Carpal Tunnel Syndrome Clinical Trial
Official title:
Treatment Efficacy of OMT for Carpal Tunnel Syndrome
This study investigated whether an eight-week regimen of osteopathic manipulative treatment would have immediate and lasting positive effects on the symptoms, functional limitation and physiologic impairment associated with Carpal Tunnel Syndrome.
The incidence of Carpal Tunnel Syndrome (CTS) in adults in the U.S. ranges from 15-20%
depending on the study, and costs over one billion dollars annually in medical care. Surgery
for CTS accounts for much of these costs with up to one third of these patients experiencing
re-occurrence of symptoms post-operatively.
The overall goal for this proposed exploratory clinical trial was to evaluate the efficacy
of a conservative, manual medicine treatment as an adjunctive therapy to standard care for
CTS. This pilot study utilized a prospective, randomized, placebo-controlled clinical trial
methodology to examine whether an eight week treatment regimen of osteopathic manipulative
treatment (OMT) when used adjunctively to standard therapy would have immediate and lasting
positive effects on the symptoms, functional limitations, and physiologic impairment
associated with CTS.
Male and female subjects between the ages of 20 and 65 who meet electro-physiologic and
symptom/functional inclusion criteria were randomly assigned to one of three study groups,
all of which will continue standard medical care with their treating physician/provider; (i)
OMT plus standard medical care; (ii) placebo (sub-therapeutic ultrasound) plus standard
medical care; and (iii) standard medical care only (no-treat).
Outcome measures were: 1. Median and Ulnar motor and sensory nerve conduction amplitudes and
distal latencies, 2. Symptoms and Functional status, 3. Strength, 4. Sensation, 5. Interior
dimensions of the carpal tunnel, and 6. Quantification (signal intensity by MRI) of water
(edema) in the Median nerve and carpal tunnel. Placebo potency and blinding success will be
evaluated. A preliminary investigation demonstrated our ability to recruit subjects and
measure these outcomes. Power analysis based upon a decrease in the mean median motor nerve
distal latency of 30% identified a minimum number of 42 subjects per treatment group.
It was expected that a significantly greater number of subjects in the OMT adjunctive
treatment group would achieve the effective change in nerve latency compared to the other
two treatment groups. It was also expected that the OMT adjunctive treatment group would
have greater improvement of all physiological and clinical outcome measures than the other
two groups.
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