Carpel Tunnel Syndrome and Physical Therapy Modalities

Not Applicable

Completed

• Conditions: Carpal Tunnel Syndrome
• Interventions: Device: pulsed electromagnetic field; Device: Therapeutic ultrasound

• Registration Number: NCT02745652
• Lead Sponsor: Cairo University

Brief Summary

Carpel tunnel syndrome (CTS) is very common complain during pregnancy with high percentage to continue postnatal. Conservative treatment is more recommended in these cases. There are many physical therapy modalities proposed to treat CTS without knowing which modality is better than the other. So the aim of this study to compare the effect of two modalities in treating CTS in postnatal females.

Detailed Description

Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve entrapment disorders in the upper limb. CTS is common during pregnancy especially in the third trimester as well, a significant percentage of females postnatal may still have some complaints up to at least 3 years postnatal.

Purpose: To compare the effect of pulsed magnetic field (PEMF) versus ultrasound (US) in treating patients with CTS. Forty postnatal female patients with idiopathic CTS were assigned randomly into two equal groups. One group received PEMF with nerve and tendon gliding exercises for the wrist 3 times for week for 4 weeks. The other group received US plus the same exercises. Pain level, sensory and motor distal latencies of the median nerve (MSDL and MMDL), sensory and motor conduction velocities of the median nerve (MSCV and MMCV), functional status scale and hand grip strength were assessed pre and post treatment

Study Timeline

• Study Start: 2014-05
• Primary Completion: 2015-01
• Study Completion: 2015-03
• Status Verified: 2016-04
• Study First Submitted: 2016-04-14
• Study First Submitted QC: 2016-04-19
• Study First Posted: 2016-04-20
• Last Update Submitted: 2016-04-20
• Last Update Posted: 2016-04-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 55

Inclusion Criteria

• Mild to moderate CTS
• Positive electro diagnostic findings: prolonged median motor distal latency (MMDL) above 4 ms, and below 6ms.
• Prolonged median sensory distal latency above 3.5 ms .
• Positive Phalen and Tinel test.
• Subjects scored pain intensity more than 5 in visual analogue scale (VAS).

Exclusion Criteria

• severe cases with delayed motor distal latency > 6ms.
• Orthopedic or neurological disorders of neck or the upper limb as cervical radiculopathy.
• Pronator teres syndrome or double crush syndrome.
• Pre- existing CTS before their last pregnancy, current pregnancy.
• Diabetic neuropathy and Thoracic outlet syndrome.
• Wasting of thenar muscles, ulnar neuropathy.
• Rheumatoid arthritis, previous fractured carpal bone and previous surgery in the forearm especially transverse ligament release

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
pulsed electromagnetic field (PEMF)	pulsed electromagnetic field	patients in this group received the pulse electromagnetic field with frequency 50 Hz and intensity 80 gauss for 30 min.The patient was in sitting position, while the forearm was rested on the bed inside the solenoid in supination position
Therapeutic ultrasound (US)	Therapeutic ultrasound	Pulsed mode US was applied over the volar surface of the forearm (the carpal tunnel area) 15 min per session with a frequency of 1 MHz and intensity of 1.0 W/cm2

Primary Outcome Measures

Name	Time	Method
Pain intensity	4 weeks change from the baseline scores	it measured by the Visual Analogue Scale (VAS).It is considered a valid way of assessing pain

Secondary Outcome Measures

Name	Time	Method
Functional status scale	4 weeks change from the baseline scores	It is a part of the Carpal Tunnel Syndrome Questionnaire (CTSQ). it asks about eight functional activities as writing, buttoning of clothes, gripping of a telephone handle