The Effect of Activity-based Sensory Reeducation Training on Symptom Severity in Patients with Carpal Tunnel Syndrome: A Randomized Controlled Study

Abstract Background: Carpal tunnel syndrome (CTS) is one of the most common types of entrapment neuropathies of the upper extremities caused by compression of the median nerve at the wrist level resulting in somatosensory deficits in the thumb, index, middle, and lateral half of the ring finger and in severe cases motor deficits in the thumb. The somatosensory system is crucial for sensorimotor integration, and sensory loss can have an impact on hand motor activities. The improvement in symptoms has also been seen to improve motor functions. As a result, it is reasonable to believe that the hand sensation and the severity of the symptoms are associated. Objectives: The objective of the study was to evaluate the effect of activity-based sensory reeducation training on symptom severity in patients with CTS using an “active cognitive approach”. Study Design: This was a randomized controlled study. Methods: A total of 30 CTS patients aged 20–60 years participated and were randomly assigned into two groups: Group 1 (experimental group) received sensory reeducation protocol for 20 min/session and repeated the same at home with traditional therapeutic exercises for 40 min/session a day till 4 weeks and Group 2 (control group) received only traditional therapeutic exercises (median nerve gliding, tendon gliding, and proximal conditioning exercises) for 1 h/session a day till 4 weeks. The assessment was done pre- and posttreatment using the Semmes Weinstein monofilament (SWM) test to measure the sensory threshold and symptom severity scale of the Boston Carpal Tunnel Questionnaires to measure the symptom severity of the affected hand. Results: Patients’ scores were analyzed in the experimental group ( n = 15) and control group ( n = 13). There was a statistically significant improvement in sensory threshold and symptom severity in the experimental group posttreatment. Significant result (test value = 2.712, P = 0.007, 95% confidence interval = 0.095–0.385) was seen in symptom severity scores, with a mean difference score of 0.68 ± 0.22 in the experimental group when compared with the control group of 0.44 ± 0.17. Between the groups, sensory threshold showed significant improvement in all the components of SWM. Conclusions: Activity-based sensory reeducation training along with traditional therapeutic exercises leads to significant improvement in symptom severity in patients with CTS.