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The Effectiveness of Electroacupuncture on Functional Status, Symptom Severity, Pain, and Grip Strength in Patients with Carpal Tunnel Syndrome: Study Protocol for a Randomized Sham-Controlled Trial

Document Type : Original Articles

Authors

1 Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Department of Orthopedics, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Science, Tehran, Islamic Republic of Iran

10.30476/jrsr.2024.100859.1450

Abstract

Background: Carpal Tunnel Syndrome (CTS) is the most common peripheral nerve entrapment condition, impairing median nerve function at the carpal tunnel level. Previous studies indicate a strong patient preference for non-surgical treatment. While some evidence suggests electroacupuncture may promote nerve regeneration and improve functional outcomes, findings remain inconclusive. This study aims to assess the impact of electroacupuncture on symptom severity, functional status, pain, and grip strength in patients with mild to moderate CTS.
Methods: This is a protocol for a randomized, sham-controlled trial. Thirty-eight patients diagnosed with CTS will be randomly assigned to either a treatment group receiving electroacupuncture or a control group receiving sham electroacupuncture. Both groups will undergo ten sessions over five weeks (twice weekly) and receive neurodynamic techniques as standard care. Outcome measures—symptom severity, functional status, pain, and grip strength—will be evaluated at baseline, after the fifth session, 48 hours after the tenth session, and two months post-treatment. This trial is registered at https://www.irct.ir/ (IRCT20191208045652N5) as of 7/12/2022.
Result: Ultimately, the results of this study will provide evidence regarding the efficacy of Electroacupuncture combined with NDT techniques on Symptom Severity, Functional Status, Pain, and Grip strength in patients with Carpal Tunnel Syndrome.
Conclusion: This study will provide insights into the efficacy of electroacupuncture as a treatment for CTS.
 

