About this trial

The aim of this study is to investigate whether the addition of Graded Motor Imagery (GMI) to progressive neurodynamic exercises is more effective than progressive neurodynamic exercises alone in individuals with carpal tunnel syndrome (CTS). The objectives are to reduce pain and symptom severity, improve pain, sensorimotor function, physical performance, and grip strength through the addition of GMI.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

mild to moderate unilateral CTS based on the Bland classification of electrodiagnostic testing ;

positive Phalen or Tinel tests;

symptoms such as paresthesia and pain associated with CTS that last longer than 3 months;

patients aged 30-60 years (when CTS becomes more prevalent);

Disqualifiers

bilateral CTS;

history of prior CTS surgery;

clinical indicators of cervical radiculopathy or polyneuropathy;

pregnancy or cognitive impairment;

Trial design

Design model

Parallel

Treatments tested in this trial

Graded Motor Imagery (GMI)
Other intervention
GMI includes three stages. GMI program will span over 6 weeks. The first 2 weeks will focus on lateralization, followed by 2 weeks of motor imagery, and the final 2 weeks will involve mirror therapy. Lateralization: Patients will be asked to differentiate whether the hands shown in the Recognise™ Hand application belongs to the right or left side of their body. Motor Imagery: Patients will be instructed to imagine slowly and smoothly moving their affected extremities to the posture depicted in the photos in the Recognise™ Hand application and then returning to the starting position. Mirror Therapy: Using a mirror measuring 300 x 300 x 300 mm³ placed between the upper extremities, patients will be instructed to progressively move only their unaffected extremity, then their affected extremity, and finally both extremities.
Progressive Neurodynamic Exercise
Other intervention
The progressive neurodynamic exercises involved holding each position for 5 seconds. Each session included two sets of 10 repetitions (2×10). The treatment lasted for 30-minute sessions, conducted twice weekly over a total of 6 weeks.
Nighttime Resting Splint
Other intervention
The night splint was fitted with a wrist splint that keeps the wrist in a neutral position, permits finger flexion, maintains the wrist within a 0°-5° extension range, and ends just distal to the distal palmar crease.

Treatment groups

46 Participants

are divided into 2 treatment groups

Group A: Graded Motor ImageryExperimental treatment 3 interventions

Group B: Progressive Neurodynamic ExercisesActive comparator 2 interventions

Trial outcomes

Primary outcomes

1

Disabilities of the Arm, Shoulder, and Hand (DASH)

DASH is a 30-item self-report tool assessing upper-extremity disability and symptoms, including daily activities, pain, numbness, joint stiffness, weakness, sleep issues, and psychological effects. Examples include turning a doorknob, changing a light bulb, and cutting food. Scores range from 0 to 100; higher scores indicate more severe symptoms and impairment.

Time frame

Baseline

2

Disabilities of the Arm, Shoulder, and Hand (DASH)

DASH is a 30-item self-report tool assessing upper-extremity disability and symptoms, including daily activities, pain, numbness, joint stiffness, weakness, sleep issues, and psychological effects. Examples include turning a doorknob, changing a light bulb, and cutting food. Scores range from 0 to 100; higher scores indicate more severe symptoms and impairment.

Time frame

After the 6-week intervention

Secondary outcomes

1

Mini Mental State Examination

The Mini-Mental State Examination (MMSE) will be used to assess the cognitive status of patients. It consists of 11 questions and is evaluated on a scale of 30 points. A score between 24-30 is considered normal, 18-23 indicates mild cognitive impairment, and a score of 17 or below is indicative of severe dementia. The MMSE assesses orientation, memory, attention, calculation, recall, language, motor function, perception, and visuospatial abilities.

Time frame

Baseline

2

Mini Mental State Examination

The Mini-Mental State Examination (MMSE) will be used to assess the cognitive status of patients. It consists of 11 questions and is evaluated on a scale of 30 points. A score between 24-30 is considered normal, 18-23 indicates mild cognitive impairment, and a score of 17 or below is indicative of severe dementia. The MMSE assesses orientation, memory, attention, calculation, recall, language, motor function, perception, and visuospatial abilities.

Time frame

After the 6-week intervention

3

Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)

A patient-reported assessment uses a 5-point Likert scale with two subscales: the 11-item Symptom Severity Scale (CTSQ-S) for symptom intensity like numbness and pain, and the 8-item Functional Status Scale (CTSQ-F) for ADL ability such as writing and dressing. Higher scores mean more severe symptoms and impairment. The BCTQ shows high reliability, validity, and sensitivity to clinical changes.

Time frame

Baseline

4

Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)

A patient-reported assessment uses a 5-point Likert scale with two subscales: the 11-item Symptom Severity Scale (CTSQ-S) for symptom intensity like numbness and pain, and the 8-item Functional Status Scale (CTSQ-F) for ADL ability such as writing and dressing. Higher scores mean more severe symptoms and impairment. The BCTQ shows high reliability, validity, and sensitivity to clinical changes.

Time frame

After the 6-week intervention

Locations

This trial has no locations.

Graded Motor Imagery in Carpal Tunnel Syndrome

About this trial

Eligibility criteria

Qualifiers

Disqualifiers

Trial design

Treatments tested in this trial

Treatment groups

Trial outcomes

Primary outcomes

Secondary outcomes

Other outcomes

Locations

Sponsors and contacts