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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04043780
Other study ID # PI19/334
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date September 24, 2019
Est. completion date September 1, 2020

Study information

Verified date November 2020
Source Universidad de Zaragoza
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

A multicentric randomized controlled trial has been designed to study the effects of a decompression prototype splint on symptoms, functional capacity and nerve conduction studies in patients with carpal tunnel syndrome.


Description:

A decompression prototype splint was designed to simulate an manual mobilization that is able to increase the CSA of the carpal tunnel and the median nerve in cadavers. These changes are important because they may relate to the decrease in CTS symptoms. Patients with mild or moderate carpal tunnel syndrome will be selected for the trial. They will be randomized in 2 groups. One group will wear an standard splint for carpal tunnel syndrome and the other the decompression prototype splint.


Recruitment information / eligibility

Status Completed
Enrollment 60
Est. completion date September 1, 2020
Est. primary completion date March 1, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Be medically diagnosed with carpal tunnel syndrome after electrophysiological tests and present mild to moderate involvement. This test is performed according to the standards established by the "American Academy of Physical Medicine and Rehabilitation" - Ability to understand and communicate their symptoms and to complete the questionnaires. Exclusion Criteria: - Previous surgery in the carpal tunnel in the same limb Other pathologies that may be associated with carpal tunnel syndrome: traumas, pathologies or disorders of the upper limb or cervical spine (cervical radiculopathy, cervical sprain, etc.) or prior cervical surgery - Concurrent comorbidities that may be the cause and interfere with the treatment of the carpal tunnel syndrome: diabetes mellitus, hypothyroidism, rheumatoid arthritis, fibromyalgia, reflex sympathetic dysfunction, obesity, renal disease, alcoholism, significant vitamin deficiency and associated viral or bacterial processes - Pregnancy - Oral drugs, physiotherapy treatment , treatment with splints or infiltrations for carpal tunnel syndrome prior or during the study.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Decompression prototype splint for carpal tunnel syndrome
This group will wear during 6 weeks a decompression prototype splint. They we be informed to wear it as long as possible during the 6 weeks.
Standard splint for carpal tunnel syndrome
This group will wear during 6 weeks a standard splint. They we be informed to wear it as long as possible during the 6 weeks.

Locations

Country Name City State
Spain Elena Estébanez de Miguel Zaragoza

Sponsors (4)

Lead Sponsor Collaborator
Universidad de Zaragoza Institut Català de la Salut, Salud Aragon, Universitat de Catalunya

Country where clinical trial is conducted

Spain, 

References & Publications (31)

Akalin E, El O, Peker O, Senocak O, Tamci S, Gülbahar S, Cakmur R, Oncel S. Treatment of carpal tunnel syndrome with nerve and tendon gliding exercises. Am J Phys Med Rehabil. 2002 Feb;81(2):108-13. — View Citation

Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999 Jul 14;282(2):153-8. — View Citation

Baker NA, Moehling KK, Rubinstein EN, Wollstein R, Gustafson NP, Baratz M. The comparative effectiveness of combined lumbrical muscle splints and stretches on symptoms and function in carpal tunnel syndrome. Arch Phys Med Rehabil. 2012 Jan;93(1):1-10. doi: 10.1016/j.apmr.2011.08.013. — View Citation

Ballestero-Pérez R, Plaza-Manzano G, Urraca-Gesto A, Romo-Romo F, Atín-Arratibel MLÁ, Pecos-Martín D, Gallego-Izquierdo T, Romero-Franco N. Effectiveness of Nerve Gliding Exercises on Carpal Tunnel Syndrome: A Systematic Review. J Manipulative Physiol Ther. 2017 Jan;40(1):50-59. doi: 10.1016/j.jmpt.2016.10.004. Epub 2016 Nov 11. Review. — View Citation

Barbosa RI, Fonseca Mde C, Rodrigues EK, Tamanini G, Marcolino AM, Mazzer N, Guirro RR, MacDermid J. Efficacy of low-level laser therapy associated to orthoses for patients with carpal tunnel syndrome: A randomized single-blinded controlled trial. J Back Musculoskelet Rehabil. 2016 Aug 10;29(3):459-66. doi: 10.3233/BMR-150640. — View Citation

