Investigation of the Effectiveness of Cervicothoracic Exercises in Individuals With Carpal Tunnel Syndrome

Condition(s) studied

Investigational drug(s) / intervention(s)

Conventional Physiotherapy Group: Participants will receive a conventional physiotherapy program consisting of transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, median nerve mobilization, wrist range-of-motion exercises, and hand strengthening exercises. TENS will be applied using sensory-level stimulation without muscle contraction. Therapeutic ultrasound will be delivered over the carpal tunnel region using standard clinical parameters. Median nerve mobilization and wrist exercises will be performed under physiotherapist supervision. The treatment will be administered five days per week for six weeks.

Cervicothoracal Exercise Group: Participants will receive cervicothoracic exercises in addition to the same conventional physiotherapy program. The cervicothoracic exercise program will include cervical mobility exercises, scapular stabilization, and thoracic spine mobility exercises designed to improve proximal neural mechanics and upper limb function. All interventions will be supervised by a physiotherapist and applied five days per week for six weeks.

Study summary

This randomized, parallel-group controlled clinical trial aims to investigate the effects of adding cervicothoracic exercises to conventional physiotherapy on pain, functional status, grip strength, and range of motion in individuals with carpal tunnel syndrome (CTS). CTS is a common compressive neuropathy of the median nerve, characterized by pain, numbness, tingling, nocturnal symptoms, and reduced hand function. Sixty adults diagnosed with CTS will be randomly allocated into two groups (n=30 each): a conventional physiotherapy group and a cervicothoracic exercise plus conventional physiotherapy group.

The conventional physiotherapy program includes transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, median nerve mobilization, wrist range-of-motion exercises, and strengthening exercises. The intervention group will receive the same conventional physiotherapy program in addition to cervicothoracic exercises targeting cervical mobility, scapular stabilization, and thoracic spine mobility. The intervention will be applied five days per week for six weeks.

Outcome measures will be assessed at baseline and at the end of week 6. Primary outcomes include pain intensity measured by the Visual Analog Scale (VAS), functional status assessed using the Boston Carpal Tunnel Questionnaire (BCTQ), and grip strength measured with a Jamar hand dynamometer. Secondary outcomes include upper extremity function evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and wrist and finger range of motion measured with a goniometer. Data will be analyzed using appropriate statistical methods, with statistical significance set at p\<0.05. This study aims to determine whether adding cervicothoracic exercises to conventional physiotherapy provides additional clinical benefits in CTS rehabilitation.

Eligibility

Primary outcome measure(s)

• Boston Carpal Tunnel Syndrome Questionnaire — Assessment will be taken initially and after the intervention (for 6 weeks, 5 days a week).
  This questionnaire will be used to measure hand and wrist symptom and function scores in carpal tunnel syndrome. The scale consists of two sub-sections: Symptom Severity and Functional Status. The Symptom Severity Scale evaluates symptoms such as pain, numbness, tingling, and nighttime awakenings, while the Functional Status Scale measures difficulties in daily living activities such as writing, grasping, and carrying objects. Each item is scored between 1 (no complaints) and 5 (very severe complaints); higher scores indicate more symptoms and functional limitations.
• Visual Analog Scale — Assessment will be taken initially and after the intervention (for 6 weeks, 5 days a week).
  The Visual Analog Scale will be used to assess pain. The Visual Analog Scale is a measurement tool that allows individuals to subjectively assess the intensity of their pain, defined by endpoints of "0 = no pain" and "10 = unbearable pain" on a 10 cm long horizontal line. Participants are asked to mark the point on this line that corresponds to the intensity of the pain they feel. A higher score indicates more severe pain.

Trial sites (2)

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