Effect of the Kinesiotaping on paın, Function and electrophysiologıcal Findings in Patient With Carpal Tunnel Syndrome
Condition: Carpal Tunnel Syndrome
MeSH terms: Carpal Tunnel Syndrome; Syndrome
Study type: Interventional

Summary: 
      The aim of this study is to compare the effectiveness of different kinesio taping techniques
      applied in carpal tunnel syndrome on pain, mobility, functional status and
      electrophysiological results and to investigate whether they are superior to the control
      group.
    

Detailed description: 
      Carpal tunnel syndrome (CTS) was first described by Paget in 1854, and detailed information
      about its clinical course and surgical techniques were made by Phalen. Carpal tunnel syndrome
      (CTS) is a clinical picture consisting of symptoms resulting from compression of the median
      nerve in the carpal tunnel at the wrist level and is the most common entrapment neuropathy.
      Although it is due to idiopathic and secondary causes, the pathophysiology of CTS is not
      fully understood.

      It is 3 times more common in women than in men. The fact that CTS occurs more frequently in
      the dominant hand supports the important role of hand activity in the emergence of the
      disease. Since the sensory branches of the median nerve innervate the first three fingers and
      half of the fourth finger, they typically complain of burning, pinprick, tingling and
      numbness in these fingers in CTS. In some cases, the pain may not match the normal sensory
      area of the median nerve in the hand.

      The diagnosis of CTS is easily made by history and physical examination. Imaging and
      electrodiagnostic studies are helpful in confirming the diagnosis.

      Treatment varies according to the degree of CTS. Different conservative treatment methods are
      used in the treatment of mild and moderate CTS. The most commonly used methods are splint,
      local corticosteroid injection (LCE), nonsteroidal anti-inflammatory drugs (NSAID) and
      conventional treatment agents (TENS, hotpack, ultrasound). Treatment modalities for edema and
      pain should not be ignored during the rehabilitation period. In this respect, kinesiotaping
      (KT) treatment, which is practical, comfortable and safe for the patient, is one of the
      complementary treatment modalities with positive clinical results.The purpose of the
      kinesiological taping (KB) method, developed by Kenzo Kase in the 1970s, is to support the
      muscle structures and increase their stability without limiting the range of motion of the
      joint. KB application is used with many indications such as pain, posture disorders,
      tendinitis bursitis, foot deformities, sports injuries, lymphedema and entrapment
      neuropathies.

      Research on the use of kinesiotaping in the conservative treatment of carpal tunnel syndrome
      has increased in recent years. The data of our study will contribute to the literature in
      order to develop the right technique for kinesiotaping in the treatment of CTS.

      The estimated number of volunteers expected to participate in the study was determined
      according to power analysis. The sample size of the study was determined by the GPower
      3.1.9.6 program, and by using the finding in a similar study in the literature, it was used
      with 80% power and 5% margin of error to catch the medium effect size between dependent
      measurements. It was decided to work with a total of minimum 60 people, 20 in each
      group.Considering the patients who may be excluded from follow-up in the study, it is planned
      to start the study with 70 patients. The diagnosis of the disease will be made by clinical
      physical examination and enmg studies, and no additional technique will be required.

      Patients will be randomly divided into 3 groups. (They will be selected by simple random
      sampling using the closed envelope method, and then Group A (kinesio taping with I tape
      technique + exercise to tendon and median nerve slipping), Group B (kinesio taping with
      button hole technique + exercise to tendon and median nerve slipping) and They will be
      divided into Group C (tendon and median nerve gliding exercise).

      In the first group, kinesio taping with the I tape technique described by Dr Kenzo Kase will
      be applied once a week, a total of 3 times, and the exercises will be taught to the patient
      and a total of 21 sessions will be applied once a day.

      In the second group, kinesio taping with the Button hole technique defined by Dr Kenzo Kase
      will be applied once a week, 3 times in total, and the exercises will be taught to the
      patient and a total of 21 sessions will be applied once a day.

      In the third group, exercises will be taught to the patient and a total of 21 sessions will
      be applied once a day.

      Kinesiotaping application; It will be done by a physical therapist who has a kinesiology
      taping course certificate.

      I tape technique: In this technique, an I tape is measured and cut from the heads of the
      metacarpals to the epicondyles of the humerus. The ends of the tape are cut and an x shape is
      obtained at the ends. The tape is folded to find the middle point, then the paper is torn
      and, starting from the middle point, the patient's wrist and elbow are moved to the extension
      of the palmaris longus entrance. distally, below the antecubital fossa, the lower forearm is
      adhered to the carpal tunnel region with mild-light (15-25%) tension. Taping is applied to
      the wrist from the dorsal side again with a field correction technique. With the wrist
      slightly flexed, the middle part of a 15-20 cm I tape is adhered to the distal radius and
      ulna from the dorsal face with very light-light (15-25%) tension. With one hand, the band is
      held over the styloid processes of the radius and ulna, and with the other hand, the wrist is
      extended. The remaining ends are cut and glued without tension, leaving a small gap between
      both ends.

      Buttonhole: In this technique, a kinesio tape is 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 humerus epicondyles on the dorsal surface of the forearm. The tape is folded and the
      middle point is found there by making 2 short incisions and 2 holes through which it will
      pass between the 3rd and 4th fingers. (button holes) are obtained. The paper on the back of
      the tape is torn and the 2nd and 3rd fingers are passed through the holes. The patient's
      wrist is extended and radial deviation is brought, and the band is adhered to the medial
      epicondyle of the forearm with very light-mild (15-25%) tension. Then, the wrist is flexed
      and ulnar deviation is brought, and it is adhered to the lateral epicondyle with very
      light-mild (15-25%) tension. The last 3-5 centimeters are adhered without tension. Taping is
      applied to the wrist from the dorsal side again with a field correction technique. With the
      wrist slightly flexed, the middle part of a 15-20 cm I tape is adhered to the distal radius
      and ulna from the dorsal face with very light-light (15-25%) tension. With one hand, the band
      is held over the styloid processes of the radius and ulna, and with the other hand, the wrist
      is extended. The remaining ends are cut and glued without tension, with a small gap between
      both ends.
    

Intervention name(s): I tape technique; Button hole technique; exercises
Intervention type(s): Other; Other; Other
Intervention description(s): I tape technique described by Dr Kenzo Kase will be applied once a week, a total of 3 times, and the exercises will be taught to the patient and a total of 21 sessions will be applied once a day.; Button hole technique defined by Dr Kenzo Kase will be applied once a week, 3 times in total, and the exercises will be taught to the patient and a total of 21 sessions will be applied once a day.; exercises will be taught to the patient and a total of 21 sessions will be applied once a day
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Patients will be randomly divided into 3 groups.Group A (kinesio taping with I tape technique + exercise to tendon and median nerve slipping), Group B (kinesio taping with button hole technique + exercise to tendon and median nerve slipping) and They will be divided into Group C (tendon and median nerve gliding exercise).
In the first group, kinesio taping with the I tape technique described by Dr Kenzo Kase will be applied once a week, a total of 3 times, and the exercises will be taught to the patient and a total of 21 sessions will be applied once a day.
In the second group, kinesio taping with the Button hole technique defined by Dr Kenzo Kase will be applied once a week, 3 times in total, and the exercises will be taught to the patient and a total of 21 sessions will be applied once a day.
In the third group, exercises will be taught to the patient and a total of 21 sessions will be applied once a day.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: kinesiotaping; electrophysiological findings; carpal tunel syndrome