Effects of a preoperative neuromobilization program offered to individuals with carpal tunnel syndrome awaiting carpal tunnel decompression surgery: A pilot randomized controlled study |
| |
| Authors: | Philippe Paquette Johanne Higgins Michel Alain Danino Patrick Harris Martin Lamontagne Dany H. Gagnon |
| |
| Affiliation: | 1. Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada;2. School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada;3. Department of Surgery, Centre Hospitalier de l’Université de Montréal, Montreal, Canada;4. Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l’Université de Montréal, Montreal, Canada;1. Occupational Therapy Department, Department of Rehabilitation Medicine, Brooke Army Medical Center, Sam Houston, TX, USA;2. Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, Sam Houston, TX, USA;3. Extremity Trauma and Amputation Center of Excellence, Sam Houston, TX, USA;4. Army Baylor Doctor of Science in Occupational Therapy Program, Center for the Intrepid, Brooke Army Medical Center, Sam Houston, TX, USA;5. Central Jersey Hand Surgery, Eatontown, NJ, USA;6. Department of Orthopaedics, Brooke Army Medical Center, Sam Houston, TX, USA;1. Occupational Therapy Department, Gannon University, Ruskin, FL, USA;2. Department of Occupational Therapy, Hand Surgery Associates, Olyphant, PA, USA;1. Department of Occupational Therapy, Monash University, Peninsula Campus, Frankston, Victoria, Australia;2. Department of Occupational Therapy, Alfred Health, Melbourne, Victoria, Australia;1. Department of Kinesiotherapy and Special Physiotherapy Methods, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland;2. Department of Physiotherapy, The Academy of Business, D?browa Górnicza, Poland;3. Department of Physiotherapy in Diseases of Internal Organs, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland |
| |
| Abstract: | ![]()
Study DesignPilot randomized controlled trial with parallel groups.IntroductionEngaging individuals with carpal tunnel syndrome (CTS) awaiting carpal tunnel decompression surgery in a preoperative rehabilitation program may mitigate pain and sensorimotor impairments, enhance functional abilities before surgery, and improve postoperative outcomes.Purpose of the StudyTo assess the feasibility and the efficacy of a novel preoperative neuromobilization exercise program (NEP).MethodsThirty individuals with CTS were randomly allocated into a four-week home-based neuromobilization exercise group or a standard care group while awaiting surgery. Outcome measures included feasibility (ie, recruitment, attrition, adherence, satisfaction, and safety) and efficacy metrics (ie, median nerve integrity and neurodynamics, tip pinch grip, pain, and upper limb functional abilities) collected before (ie, at the baseline and about four weeks later) and four weeks after surgery.ResultsThirty individuals with CTS were recruited (recruitment rate = 11.8%) and 25 completed the study (attrition rate = 16.7%). Adherence (94%) and satisfaction with the program (eg, enjoy the exercises and likeliness to repeat the NEP (≥4.2/5) were high and no serious adverse event was reported. NEP-related immediate pre- and post-surgery beneficial effects on pain interference were documented (P = .05, η2 = .10), whereas an overall increased neurodynamics (P = .04, η2 = .11) and decreased pain severity (P = .01, η2 = .21) were observed.DiscussionEngaging in the proposed NEP has limited beneficial effect as a stand-alone intervention on pre- and post-surgery outcomes for individuals with CTS. Expanding the program’s content and attribute by adding other components including desensitization maneuvers and novel therapies promoting corticospinal plasticity is recommended.ConclusionA preoperative NEP completed by individuals with CTS awaiting surgery is feasible, acceptable, and safe. However, given the limited beneficial effectsof the program, revision of its content and attributes is recommended before proceeding to large-scale trials. |
| |
| Keywords: | Carpal tunnel syndrome Exercise therapy Physical therapy Rehabilitation Ultrasonography |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