Bland JD. A neurophysiological grading scale for carpal tunnel syndrome. Muscle Nerve. 2000 Aug;23(8):1280-3. — View Citation

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. Arch Phys Med Rehabil. 2007 Nov;88(11):1429-35. — View Citation

Buckle PW, Devereux JJ. The nature of work-related neck and upper limb musculoskeletal disorders. Appl Ergon. 2002 May;33(3):207-17. Review. — View Citation

Bueno-Gracia E, Pérez-Bellmunt A, López-de-Celis C, Shacklock M, Salas-López A, Simon M, Álvarez-Díaz P, Tricás-Moreno JM. Dimensional changes of the carpal tunnel and median nerve during manual mobilization of the carpal bones - Anatomical study. Clin Biomech (Bristol, Avon). 2018 Nov;59:56-61. doi: 10.1016/j.clinbiomech.2018.09.001. Epub 2018 Sep 3. — View Citation

Bueno-Gracia E, Ruiz-de-Escudero-Zapico A, Malo-Urriés M, Shacklock M, Estébanez-de-Miguel E, Fanlo-Mazas P, Caudevilla-Polo S, Jiménez-Del-Barrio S. Dimensional changes of the carpal tunnel and the median nerve during manual mobilization of the carpal bones. Musculoskelet Sci Pract. 2018 Aug;36:12-16. doi: 10.1016/j.msksp.2018.04.002. Epub 2018 Apr 4. — View Citation

Bulut GT, Caglar NS, Aytekin E, Ozgonenel L, Tutun S, Demir SE. Comparison of static wrist splint with static wrist and metacarpophalangeal splint in carpal tunnel syndrome. J Back Musculoskelet Rehabil. 2015;28(4):761-7. doi: 10.3233/BMR-140580. — View Citation

Celik B, Paker N, Celik EC, Bugdayci DS, Ones K, Ince N. The effects of orthotic intervention on nerve conduction and functional outcome in carpal tunnel syndrome: A prospective follow-up study. J Hand Ther. 2015 Jan-Mar;28(1):34-7; quiz 38. doi: 10.1016/j.jht.2014.07.008. Epub 2014 Oct 6. — View Citation

De Angelis MV, Pierfelice F, Di Giovanni P, Staniscia T, Uncini A. Efficacy of a soft hand brace and a wrist splint for carpal tunnel syndrome: a randomized controlled study. Acta Neurol Scand. 2009 Jan;119(1):68-74. doi: 10.1111/j.1600-0404.2008.01072.x. Epub 2008 Jul 13. — View Citation

Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001 Nov;94(2):149-58. — View Citation

Foley M, Silverstein B, Polissar N. The economic burden of carpal tunnel syndrome: long-term earnings of CTS claimants in Washington State. Am J Ind Med. 2007 Mar;50(3):155-72. — View Citation

Foley M, Silverstein B. The long-term burden of work-related carpal tunnel syndrome relative to upper-extremity fractures and dermatitis in Washington State. Am J Ind Med. 2015 Dec;58(12):1255-69. doi: 10.1002/ajim.22540. Epub 2015 Nov 2. — View Citation

Golriz B, Ahmadi Bani M, Arazpour M, Bahramizadeh M, Curran S, Madani SP, Hutchins SW. Comparison of the efficacy of a neutral wrist splint and a wrist splint incorporating a lumbrical unit for the treatment of patients with carpal tunnel syndrome. Prosthet Orthot Int. 2016 Oct;40(5):617-23. doi: 10.1177/0309364615592695. Epub 2015 Jul 20. — View Citation

Healy A, Farmer S, Pandyan A, Chockalingam N. A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions. PLoS One. 2018 Mar 14;13(3):e0192094. doi: 10.1371/journal.pone.0192094. eCollection 2018. Review. — View Citation

Jablecki CK, Andary MT, Floeter MK, Miller RG, Quartly CA, Vennix MJ, Wilson JR; American Association of Electrodiagnostic Medicine; American Academy of Neurology; American Academy of Physical Medicine and Rehabilitation. Practice parameter: Electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2002 Jun 11;58(11):1589-92. — View Citation

