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

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.

A comparative study on tendon transfer surgery in patients with radial nerve palsy.

BACKGROUND: Lesions in peripheral nerves are highly prevalent in the upper extremity. The present study compares different tendon transfer surgeries in patients with radial nerve palsy. METHODS: Fifty patients with radial nerve palsy were randomly selected among patients who referred to Tehran 15(th) Khordad Hospital during 2006-2011. They were divided into two groups of 17 and 33 subjects. Single tendon transfer surgery was performed on 33 and ternary tendon transfer surgery on 17 patients and were compared. RESULTS: No significant difference was noticed in the range of motion of metacarpophalangeal joint, proximal interphalangeal joint and distal interphalangeal joint joints between the two groups. There was also no significant difference in the results of single tendon and ternary tendon transfer surgeries between the two groups. There was no need to sacrifice three tendons in tendon transfer surgeries on patients with radial nerve palsy. CONCLUSION: Single tendon transfer surgery may help establishing a finger extension while indicates to its considerable advantages of surgical simplicity, shorter surgery time, less complications and surgery scars.