Keywords

References
  1. Hernández-Secorún M, Montaña-Cortés R, Hidalgo-García C, Rodríguez-Sanz J, Corral-de-Toro J, Monti-Ballano S, et al. Effectiveness of Conservative Treatment According to Severity and Systemic Disease in Carpal Tunnel Syndrome: A Systematic Review. International journal of environmental research and public health. 2021;18(5).
  2. Yassin M, Ahmadi A. Physical therapy for common musculoskeletal disorder. Tehran: Adiban Publication. 2009.
  3. Karimi N, Tabrizi N, Moosavi M, Yadani charatti J. Prevalence of Carpal Tunnel Syndrome and Associated Risk Factors. Journal of Mazandaran University of Medical Sciences. 2017;26(146):179-84.
  4. Moosazadeh M, Asadi-Aliabadi M, Rostami F, Farshidi F, Karimi N. Prevalence of carpal tunnel syndrome in Iran: A systematic review and meta-analysis. Journal of Mazandaran University of Medical Sciences. 2018;28(161):144-53.
  5. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. Jama. 1999;282(2):153-8.
  6. Zhuang T, Kortlever JT, Shapiro LM, Baker L, Harris AH, Kamal RN. The influence of cost information on treatment choice: a mixed-methods study. The Journal of hand surgery. 2020;45(10):899-908. e4.
  7. Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology. 2016;15(12):1273-84.
  8. Ibrahim I, Khan WS, Goddard N, Smitham P. Carpal tunnel syndrome: a review of the recent literature. The open orthopaedics journal. 2012;6:69-76.
  9. Patterson M. Apley's Concise System of Orthopaedics and Fractures (3rd edn). Ann R Coll Surg Engl. 2006;88(4):425-6.
  10. Wolny T, Linek P. The Effect of Manual Therapy Including Neurodynamic Techniques on the Overall Health Status of People With Carpal Tunnel Syndrome: A Randomized Controlled Trial. Journal of manipulative and physiological therapeutics. 2018;41(8):641-9.
  11. Wolny T, Saulicz E, Linek P, Shacklock M, Myśliwiec A. Efficacy of Manual Therapy Including Neurodynamic Techniques for the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial. Journal of manipulative and physiological therapeutics. 2017;40(4):263-72.
  12. Brininger TL, Rogers JC, Holm MB, Baker NA, Li ZM, Goitz RJ. Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial. Archives of physical medicine and rehabilitation. 2007;88(11):1429-35.
  13. Horng Y-S, Hsieh S-F, Tu Y-K, Lin M-C, Horng Y-S, Wang J-D. The comparative effectiveness of tendon and nerve gliding exercises in patients with carpal tunnel syndrome: a randomized trial. American journal of physical medicine & rehabilitation. 2011;90(6):435-42.
  14. Alam M, Khan M, Ahmed SI, Ali SS. Effectiveness of neural mobilization and ultrasound therapy on pain severity in carpal tunnel syndrome. Biomedical Research and Therapy. 2018;5(4):2187-93.
  15. Alfonso C, Jann S, Massa R, Torreggiani A. Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review. Neurological Sciences. 2010;31(3):243-52.
  16. Lim YH, Chee DY, Girdler S, Lee HC. Median nerve mobilization techniques in the treatment of carpal tunnel syndrome: A systematic review. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2017;30(4):397-406.
  17. Jarvik JG, Comstock BA, Kliot M, Turner JA, Chan L, Heagerty PJ, et al. Surgery versus non-surgical therapy for carpal tunnel syndrome: a randomised parallel-group trial. Lancet (London, England). 2009;374(9695):1074-81.
  18. Chung VCH, Ho RST, Liu S, Chong MKC, Leung AWN, Yip BHK, et al. Electroacupuncture and splinting versus splinting alone to treat carpal tunnel syndrome: a randomized controlled trial. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2016;188(12):867-75.
  19. Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology. 2014;120(2):482-503.
  20. Badia M, Santafe M. Acupuncture and electroacupuncture in the treatment of carpal tunnel syndrome: Systematic review. Revista Fisioterapia Invasiva / Journal of Invasive Techniques in Physical Therapy. 2020;03.
  21. Tezel N, Umay E, Yılmaz V, Cakci A. Acupuncture plus night splint for quality of life and disability in patients with carpal tunnel syndrome: a randomized controlled trial. Integrative medicine research. 2019;8(4):284-8.
  22. Li T, Yan J, Hu J, Liu X, Wang F. Efficacy and safety of electroacupuncture for carpal tunnel syndrome (CTS): A systematic review and meta-analysis of randomized controlled trials. Frontiers in surgery. 2022;9:952361.
  23. Fei J, Gao L, Li HH, Yuan QL, Li LJ. Electroacupuncture promotes peripheral nerve regeneration after facial nerve crush injury and upregulates the expression of glial cell-derived neurotrophic factor. Neural regeneration research. 2019;14(4):673-82.
  24. Maeda Y, Kim H, Kettner N, Kim J, Cina S, Malatesta C, et al. Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain : a journal of neurology. 2017;140(4):914-27.
  25. Butler DS. The neurodynamic techniques: a definitive guide from the Noigroup team: Noigroup publications; 2005.
  26. Ellis R, Blyth R, Arnold N, Miner-Williams W. Is there a relationship between impaired median nerve excursion and carpal tunnel syndrome? A systematic review. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2017;30(1):3-12.
  27. Wolny T, Linek P. Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial. Clinical rehabilitation. 2019;33(3):408-17.
  28. Chen ZX, Li Y, Zhang XG, Chen S, Yang WT, Zheng XW, et al. Sham Electroacupuncture Methods in Randomized Controlled Trials. Scientific reports. 2017;7:40837.
  29. Wolny T. The Use of Neurodynamic Techniques in the Conservative Treatment of Carpal Tunnel Syndrome - a Critical Appraisal of the Literature. Ortopedia, traumatologia, rehabilitacja. 2017;19(5):427-40.
  30. Talebi GA, Saadat P, Javadian Y, Taghipour M. Comparison of two manual therapy techniques in patients with carpal tunnel syndrome: A randomized clinical trial. Caspian journal of internal medicine. 2020;11(2):163-70.
  31. Wolny T, Linek P. Neurodynamic Techniques Versus "Sham" Therapy in the Treatment of Carpal Tunnel Syndrome: A Randomized Placebo-Controlled Trial. Archives of physical medicine and rehabilitation. 2018;99(5):843-54.
  32. Salehi S, Hessami O, Rashed A, Hassabi M, PourSaeid Esfehani M, Abedi Yakta A, et al. The Assessment of Acupuncture and Exercise Therapy in Patients with Carpal Tunnel Syndrome: Randomized Clinical Trial. Novelty in Biomedicine. 2019;7(4):201-9.
  33. Kong JT, Puetz C, Tian L, Haynes I, Lee E, Stafford RS, et al. Effect of Electroacupuncture vs Sham Treatment on Change in Pain Severity Among Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA network open. 2020;3(10):e2022787.
  34. Wolny T, Saulicz E, Linek P, Myśliwiec A, Saulicz M. Effect of manual therapy and neurodynamic techniques vs ultrasound and laser on 2PD in patients with CTS: A randomized controlled trial. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2016;29(3):235-45.
  35. Lewis KJ, Coppieters MW, Ross L, Hughes I, Vicenzino B, Schmid AB. Group education, night splinting and home exercises reduce conversion to surgery for carpal tunnel syndrome: a multicentre randomised trial. Journal of physiotherapy. 2020;66(2):97-104.
  36. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. The Journal of bone and joint surgery American volume. 1993;75(11):1585-92.
  37. Hassankhani GG, Moradi A, Birjandinejad A, Vahedi E, Kachooei AR, Ebrahimzadeh MH. Translation and Validation of the Persian Version the Boston Carpal Tunnel Syndrome Questionnaire. The archives of bone and joint surgery. 2018;6(1):71-7.
  38. Jensen MP, Turner JA, Romano JM, Fisher LD. Comparative reliability and validity of chronic pain intensity measures. Pain. 1999;83(2):157-62.
  39. Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. Journal of clinical nursing. 2005;14(7):798-804.
  40. Cohen J. A power primer. Psychological bulletin. 1992;112(1):155-9.
  41. Atroshi I, Larsson GU, Ornstein E, Hofer M, Johnsson R, Ranstam J. Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial. BMJ (Clinical research ed). 2006;332(7556):1473.
  42. Atroshi I, Zhou C, Jöud A, Petersson IF, Englund M. Sickness absence from work among persons with new physician-diagnosed carpal tunnel syndrome: a population-based matched-cohort study. PLoS One. 2015;10(3):e0119795.

 

Journal of Rehabilitation Sciences & Research
Volume 12, Issue 1
March 2025
Pages 45-52
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