Keith MW, Masear V, Chung KC, Maupin K, Andary M, Amadio PC, Watters WC 3rd, Goldberg MJ, Haralson RH 3rd, Turkelson CM, Wies JL, McGowan R. American Academy of Orthopaedic Surgeons Clinical Practice Guideline on diagnosis of carpal tunnel syndrome. J Bone Joint Surg Am. 2009 Oct;91(10):2478-9. doi: 10.2106/JBJS.I.00643. — View Citation

Li ZM, Gabra JN, Marquardt TL, Kim DH. Narrowing carpal arch width to increase cross-sectional area of carpal tunnel--a cadaveric study. Clin Biomech (Bristol, Avon). 2013 Apr;28(4):402-7. doi: 10.1016/j.clinbiomech.2013.02.014. Epub 2013 Apr 9. — View Citation

Manente G, Torrieri F, Di Blasio F, Staniscia T, Romano F, Uncini A. An innovative hand brace for carpal tunnel syndrome: a randomized controlled trial. Muscle Nerve. 2001 Aug;24(8):1020-5. — View Citation

Marquardt TL, Gabra JN, Li ZM. Morphological and positional changes of the carpal arch and median nerve during wrist compression. Clin Biomech (Bristol, Avon). 2015 Mar;30(3):248-53. doi: 10.1016/j.clinbiomech.2015.01.007. Epub 2015 Jan 31. — View Citation

Oteo-Álvaro Á, Marín MT, Matas JA, Vaquero J. [Spanish validation of the Boston Carpal Tunnel Questionnaire]. Med Clin (Barc). 2016 Mar 18;146(6):247-53. doi: 10.1016/j.medcli.2015.10.013. Epub 2015 Dec 10. Spanish. — View Citation

Page MJ, Massy-Westropp N, O'Connor D, Pitt V. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev. 2012 Jul 11;(7):CD010003. doi: 10.1002/14651858.CD010003. Review. — View Citation

Roel-Valdés J, Arizo-Luque V, Ronda-Pérez E. [Epidemiology of occupationally-caused carpal tunnel syndrome in the province of Alicante, Spain 1996-2004]. Rev Esp Salud Publica. 2006 Jul-Aug;80(4):395-409. Spanish. — View Citation

Stapleton MJ. Occupation and carpal tunnel syndrome. ANZ J Surg. 2006 Jun;76(6):494-6. — View Citation

Wang JC, Liao KK, Lin KP, Chou CL, Yang TF, Huang YF, Wang KA, Chiu JW. Efficacy of Combined Ultrasound-Guided Steroid Injection and Splinting in Patients With Carpal Tunnel Syndrome: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2017 May;98(5):947-956. doi: 10.1016/j.apmr.2017.01.018. Epub 2017 Feb 14. — View Citation

Weng C, Dong H, Chu H, Lu Z. Clinical and electrophysiological evaluation of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome. J Phys Ther Sci. 2016 Aug;28(8):2274-8. doi: 10.1589/jpts.28.2274. Epub 2016 Aug 31. — View Citation

Werner RA, Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol. 2002 Sep;113(9):1373-81. Review. — View Citation

Zinnuroglu M, Baspinar M, Beyazova M. Carpal lock and the volar-supporting orthosis in mild and moderate carpal tunnel syndrome. Am J Phys Med Rehabil. 2010 Sep;89(9):759-64. doi: 10.1097/PHM.0b013e3181e721ed. — View Citation

