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Vinita Manchanda

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Effect of neural mobilization and splinting on carpal tunnel syndrome

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Study objective: To evaluate the clinical benefit of neural mobilization and splinting compared with splinting alone in carpal tunnel syndrome (CTS).

Methods: Patients were randomized into two groups using Pre/Post-test experimental design. On day 0 and 21st (i.e. pre and post treatment), patients were administered Boston Questionnaire. Grip strength, pain intensity, and sensory testing were completed using validated outcomes measures. Both groups were advised to wear full-time neutral angle wrist splint for three weeks. Neuromobilisation technique for the median nerve was performed, the protocol included treatment of total three weeks, with six days per week management for only one group additionally and they were encouraged by the therapist to complete the self mobilisation home exercise program once a day. Independent t-test was used to compare VAS, sensory testing at three sites name as site 1(tip of the thumb), site 2(proximal index finger), site 3(tip of the index finger) and grip strength between the groups on 0 and the 21st day. Mann-Whitney Test was used to compare the score of Boston Questionnaire Symptom Severity Scale and Functional Status Scale between the groups on 0 and the 21st day.

Results: The data showed that with the use of three weeks protocol there was a significant difference (p<0.05) between post treatment values of VAS score, Boston Questionnaire Symptom Severity Scale , Functional Status Scale taken and Sensory testing at three sites i.e site 1,site 2 and site 3 on 21st day between group A and group B but more improvement was seen in the group B. The data of this study showed that there was non-significant difference between post treatment values of Grip strength on 21st day between group A and group B i.e. there was no improvement in grip strength.

Conclusion: This study demonstrated that patients suffering from CTS can have substantial improvement with the combined treatment of neural mobilisation and splinting.

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