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The Influence of Physiotherapy on the Range of Motion and Kinesthetic Sensation of Movement in the Radiocarpal Articulation in Patients with Carpal Tunnel Syndrome

Tomasz Wolny, Edward Saulicz, Pawe? Linek, Andrzej Myśliwiec and Adam Zajac

Background: Range of motion (ROM) and kinesthetic differentiation of movement (KDM) significantly influence hand functions during work and while performing everyday activities. Because to date ROM and KDM in carpal tunnel syndrome (CTS) patients and its changes following different forms of physiotherapy have not been thoroughly assessed, they became the objective of our study. The aim was to assess the influence of two physiotherapeutic programs on the ROM and KDM in patients with CTS.

Methods: 140 people participated in the experiment, including 122 (87,15%) women and 18 (,85%) men. Each person who was not excluded and fulfilled the inclusion criteria to the study was randomly assigned to a group rehabilitated by means of either manual therapy including neurodynamic techniques (MT) or physical therapy including electrophysical modalities (EM). ROM and KDM were assessed. The therapy in MT group was based on manual therapy including neurodynamic techniques and in the EM group on laser therapy and ultrasounds.

Results: Statistically significant improvement was observed in flexion and extension ROM in upper extremities with CTS only in the MT group (p<0.001). Similar effects were obtained in KDM. Similar results distribution occurred while comparing extremities with CTS and healthy extremities. Statistically significant improvement in assessment of ROM and KDM were observed only in the MT group (p<0.001).

Conclusions: Therapeutic program using manual therapy including neurodynamic techniques improves ROM and KDM in patients with CTS. The cycle of therapy improved the status of symptomatic limbs. A decreased difference in terms of ROM and KDM in the symptomatic limb in relation to the asymptomatic limb was observed.