School of Physical Therapy and Rehabilitation, Kirsehir Ahi Evran University, Kirsehir, Turkey.
School of Physical Therapy and Rehabilitation, Kirsehir Ahi Evran University, Kirsehir, Turkey.
J Hand Ther. 2023 Oct-Dec;36(4):773-785. doi: 10.1016/j.jht.2023.02.004. Epub 2023 Aug 11.
Single-blinded, randomized controlled study.
Carpal Tunnel Syndrome (CTS) causes pain and loss of function in the affected hand. The mobilization with movement (MWM) technique is a manual therapy method applied to correct joint movement limitation and to relieve pain and functional disorders.
This study aimed to examine the effectiveness of MWM technique on pain, grip strength, range of motion, edema, hand reaction, nerve conduction, and functional status in patients with CTS.
A total of 45 patients enrolled in the study. The MWM group (n = 18) completed a 4-week combined conservative physiotherapy and MWM program, whereas the control group (n = 18) received only the 4 weeks of conservative physiotherapy. Pain severity according to the numerical rating scale was used as primary outcome.
We found an improvement within the subjects in resting pain (MWMG:5.1 ± 3.6 vs 1.1 ± 2.4, Effect Size (ES)=1.3; CG:4.5 ± 3.3 vs 1.0 ± 2.2, ES=1.1), in activity pain (MWMG:6.5 ± 3.7 vs 1.1 ± 2.4, ES=1.5; CG:4.8 ± 3.4 vs 2.2 ± 2.3, ES=1) and in night pain (MWMG:5.9 ± 3.2 vs 1.8 ± 2.5, ES=1.2; CG:5.3 ± 4.2 vs ± 2.3 ± 3.5, ES=0.9). For between the groups, a statistical difference was found for the activity pain, Disabilities of the Arm Shoulder and Hand Questionnaire score (MWMG:52.2 ± 23.8 vs 27 ± 24.7, ES=1.3; CG:47.0 ± 24.8 vs 41.5 ± 22.1, ES=0.2), Michigan Hand Outcomes Questionnaire (MHQ-1), (MWMG:44.4 ± 23.7 vs 74.7 ± 24.5, ES=1.3; CG:44.8 ± 17.4 vs 57.4 ± 21.7, ES=0.9) and MHQ-5 (MWMG:68.8 ± 13.1 vs 82.5 ± 11.5, ES=0.9; CG:63.4 ± 26.7 vs 59.3 ± 25.8, ES=0.1) parameters in favour of MWM group.
This study showed that MWM compared to conservative physiotherapy might be more effective in reducing perceived symptoms in mild and moderate CTS patients.
MWM produced a small benefit to recovery of activity pain and upper extremity functionality level outcomes of patients with mild to moderate CTS when added to a traditional CTS physical therapy program.
单盲、随机对照研究。
腕管综合征（CTS）会导致手部疼痛和功能丧失。运动松动术（MWM）是一种用于纠正关节运动受限、缓解疼痛和功能障碍的手动治疗方法。
本研究旨在探讨 MWM 技术对 CTS 患者疼痛、握力、活动范围、水肿、手部反应、神经传导和功能状态的影响。
共有 45 名患者入组本研究。MWM 组（n=18）完成了为期 4 周的联合保守物理治疗和 MWM 方案，而对照组（n=18）仅接受了 4 周的保守物理治疗。根据数字评分量表评估的疼痛严重程度为主要结局。
我们发现，与治疗前相比，MWM 组患者的静息疼痛（MWMG：5.1 ± 3.6 对 1.1 ± 2.4，效应量（ES）=1.3；CG：4.5 ± 3.3 对 1.0 ± 2.2，ES=1.1）、活动时疼痛（MWMG：6.5 ± 3.7 对 1.1 ± 2.4，ES=1.5；CG：4.8 ± 3.4 对 2.2 ± 2.3，ES=1）和夜间疼痛（MWMG：5.9 ± 3.2 对 1.8 ± 2.5，ES=1.2；CG：5.3 ± 4.2 对 1.5 ± 2.3，ES=0.9）均有所改善。在组间比较中，活动时疼痛、手臂肩手功能障碍问卷评分（MWMG：52.2 ± 23.8 对 27 ± 24.7，ES=1.3；CG：47.0 ± 24.8 对 41.5 ± 22.1，ES=0.2）、密歇根手功能问卷（MHQ-1）（MWMG：44.4 ± 23.7 对 74.7 ± 24.5，ES=1.3；CG：44.8 ± 17.4 对 57.4 ± 21.7，ES=0.9）和 MHQ-5（MWMG：68.8 ± 13.1 对 82.5 ± 11.5，ES=0.9；CG：63.4 ± 26.7 对 59.3 ± 25.8，ES=0.1）参数均有利于 MWM 组。
本研究表明，与保守物理治疗相比，MWM 可能更有效地减轻轻度和中度 CTS 患者的症状。
当 MWM 技术加入到传统 CTS 物理治疗方案中时，对于轻度至中度 CTS 患者的活动时疼痛和上肢功能水平的恢复，MWM 有轻微的益处。
