{"id":17303,"date":"2023-09-26T12:00:06","date_gmt":"2023-09-26T10:00:06","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=research&p=17303"},"modified":"2024-03-04T10:06:20","modified_gmt":"2024-03-04T09:06:20","slug":"exercise-carpal-tunnel-syndrome","status":"publish","type":"research","link":"https:\/\/www.physiotutors.com\/research\/exercise-carpal-tunnel-syndrome\/","title":{"rendered":"Effectiveness of Pain Education and Exercise for Carpal Tunnel Syndrome Delivered Through Telerehabilitation"},"featured_media":17307,"template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":""},"featured-tag":[],"tracking_tag":[2206,2195],"class_list":["post-17303","research","type-research","status-publish","has-post-thumbnail","hentry","tracking_tag-pain-psychosocial","tracking_tag-wrist-hand"],"acf":{"free_access":"unfree","app_link":"https:\/\/app.physiotutors.com\/research-reviews\/exercise-carpal-tunnel-syndrome","sections":[{"acf_fc_layout":"page-header-small","background":{"background_image":17315,"background_image_alt_text":"Exercise for carpal tunnel syndrome"},"heading":"Effectiveness of Pain Education and Exercise for Carpal Tunnel Syndrome Delivered Through Telerehabilitation","subheading":"N\u00fa\u00f1ez-Cort\u00e9s et al., Musculoskelet Sci Pract. (2023) ","benefits":[{"benefit":"The use of telerehabilitation to deliver an exercise program combined with pain education was studied in carpal tunnel syndrome "},{"benefit":"It was compared against exercise therapy alone "},{"benefit":"No differences were observed in the primary endpoint at week 6"}]},{"acf_fc_layout":"content","background_color":"none","content_alignment":"left","content_editor":"

Introduction<\/h2>\r\nPain education is everywhere, and that is a good thing. It has been shown to reduce levels of anxiety and distress in various musculoskeletal conditions. When you inform (or educate, what is in a name) your patient well, you already have an advantage despite the type of treatment you opt for. More and more evidence points to the relevance of self-management. As such, physiotherapy is turning away from \u201ctreating\u201d patients and moving on to guide someone through a certain pathology. In this aspect, I chose to review this RCT as it combined both. The application of pain education and exercise for carpal tunnel syndrome delivered through telerehabilitation.\r\n\r\n \r\n

Methods<\/h2>\r\nIn this RCT, pain education and exercise for carpal tunnel syndrome were compared against exercise only. Both interventions were delivered through telerehabilitation.\r\n\r\nParticipants were between the ages of 18 and 60 years and had moderate to severe carpal tunnel syndrome. This definition was established according to the clinical practice guidelines of the Academy of Orthopaedic Physical Therapy and the Academy of Hand and Upper Extremities Physical Therapy. We covered this practice guideline on our YouTube channel, which you can watch here. Further, their symptoms were present for at least 3 months and could have been unilateral or bilateral in presence.\r\n\r\nThe included participants were randomized on a 1:1 allocation ratio to receive exercise only compared to pain education and exercise for carpal tunnel syndrome. Both groups received the exercise therapy program through telerehabilitation. Three telerehabilitation sessions were supervised by physiotherapists every 15 days.\r\n\r\nIn the exercise group participants performed aerobic exercise, digital flexor tendon gliding, neurodynamic home exercises, and self-stretching.\r\n\r\n[caption id=\"attachment_17304\" align=\"alignnone\" width=\"1090\"]\"Pain From: N\u00fa\u00f1ez-Cort\u00e9s et al., Musculoskelet Sci Pract. (2023)[\/caption]\r\n\r\n \r\n\r\nThese exercises were performed three times per week for 6 weeks, with a 48-hour interval between each session. Each exercise session lasted approximately 30 min. In total, 15 self-managed and 3 supervised sessions were held.\r\n\r\nIn the group receiving pain education and exercise for carpal tunnel syndrome, participants received 3 additional sessions of pain neuroscience education. The table hereunder depicts the detailed program for both groups.\r\n\r\n[caption id=\"attachment_17305\" align=\"alignnone\" width=\"1682\"]\"Pain From: N\u00fa\u00f1ez-Cort\u00e9s et al., Musculoskelet Sci Pract. (2023)[\/caption]\r\n\r\n \r\n\r\nPain intensity was the primary outcome of interest and this was measured using the NPRS at 6 weeks and 12 weeks. Other outcome measures included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia-11, Boston Carpal Tunnel Questionnaire (BCTQ), Hospital Anxiety and Depression Scale (HADS), EuroQol5-dimensions (EQ-5D), and the Patient Global Impression of Change Scale (PGICS).\r\n\r\n \r\n

Results<\/h2>\r\nThe analysis of the baseline characteristics revealed no significant differences between the groups at the start of the study.\r\n\r\n[caption id=\"attachment_17306\" align=\"alignnone\" width=\"1676\"]\"Pain From: N\u00fa\u00f1ez-Cort\u00e9s et al., Musculoskelet Sci Pract. (2023)[\/caption]\r\n\r\n \r\n\r\nThe study wanted to know whether pain education combined with exercise was better than exercise alone. So they tried to rate the between-group effects.\r\n\r\nThe paper stated that there was no interaction effect or main effect for group, but a main effect for time was observed. Further, they state: \u201cSignificant and clinically relevant differences in NPRS were observed at week 6 in the PNE + exercise group (MD: 2.0 points, 95% CI: -3.8 to \u22120.2). The exercise group showed no improvement at any time point\u201d.\r\n\r\n \r\n

Questions and thoughts<\/h2>\r\n