Clinical and Electrophysiological Evaluation of the Effectiveness for Manual Lymphatic Drainage

Study Overview
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Brief Summary
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When the other usage areas of the manual lymphatic drainage technique in the literature, except for the treatment of lymphedema, were examined recently, it was seen that it was also applied in orthopedic and neurological cases in a limited number of studies. The aim of our study is to investigate the effectiveness of manual lymphatic drainage on clinical and electrophysiological findings in carpal tunnel syndrome

Official Title
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Clinical and Electrophysiological Evaluation of the Effectiveness of Manual Lymphatic Drainage in Patients With Mild-to-moderate Carpal Tunnel Syndrome

Conditions
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Carpal Tunnel Syndrome, Electrophysical Evaluation, Manual Lymphatic Drainage

Intervention / Treatment
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* Other: manual lymphatic drainage (massage)
* Other: Splint treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of mild to moderate carpal tunnel syndrome on electrodiagnostic examination Being between 20-55 years old Volunteering to participate in the treatment to be given Exclusion Criteria: Have a systemic inflammatory disease Having any disease that may cause polyneuropathy, such as diabetes mellitus Cognitive impairment Receiving psychotherapy Having a pacemaker illiterate Having a disease affecting the central nervous system Having a hearing problem Any skin disease that would contraindicate manual lymphatic drainage Arterial or venous circulation disorder that would contraindicate manual lymphatic drainage

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study group<br> | Other: manual lymphatic drainage (massage)<br>* Patients will begin treatment with manual lymphatic drainage in the affected extremity. In this context, while the patients are in the supine hook position, lymph drainage will be applied first to the neck and then to the abdomen. After the stimulation of the central lymph nodes, the lymph circulation will be increased by stimulating the axillary lymph nodes of the relevant region. First, the proximal part will be drained and it will be advanced towards the distal. Drainage will be repeated depending on the edema at the distal forearm-wrist level.<br>Other: Splint treatment<br>* The splint routinely given to patients diagnosed with mild to moderate carpal tunnel syndrome will be given to both groups in these patients<br>|
| Active Comparator: control group<br> | Other: Splint treatment<br>* The splint routinely given to patients diagnosed with mild to moderate carpal tunnel syndrome will be given to both groups in these patients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pressure pain threshold | Each evaluation will be repeated 3 times with 10 seconds between measurements, and the data will be recorded by taking the average of the last two measurements (15). The patients will be evaluated by measuring the transverse carpal ligament, radioulnar joint and extensor digitorum muscle with an algometer before and at the end of the treatment. measurements will be recorded in kg/cm2 | 15 minutes | 
| Boston Carpal Tunnel Questionnaire (BCTQ) | BCTQ, a self-report measure of CTS, evaluates two domains: 1. The symptom severity scale (BCTQSS) has 11 items that assess pain, paresthesia, and weakness. 2. The functional status scale (BCTQ-FS) evaluates the ability to perform manual activities with 8 items. Each item evaluates the increasing severity of symptoms or difficulty with a high score. | 10 minutes | 
| Electrodiagnostic evaluation | Median motor nerve latency, median motor nerve conduction velocity, compound muscle action potential amplitude will be measured at both levels. Median sensory nerve conduction studies will be performed by antidromic recording with a superficial electrode from the 3rd finger and a stimulus will be given from the wrist 14 cm proximal. Median sensory nerve latency, median sensory nerve conduction velocity and sensory nerve action potential will be calculated for both applications. nerve potentials will be calculated in m/sec | 15 minutes |