Telerehabilitation in Carpal Tunnel Syndrome
Condition: Carpal Tunnel Syndrome
MeSH terms: Carpal Tunnel Syndrome; Syndrome
Study type: Interventional

Summary: 
      Carpal tunnel syndrome (CTS) is a compressive peripheral neuropathy characterized by pain,
      tingling sensation and paresthesia in the territory of the median nerve. These symptoms cause
      significant functional impairment that affects patients' quality of life. Pain neuroscience
      education (PNE) combined with therapeutic exercise (TE) has shown good results in patients
      with chronic pain, but the effects of this multimodal treatment via telerehabilitation have
      not been studied in patients with CTS. Telerehabilitation has demonstrated clinical and
      functional outcomes as effective as face-to-face interventions, being a good alternative to
      improve accessibility to rehabilitation care in a context of pandemic and social distancing.
      The purpose of this study is to provide coordinated, patient-centered care by implementing a
      Telerehabilitation model for patients with severe CTS. The objective of this study was to
      compare the effectiveness of a multimodal therapy program (TE plus PNE) versus a unimodal
      treatment (TE) in patients with CTS.

      A Randomized Controlled Trial, simple-blind and multicenter study will be conducted. Patients
      will be randomly assigned to the multimodal treatment group (TE plus PNE) or to the unimodal
      treatment group (TE). At admission, an investigator blinded to treatment assignment will
      conduct data collection. The measurements will be the following outcomes: a) Pain
      Catastrophizing Scale; b) Tampa Scale for Kinesiophobia-11; c) Numerical Rating Scale (NRS);
      d) Boston Carpal Tunnel Questionnaire; e) Hospital Anxiety and Depression Scale; f) Quality
      of Life, using the EQ-5D instrument; g) Patient's global impression of change; h) Katz
      Diagram; These evaluations will be performed again at week 6 and 12.
    


Intervention name(s): Multimodal treatment; Unimodal treatment
Intervention type(s): Other; Other
Intervention description(s): A multimodal telerehabilitation intervention will be conducted through Whatsapp video calls. The combined treatment includes: 1) One 30-minute session of education in neurosciences of pain, using audiovisual material with examples and metaphors to improve the patient's understanding. In addition, two sessions of reinforcement of key contents will be held every 15 days; 2) Therapeutic exercise program: active wrist and finger exercises, stretching, mobilization exercises of the median nerve, and aerobic exercise (brisk walking). Each exercise will be dosed on a personalized basis, with a perceived exertion of 4-5 on the Borg scale. Therapeutic exercise will be self-administered, 3 sessions per week for 6 weeks. Telerehabilitation sessions will be performed every 15 days to monitor adherence and adjust the exercise dose.; An unimodal telerehabilitation intervention will be performed through Whatsapp video calls. The treatment will include only a therapeutic exercise program: active wrist and finger exercises, stretching, mobilization exercises of the median nerve, and aerobic exercise (brisk walking). Each exercise will be dosed on a personalized basis, with a perceived exertion of 4-5 on the Borg scale. Therapeutic exercise will be self-administered, 3 sessions per week for 6 weeks. Telerehabilitation sessions will be performed every 15 days to monitor adherence and adjust the exercise dose.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: pain; disability; education; exercise