applied. Pain intensity, symptom severity, functionality, hand grip strength and electrophysiological parameters were evaluated before and after treatment. This study draws attention to the importance of multidisciplinary and holistic approaches in the treatment of CTS and offers important contributions to clinical practice.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Investigator)
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Male or female patients between the ages of 18 and 65 who applied to Ahi Evran University Physical Medicine and Rehabilitation Outpatient Clinic and were diagnosed with moderate or mild carpal tunnel syndrome by clinical, physical examination and EMG
- •Patients who understand and can apply the patient information form
- •Patients who gave consent and participated in the study according to the informed consent form
Exclusion Criteria
- •Cervical radiculopathy
- •Polyneuropathy
- •Brachial plexopathy
- •History of trauma or fracture of the wrist and forearm
- •Systemic corticosteroid use, history of malignancy
- •History of carpal tunnel syndrome surgery
- •Pregnant and lactating women
- •Severe carpal tunnel syndrome, tenar atrophy on physical examination
- •Patient reluctance to participate in treatment
Arms & Interventions
Control Group
Control Group:
Resting splint fixing the ankle in neutral position
Worn every night before going to bed, used for 6-8 hours
Objective: To reduce the pressure on the median nerve
Exercise Programme:
Applied 1-2 times a day
Each exercise 10 repetitions, 2 sets
Content:
Nerve mobilisation exercises (median nerve sliding and stretching)
Wrist stretching and flexor-extensor tendon sliding exercises
Finger opening-closing, fist making exercises
Intervention: Conservative treatment (Other)
ESWT group
ESWT group:
Resting splint fixing the ankle in neutral position
Worn every night before going to bed, used for 6-8 hours
Objective: To reduce the pressure on the median nerve
Exercise Programme:
Applied 1 time per day
Each exercise 10 repetitions, 2 sets
Content:
Nerve mobilisation exercises (median nerve sliding and stretching)
Wrist stretching and flexor-extensor tendon sliding exercises
Finger opening-closing, fist making exercises
ESWT Protocol:
Device Radial ESWT device
Area of application Wrist volar surface (carpal tunnel area)
Parameters
Frequency: 5 Hz
4 Bar
Number of beats 2000 pulses/session
Application time 5-10 minutes per session
Intervention: Conservative treatment (Other)
ESWT group
ESWT group:
Resting splint fixing the ankle in neutral position
Worn every night before going to bed, used for 6-8 hours
Objective: To reduce the pressure on the median nerve
Exercise Programme:
Applied 1 time per day
Each exercise 10 repetitions, 2 sets
Content:
Nerve mobilisation exercises (median nerve sliding and stretching)
Wrist stretching and flexor-extensor tendon sliding exercises
Finger opening-closing, fist making exercises
ESWT Protocol:
Device Radial ESWT device
Area of application Wrist volar surface (carpal tunnel area)
Parameters
Frequency: 5 Hz
4 Bar
Number of beats 2000 pulses/session
Application time 5-10 minutes per session
Intervention: ESWT (Other)
ESWT+Taping Group
ESWT+Taping Group:
Resting splint fixing the ankle in neutral position Worn every night before going to bed, used for 6-8 hours Objective: To reduce the pressure on the median nerve
Exercise Programme:
Applied 1 time per day Each exercise 10 repetitions, 2 sets
Content:
Nerve mobilisation exercises (median nerve sliding and stretching) Wrist stretching and flexor-extensor tendon sliding exercises Finger opening-closing, fist making exercises
ESWT Protocol:
Device Radial ESWT device Area of application Wrist volar surface (carpal tunnel area) Parameters Frequency: 5 Hz 4 Bar Number of beats 2000 pulses/session
Kinesiobanding technique Kinesio taping was performed with the Button hole technique described by Dr Kenzo Kase. In this technique, a kinesio tape was measured and cut from the medial and lateral epicondyle level on the palmar side of the forearm, from the base of the proximal phalanges to the epicondyles of the humerus on the dorsal side of the forearm.
Intervention: Conservative treatment (Other)
ESWT+Taping Group
ESWT+Taping Group:
Resting splint fixing the ankle in neutral position Worn every night before going to bed, used for 6-8 hours Objective: To reduce the pressure on the median nerve
Exercise Programme:
Applied 1 time per day Each exercise 10 repetitions, 2 sets
Content:
Nerve mobilisation exercises (median nerve sliding and stretching) Wrist stretching and flexor-extensor tendon sliding exercises Finger opening-closing, fist making exercises
ESWT Protocol:
Device Radial ESWT device Area of application Wrist volar surface (carpal tunnel area) Parameters Frequency: 5 Hz 4 Bar Number of beats 2000 pulses/session
Kinesiobanding technique Kinesio taping was performed with the Button hole technique described by Dr Kenzo Kase. In this technique, a kinesio tape was measured and cut from the medial and lateral epicondyle level on the palmar side of the forearm, from the base of the proximal phalanges to the epicondyles of the humerus on the dorsal side of the forearm.
Intervention: ESWT (Other)
ESWT+Taping Group
ESWT+Taping Group:
Resting splint fixing the ankle in neutral position Worn every night before going to bed, used for 6-8 hours Objective: To reduce the pressure on the median nerve
Exercise Programme:
Applied 1 time per day Each exercise 10 repetitions, 2 sets
Content:
Nerve mobilisation exercises (median nerve sliding and stretching) Wrist stretching and flexor-extensor tendon sliding exercises Finger opening-closing, fist making exercises
ESWT Protocol:
Device Radial ESWT device Area of application Wrist volar surface (carpal tunnel area) Parameters Frequency: 5 Hz 4 Bar Number of beats 2000 pulses/session
Kinesiobanding technique Kinesio taping was performed with the Button hole technique described by Dr Kenzo Kase. In this technique, a kinesio tape was measured and cut from the medial and lateral epicondyle level on the palmar side of the forearm, from the base of the proximal phalanges to the epicondyles of the humerus on the dorsal side of the forearm.
Intervention: Kinesiotaping (Other)
Outcomes
Primary Outcomes
Pain Severity
Time Frame: 5 week
Visual Analogue Scale (VAS) was used to determine the presence and severity of low back pain in the study participants. GAS is a practical test with high validity and reliability in pain assessment. GAS is an assessment method numbered from 0 to 10, where '0' indicates no pain and '10' indicates the presence of the most severe pain. Participants were asked to mark the degree of pain they had on this scale and recorded.
Secondary Outcomes
- Symptom Severity and Functionality(5 week)
- Hand Grip Strength(5 week)
- Electrophysiological Assessments(5 week)
Investigators
Mehmet CANLI
Lecturer
Kirsehir Ahi Evran Universitesi