Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 26433
  Title Peripheral and central adaptations after a median nerve neuromobilization program completed by individuals with carpal tunnel syndrome: An exploratory mechanistic study using musculoskeletal ultrasound imaging and transcranial magnetic stimulation
Journal J Manipulative Physiol Ther. 2020 Jul-Aug;43(6):566-578
Peer Review Yes
Publication Type Article

Objective: Neuromobilization exercises are increasingly advocated in the conservative management of individuals with carpal tunnel syndrome (CTS), as they may mitigate CTS-related signs and symptoms via potential peripheral (ie, musculoskeletal) and central (ie, neurophysiological) adaptations. However, the mechanisms underlying these adaptations have not been studied extensively. Hence, this exploratory and mechanistic study aims to evaluate the potential peripheral and central adaptations that may result in individuals with CTS who have completed a neuromobilization program.

Methods: Fourteen individuals with CTS were evaluated before and 1 week after the completion of a 4-week neuromobilization program that incorporated median nerve sliding exercises. Pain and upper limb functional abilities were assessed using standardized questionnaires. The biological integrity and mechanical properties of the median nerve and the corticospinal excitability were quantified using musculoskeletal ultrasound imaging and transcranial magnetic stimulation, respectively.

Results: Upon completion of the program, participants reported both large and moderate improvements in pain (P ≤ .03) and upper limb functional abilities (P = .02), respectively. The biological integrity and mechanical properties of the median nerve remained unchanged (P ≥ .22), whereas a small significant increase in corticospinal excitability (P = .04) was observed.

Conclusion: The proposed neuromobilization program appears promising to improve pain and upper limb functional abilities in individuals with CTS. These improvements may be preferentially mediated via central, rather than peripheral, adaptations. Future studies, especially with a larger sample size, longer intervention duration, and additional measurement times, are needed to strengthen current evidence.

Author keywords: Carpal Tunnel Syndrome; Pain; Exercise Therapy; Wrist; Physical Therapy Modalities

Author affiliations: School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada.

This abstract is reproduced with the permission of the publisher; full text is available by subscription. Click on the above link and select a publisher from PubMed's LinkOut feature.


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