[en] Background: Several systematic reviews have questioned the effectiveness of strategies based on conservative and mobilization exercises in the treatment of carpal tunnel syndrome (CTS). However, there is no review work has been focused on assessing specifically the effectiveness of manual therapy in the treatment of CTS. Objectives: The aim of this review was to determine the effectiveness of different methods of manual therapy (treatment of soft tissue, neural mobilization, joint mobilization) on carpal tunnel syndrome (CTS). Data source: We carried out a systematic review in PubMed, Scopus, Web of Science, CINAHL and PEDro data. The search was conducted in the months of February and March 2015. Eligibility criteria, participants and interventions: Two independent reviewers submitted the results to the inclusion/exclusion criteria to determine the validity of the studies in the review. Randomized clinical trials with patients with clinical and / or electrophysiological STC were included. Patients were both men and women, adults and with unilateral or bilateral involvement. We included any form of manual therapy administered by a therapist, such as soft tissue therapy (massage therapy, myofascial therapy, ischemic compression techniques ...), neural mobilization, joint mobilization, and combination of therapy neural mobilization with soft tissue, and joint mobilization with soft tissue. Evaluation of studies and synthesis methods: The study assessment was performed by 2 reviewers, comparing results between different groups in each study, and the various processing procedures. Once you have done this, a comparative results were obtained. Results: 21 studies were located first, of which only 10 were finally included (N=354). A high level of evidence for the use of this type of therapy is found not only in major producing symptoms such as pain syndrome, severity or alteration of the functionality, but also in grip strength, range of motion or electrophysiological parameters . Limitations: Future studies should bet on multimodal approaches in which different physical agents are applied, and adjust therapy procedures manual dysfunctional conditions of the patients, trying to use homogeneous samples. Conclusions: A high level of evidence for the effectiveness of manual therapy in the treatment of CTS was found. The works that combined different techniques of manual therapy had better outcomes. Implications: Due to the high level of evidence found, the use of this therapy in the treatment of STC is recommended, but should not be considered as a method of exclusive treatment, but must rely on other types of therapies (active work , splint ...) for best results.

[gl] Antecedentes: Diferentes revisións sistemáticas poñen en dúbida a eficacia das estratexias conservadoras baseadas en exercicios e movilizacións no tratamento do síndrome do túnel carpiano (STC). Sin embargo, non existe ningún traballo de revision centrado en avaliar de forma específica a eficacia da terapia manual no tratamento do STC. Obxectivos: Determinar a eficacia de diferentes métodos de terapia manual (tratamento de tecidos brandos, neuromovilización, movilización articular) na síndrome do túnel do carpo (STC). Fonte de datos: Realizouse unha revisión sistemática nas bases de datos PubMed, Scopus, Web of Science, CINAHL e PEDro. A investigación foi realizada nos meses de febreiro e marzo de 2015. Criterios de elixibilidade, participantes e intervencións: Dous revisores independentes someteron os resultados aos criterios de inclusión / exclusión para determinar a validez dos estudos na revisión. Os ensaios clínicos aleatorizados con pacientes con diagnóstico clínico e / ou eletrofisiológico de STC foron incluídos. Os pacientes eran homes e mulleres, maiores de idade e con afectación unilateral ou bilateral. Foi incluida calqueira forma de terapia manual administrada por un terapeuta, tales como terapia de tecidos brandos (masaxe terapéutico, terapia miofascial, técnicas de compresión isquémica...), neuromovilización, movilización articular, e de combinación de neuromovilización e tecidos brandos, e movilización articular e terapia de tecidos brandos. Avaliación de estudos e métodos de síntese: A avaliación dos estudos foi realizada por dous revisores, comparando os resultados entre os distintos grupos en cada estudo, e entre os distintos métodos de tratamento aplicados. Tras isto, foron obtidos varios resultados comparativos. Resultados: Foron localizados e analizados 21 estudos, dos cales só 10 foron finalmente incluídos (N=354). Atopouse un elevado nivel de evidencia para o uso deste tipo de terapia, non só nos principais síntomas tales como a dor, a gravidade ou a función, senón tamén na forza de prensión, movilidade, estado de ánimo e parámetros electrofisiolóxicos. Limitacións: Estudos futuros deberán apostar por enfoques multimodais nos que se apliquen diferentes axentes físicos, así como axustar os procedementos de terapia manual as condicións disfuncionais dos pacientes, tratando de empregar mostras más homoxéneas. Conclusións: Atopouse un elevado nivel de evidencia para a eficacia da terapia manual no tratamento de CTS. Os estudos que combinaron diferentes técnicas de terapia manual tiveron mellores resultados. Implicacións: Debido ao alto nivel de evidencia atopado, recoméndase o uso desta terapia para o tratamento de STC, ainda que non se debe ser considerar como un método de tratamento exclusivo, senón que debe contar con outros tipos de terapias (traballo activo, férula ...) para obter mellores resultados.