Efficacy of Sensory Re-Education Paradigm on Functional Outcomes in Patients with Carpal Tunnel Syndrome

Abstract

Background: Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy due to compression of the median nerve as it travels through the wrist at the carpal tunnel. Aim of Study: The aim of the study was to investigate the efficacy of sensory re-education paradigm on functional outcomes of patients with carpal tunnel syndrome. Subjects and Methods: Thirty participants was be randomly assigned to either the sensory re-education paradigm group or the traditional physical therapy group. First group (control group), the patients received standard physical therapy program including progressive active and resisted therapeutic exercises, median nerve gliding exercises and tendon gliding exercises. Second group (experimental study group), the patients received sensory re-education paradigm as the followings; Step 1: Splinting as a constant maintained touch for fifteen minutes, Step 2: Topical anesthesia for pain reduction by using 8% Lidocaine spray for 15 minutes, Step 3: Massage using different textures; graduating from the softest to rougher one with same speed and pressure, Step 4: Proprioceptive Neuromuscular Facilitation (PNF) technique using extension, adduction and internal rotation with extended elbow pattern. Sensory function was assessed by Semmes-Weinstein monofilament, pain intensity level was assessed by a Visual Analogue Scale (VAS), hand grip was assessed by using hand held dynamom-eter and functional outcomes were assessed by using Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Results: There was a statistically significant improvement in the measured parameters in both groups when comparing their pre and post-treatment mean values. However, significant difference was recorded between the two groups after treatment in favor of the study group. Conclusion: The obtained results suggest that the appli-cation of sensory re-education paradigm become a beneficial therapeutic technique in improving the functional outcomes as a whole in patients with CTS when adjunct to a physical therapy program.