Bilateral vs. Unilateral Neuromobilization in Carpal Tunnel Syndrome
NCT Number: NCT06554405
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Carpal Tunnel Syndrome
Interventions: OTHER: Unilateral Intervention|OTHER: Bilateral Intervention
Sponsor: Gazi University
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 44
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (OUTCOMES_ASSESSOR)|Primary Purpose: TREATMENT
Start Date: 2024-07-12
Completion Date: 2025-01-20
Locations: Gazi University Faculty of Health Sciences, Ankara, Turkey

Summary:
This study aims to investigate whether bilateral (both extremities together) neuromobilization is superior to unilateral (only the affected side) neuromobilization in individuals diagnosed with Carpal Tunnel Syndrome.

Primary Outcome Measures: Visual Analog Scale (VAS), The Visual Analog Scale (VAS) will be used for pain assessment. The individual will make a mark on a 10-centimeter horizontal line, where 0 indicates no pain and 10 indicates maximum pain. This marking will be done separately for both rest and activity periods. The data will be recorded in centimeters., Four weeks
Secondary Outcome Measures: Light Touch and Pressure Sense, Light touch and pressure assessment will be performed using the Semmes-Weinstein Monofilament test. This test kit contains five filaments ranging from 2.83 (0.07 grams of force) to 6.65 (300 grams of force). These filaments are applied to the skin. During the assessment, the individual should not see the filament. First, the unaffected side is assessed, followed by the affected side. During the evaluation, the filament is applied to the skin at a 90-degree angle and held for 1.5 seconds. The application sites for the median nerve are the pulp of the first finger and the pulp of the second finger. The patient is asked if they can feel the filament and should respond with "yes" or "no." The evaluation starts with the lowest filament, 2.83, which represents normal sensation. If the patient responds "yes," their sensation is recorded as normal. If not, progressively higher-value filaments are used until a "yes" response is obtained., Four weeks|Gross Grip Strength, For gross grip strength measurement, a hydraulic hand dynamometer (Baseline®, USA) will be used. The measurement will be conducted in the standard position specified by the American Society of Hand Therapists. In this position, the individual will sit on a chair with back support, with the elbow at 90 degrees of flexion and the wrist in a neutral position. The person will be asked to squeeze the dynamometer with maximum force. The measurement will be repeated three times, and the average will be recorded in kg/f., Four weeks|Pinch Grip Strength, For pinch grip strength measurement, a mechanical pinch meter (Baseline®, USA) will be used. Lateral (key) pinch, two-point (bipod, tip) pinch, and three-point (tripod, palmar) pinch measurements will be performed separately. For the lateral pinch, the patient will be asked to squeeze the end of the pinch meter between the thumb and the lateral surface of the middle phalanx of the second finger with maximum force. For the two-point pinch strength measurement, the patient will be asked to squeeze the pinch meter between the thumb and the pulp of the second finger, and for the three-point pinch strength measurement, between the thumb, the second finger, and the third finger as tightly as possible. Assessments will be conducted bilaterally, starting with the healthy side. The measurements will be repeated three times for each side, and the averages will be recorded in kg/f., Four weeks|Functional Level and Disease Severity Assessment (Boston Carpal Tunnel Syndrome Questionnaire), The Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ), developed in 1993, will be used to assess individuals' functional status and symptoms. The Turkish validity and reliability study of the test has been conducted.. The test consists of two self-assessment sections: one with 11 questions evaluating symptom severity and another with 8 questions evaluating functional capacity. It is a Likert-type questionnaire, where 1 indicates the best condition and 5 indicates the worst condition. The total score is calculated by dividing the total points by the number of questions, resulting in a score between 1 and 5., Four weeks