* Note: There are 31 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Intensity of symptoms at baseline Intensity of the symptoms (pain, paraesthesia...) will be assess with a visual analogic scale (VAS). A VAS is usually a 100-mm long horizontal line with verbal descriptors (word anchors) at each end to express the extremes of the feeling. Patients mark the point on the line that best corresponds to their symptom severity . When reading the VAS, the position of the respondent's cross is generally assigned a score between 0 and 100. The scores can then be simply transferred to a 100-value scale using a millimeter tape measure. Baseline
Primary Intensity of the symptoms at 6 weeks Intensity of the symptoms (pain, paraesthesia...) will be assess with a visual analogic scale (VAS). A VAS is usually a 100-mm long horizontal line with verbal descriptors (word anchors) at each end to express the extremes of the feeling. Patients mark the point on the line that best corresponds to their symptom severity . When reading the VAS, the position of the respondent's cross is generally assigned a score between 0 and 100. The scores can then be simply transferred to a 100-value scale using a millimeter tape measure. 6 weeks
Primary Intensity of the symptoms at 4 months Intensity of the symptoms (pain, paraesthesia...) will be assess with a visual analogic scale (VAS). A VAS is usually a 100-mm long horizontal line with verbal descriptors (word anchors) at each end to express the extremes of the feeling. Patients mark the point on the line that best corresponds to their symptom severity . When reading the VAS, the position of the respondent's cross is generally assigned a score between 0 and 100. The scores can then be simply transferred to a 100-value scale using a millimeter tape measure. 4 months
Primary Nerve conduction studies at baseline The nerve conduction will be assess with electroneurogram. Baseline
Primary Nerve conduction studies at 6 weeks The nerve conduction will be assess with electroneurogram. 6 weeks
Primary Self-reported symptom severity and functional status at baseline This outcome will be assess with The Boston Carpal Tunnel Questionnaire (BCTQ), that is a disease-specific measure of self-reported symptom severity and functional status. The Boston Carpal Tunnel Questionnaire (BCTQ), is a patient-based outcome measure that has been developed specifically for patients with CTS. It has two distinct scales, the Symptom Severity Scale (SSS) which has 11 questions and uses a five-point rating scale and the Functional Status Scale (FSS) containing 8 items which have to be rated for degree of difficulty on a five-point scale. Each scale generates a final score (sum of individual scores divided by number of items) which ranges from 1 to 5, with a higher score indicating greater disability. Baseline
Primary Self-reported symptom severity and functional status at 6 weeks This outcome will be assess with The Boston Carpal Tunnel Questionnaire (BCTQ), that is a disease-specific measure of self-reported symptom severity and functional status. The Boston Carpal Tunnel Questionnaire (BCTQ), is a patient-based outcome measure that has been developed specifically for patients with CTS. It has two distinct scales, the Symptom Severity Scale (SSS) which has 11 questions and uses a five-point rating scale and the Functional Status Scale (FSS) containing 8 items which have to be rated for degree of difficulty on a five-point scale. Each scale generates a final score (sum of individual scores divided by number of items) which ranges from 1 to 5, with a higher score indicating greater disability. 6 weeks
Primary Self-reported symptom severity and functional status at 4 months This outcome will be assess with The Boston Carpal Tunnel Questionnaire (BCTQ), that is a disease-specific measure of self-reported symptom severity and functional status. The Boston Carpal Tunnel Questionnaire (BCTQ), is a patient-based outcome measure that has been developed specifically for patients with CTS. It has two distinct scales, the Symptom Severity Scale (SSS) which has 11 questions and uses a five-point rating scale and the Functional Status Scale (FSS) containing 8 items which have to be rated for degree of difficulty on a five-point scale. Each scale generates a final score (sum of individual scores divided by number of items) which ranges from 1 to 5, with a higher score indicating greater disability. 4 months
Primary Global Perceived Effect at 6 weeks Global perceived effect will be assess with the Global Perceived Effect scale. The global perceived effect scale (GPES) is a commonly used method for measuring patients' assessment of their condition. One of the underlying assumptions of the GPE is that it measures a global assessment of change in the patient's chief complaint. Global Perceived Effect Scale (GPES) consists of a scale of five points that varies from less than five points (much worse), zero (no change) and five points (completely recovered). The participants are asked in the following way for all the measures of the overall effect perceived: "Compared with the beginning of the episode, how do you describe your wrist/hand today?". Positive scores represent better recovery and negative scores indicate a worsening of symptoms. 6 weeks
Primary Global Perceived Effect at 4 months Global perceived effect will be assess with the Global Perceived Effect scale. The global perceived effect scale (GPES) is a commonly used method for measuring patients' assessment of their condition. One of the underlying assumptions of the GPES is that it measures a global assessment of change in the patient's chief complaint. Global Perceived Effect Scale (GPES) consists of a scale of five points that varies from less than five points (much worse), zero (no change) and five points (completely recovered). The participants are asked in the following way for all the measures of the overall effect perceived: "Compared with the beginning of the episode, how do you describe your wrist/hand today?". Positive scores represent better recovery and negative scores indicate a worsening of symptoms. 4 months
Secondary Adherence to the treatment The participants will fill in a calendar indicating the hours of use 6 weeks
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