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Improving Symptoms, Pain, Functioning, and Strength for Persons with Carpal Tunnel Syndrome

Journal: The Journal of the American Osteopathic Association Date: 2006/08, 106(8):Pages: 486. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2006.106.8.471/html)

Keywords:

carpal tunnel syndrome [27]
OMT [3102]
osteopathic manipulative treatment [3124]
randomized controlled trial [766]

Abstract:

Purpose: The purpose of this study was to examine whether OMT could reduce symptoms, improve functioning, decrease pain, and improve strength in persons with CTS. Hypothesis 1: OMT will decrease symptom severity and pain. Hypothesis 2: OMT will improve daily functioning and strength. Methods: Subjects (N=32) between 21 and 70 with confirmed diagnosis of CTS based on Nerve Conduction Studies (NCS), who had none of the medical exclusions consented and were randomized to two groups (OMT and Control). OMT group received one treatment, Control group received one sub-therapeutic ultrasound treatment. Power analysis called for 19 subjects per group. Symptom severity and functional status were self-reported using the Levine scales for CTS. Pain was measured with the visual analog scale. Grip strength was tested using a Jamar Dynamometer. Based on the literature, the average of three scores taken at each visit for grip strength, key pinch strength, tripod pinch strength, and tip pinch strength was used for the analysis. Outcome measures were taken at entry to the study, mid point, and after the last treatment session. Results: The OMT treatment group had complete data for 14 subjects, and the control group 18. The groups were similar in composition on gender, age, and body mass index (BMI). BMI correlated with symptom severity scores (r 0.392, P=.035) and functional status scores (r 0.379, P=.043). Baseline nerve conduction studies for median motor latencies (MML) differed significantly between groups (P=.047), and MML was related to symptom (r 0.437, P=.014) and function scores (r 0.418, P=.019). The OMT group reported significantly improved functioning at the end of the trial (P=0.019) but between group changes were not significant. For the OMT group, grip strength changed significantly (P=.013). The control group made significant improvement in pinch and tripod pinch strength (P=.034). Conclusions: This RCT was exploratory and preliminary; limited by a small sample size. This study, however, provided statistical support for trends in the efficacy of OMT for CTS and supported a successful R21 proposal to the NIH-NCCAM for a three year RCT for OMT in CTS patients.


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