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Physiologic and Anatomic Changes in Carpal Tunnel Syndrome: Is Osteopathic Manipulative Treatment an Effective Non-surgical Alternative Therapy?

Journal: The Journal of the American Osteopathic Association University of North Texas Health Science Center, Date: 2004/08, 104(8):Pages: 339. doi: Subito , type of study: pretest posttest design

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2004.104.8.337/html)

Keywords:

carpal tunnel syndrome [27]
OMT [3102]
osteopathic manipulative treatment [3124]
physiology [34]
pretest posttest design [140]
wrist [12]

Abstract:

Objective: Carpal tunnel syndrome (CTS), caused by compression of the median nerve within the carpal tunnel, affects up to 10% of the adult population in the United States with medical costs exceeding $2 billion annually. The goal of this blinded clinical trial is to assess physiologic and anatomic changes in a treatment compared to a placebo group in subjects with CTS using nerve conduction studies (NCS) and magnetic resonance imaging (MRI). Methods: A power analysis called for 25 subjects in each treatment group. Eligibility criteria include adults between 21 and 70 with a clinical diagnosis of CTS and increased latency in the median nerve on NCS. Outcome measures are Median motor and sensory nerve conduction distal latencies, carpal tunnel AP and transverse dimension, cross sectional area, and edema within the carpal tunnel and median nerve. Subjects receive six treatments, NCS occur at baseline, the fourth treatment, and one week following the last treatment. A MRI of the wrist is taken pre and post treatment protocol. Results: Twenty-four subjects have completed the study to date. Preliminary results indicate a significant improvement (p<0.05) in median nerve motor distal latency of the treatment group compared to placebo group using ANOVA repeated measures analysis. No significant improvement has been found in the other median nerve distal latencies. Further data analysis of NCS is pending data entry and further subject recruitment. Analysis of the MRI studies is pending data collection by the radiologist and further subject recruitment. Conclusions: As an initial, exploratory study of the utility of repeated NCS to detect changes in nerve conduction and MRIs to detect anatomic changes and the presence of fluid/edema in the carpal tunnel, this study is promising. At the end of the study in June a more in-depth assessment of the clinical results and the issues related to both placebo effects and outcome measures validity and reliability will be provided.


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