Effect of Neural Mobilisation Versus Nerve and Tendon Gliding Exercises in Carpal Tunnel Syndrome: A Randomised Clinical Trial

ABSTRACT Introduction: Neural mobilisation versus nerve and tendon gliding exercises are a treatment technique that may improve symptoms related to Carpal Tunnel Syndrome (CTS). Aim: To find whether the neural mobilisation and nerve and tendon gliding exercises are effective or not on pain and functional status in individuals diagnosed with CTS and to find which treatment technique is more effective. Materials and Methods: In this randomised clinical trial, Sixty hands diagnosed with mild to moderate CTS clinically as well as electrophysiologically were selected from Physiotherapy Out-Patient Department of the Shree Krishna Hospital, Karamsad from October 2014 to April 2015 and randomly assigned into 2 groups. Group A was given Ultrasound, Neural mobilisation and night splinting. Group B was given Ultrasound, nerve and tendon gliding exercises and night splinting. Assessments were done prior and at the end of twelve sessions for all treatment of both the groups. The subjects were assessed in terms of Symptom Severity Scale and Functional Severity Scale as subjective outcome measures. Objective outcome measures comprised of Grip strength, Pinch strength and two point discrimination. Normalcy of data was checked through Kolmogorov-Smirnov test. Baseline homogeneity for outcome measures was established by unpaired t-test. Paired t-test was used for intra-group analysis and unpaired t-test was used for inter-group analysis and p-value was set at less than 0.05. Statistical power was set at 0.80. Results: All the outcome measures in intra-group analysis for both the groups showed significant improvements. Inter-group analysis proved that neural mobilisation is more effective in terms of reduction of symptom severity, improvement in functional status, grip strength and pinch strength than nerve and tendon gliding exercises except two point discrimination (p<0.05). Conclusion: Neural mobilisation and nerve and tendon gliding exercises are effective in treating CTS and reducing associated disability. Neural mobilisation is more effective than nerve and tendon gliding exercises in terms of improvement.