Immediate effect of neural mobilization and carpal bones mobilization on median nerve conduction in patients with carpal tunnel syndrome: A randomized controlled clinical trial.

BACKGROUND

Carpal bone mobilization and neural mobilization techniques have been proposed as effective interventions to improve median nerve physiology at the wrist in patients with carpal tunnel syndrome. However, the isolated and immediate effects of these techniques remain unclear.

PURPOSE: To analyze the immediate effects of carpal bone mobilization and median nerve mobilization on electrophysiological parameters in patients with carpal tunnel syndrome.

STUDY

DESIGN

Three-arm, parallel-group randomized controlled trial with 1:1:1 allocation ratio.

METHODS

A total of 74 patients with carpal tunnel syndrome (57 women; mean [SD] age: 54.64 [11.80] years) were included. Participants were randomly assigned to three groups: neural-group (n = 25), which received three sets of 15 neural mobilization repetitions; joint-group (n = 24), which received five 30-second applications of carpal bone mobilization; and control-group (n = 25), which received no intervention. Electrophysiological variables were assessed before and immediately after the intervention in all groups.

RESULTS

A significant between-group increase in motor conduction velocity was observed in the joint mobilization group compared with the control group (mean difference: 2.23 m/s; 95% CI: 0.81-3.64; p < 0.001) and the neural mobilization group (mean difference: 2.22 m/s; 95% CI: 0.81-3.65; p < 0.001). Within-group analysis showed significant increases in motor conduction velocity (1.94 ± 2.30 m/s; p < 0.001) and sensory conduction velocity (0.96 ± 11.36 m/s; p = 0.01) in the joint mobilization group. Additionally, a significant increase in sensory amplitude (2.30 ± 5.11; p = 0.03) was observed in the neural mobilization group.

CONCLUSIONS

Carpal bone mobilization produces immediate improvements in sensory and motor conduction velocities in patients with carpal tunnel syndrome. Neural mobilization may have a modest effect on sensory amplitude of the median nerve; however, these findings should be interpreted with caution.