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    The effectiveness of mobilization with movement on patients with mild and moderate carpal tunnel syndrome: A single-blinded, randomized controlled study
    (Hanley & Belfus-Elsevier Inc, 2023) Ceylan, Ismail; Buyukturan, Oznur; Aykanat, Omer; Buyukturan, Buket; Sas, Senem; Ceylan, Mehmet Fethi
    Study design: Single-blinded, randomized controlled study. Introduction: Carpal Tunnel Syndrome (CTS) causes pain and loss of function in the affected hand. The mobilization with movement (MWM) technique is a manual therapy method applied to correct joint movement limitation and to relieve pain and functional disorders. Purpose of the study: This study aimed to examine the effectiveness of MWM technique on pain, grip strength, range of motion, edema, hand reaction, nerve conduction, and functional status in patients with CTS. Methods: A total of 45 patients enrolled in the study. The MWM group ( n = 18) completed a 4-week combined conservative physiotherapy and MWM program, whereas the control group ( n = 18) received only the 4 weeks of conservative physiotherapy. Pain severity according to the numerical rating scale was used as primary outcome. Results: We found an improvement within the subjects in resting pain (MWMG:5.1 +/- 3.6 vs 1.1 +/- 2.4, Effect Size (ES) = 1.3; CG:4.5 +/- 3.3 vs 1.0 +/- 2.2, ES = 1.1), in activity pain (MWMG:6.5 +/- 3.7 vs 1.1 +/- 2.4, ES = 1.5; CG:4.8 +/- 3.4 vs 2.2 +/- 2.3, ES = 1) and in night pain (MWMG:5.9 +/- 3.2 vs 1.8 +/- 2.5, ES = 1.2; CG:5.3 +/- 4.2 vs +/- 2.3 +/- 3.5, ES = 0.9). For between the groups, a statistical difference was found for the activity pain, Disabilities of the Arm Shoulder and Hand Questionnaire score (MWMG:52.2 +/- 23.8 vs 27 +/- 24.7, ES = 1.3; CG:47.0 +/- 24.8 vs 41.5 +/- 22.1, ES = 0.2), Michigan Hand Outcomes Questionnaire (MHQ-1), (MWMG:44.4 +/- 23.7 vs 74.7 +/- 24.5, ES = 1.3; CG:44.8 +/- 17.4 vs 57.4 +/- 21.7, ES = 0.9) and MHQ-5 (MWMG:68.8 +/- 13.1 vs 82.5 +/- 11.5, ES = 0.9; CG:63.4 +/- 26.7 vs 59.3 +/- 25.8, ES = 0.1) parameters in favour of MWM group. Discussion: This study showed that MWM compared to conservative physiotherapy might be more effective in reducing perceived symptoms in mild and moderate CTS patients. Conclusions: MWM produced a small benefit to recovery of activity pain and upper extremity functionality level outcomes of patients with mild to moderate CTS when added to a traditional CTS physical therapy program. (c) 2023 Elsevier Inc. All rights reserved.

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