Effectiveness of Tendon and Nerve Gliding Exercises in the Treatment of Patients With Mild Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial

Abstract

Background: There is limited evidence regarding the efficacy of different treatment options in patients with carpal tunnel syndrome (CTS). This study aimed at assessing the effectiveness of nerve and tendon gliding exercises in the treatment of patients with mild CTS.

Methods: The current prospective, randomized trial with pretest-posttest design was conducted on 80 patients with mild CTS randomly assigned to 2 groups. The treatment group was instructed to perform gliding exercises in addition to the wrist splint use. The control group only used the wrist splint. All the patients were instructed to use the splint at night and during the day if required. Patients were evaluated in terms of clinical parameters (ie, grip and pinch strength). The severity of symptoms and functional status was also determined using the Boston Carpal Tunnel Syndrome Questionnaire. The subjects were followed up for 6 weeks.

Results: There were no significant differences in all parameters between groups. The pretest-posttest analysis showed a statistically significant improvement in subjective and objective parameters in the treatment group. However, in the control group, only a significant improvement was observed in grip strength. Wrist splint use led to a significant change in the severity of symptoms only over the second week.

Conclusions: Both gliding exercise and wrist splint groups showed some improvement in the severity of symptoms and functional status scores. However, the gliding exercises did not offer additional benefit compared with wrist splint alone.

Keywords: carpal tunnel syndrome; conservative treatment; nerve gliding exercises; tendon gliding exercises; wrist splint.

Figure 1.

The study flowchart.

Figure 2.

Tendon gliding exercises. In tendon gliding exercises, fingers are held in 5 positions of (a) straight, (b) hook, (c) fist, (d) tabletop, and (e) long fist.

Figure 3.

Nerve gliding exercises. Note. (a) Wrist in a neutral position, and the fingers and thumb in flexion. (b) Wrist in a neutral position, and the fingers and thumb in extension. (c) Wrist and fingers in extension and the thumb in a neutral position. (d) Wrist, fingers, and thumb in extension. (e) Wrist, fingers, and thumb in extension and the forearm in supination. (f) Mild extension to the exercising thumb by the opposite hand.