This project aims to analyze the use of hyperthermia within a treatment protocol for Carpal Tunnel Syndrome (CTS), as well as to determine the difference between two and three sessions per week. Study participants will be divided into four intervention groups: the first will receive two sessions per week for a period of six months, while the second will receive three sessions per week for the same period. The treatment protocol will consist of therapeutic physical exercise focused on the hand flexor muscles and neural stretching, the application of hyperthermia to the carpal tunnel and adjacent areas, and the use of a night splint. The third and fourth intervention groups will receive the same treatment as mentioned above, but without hyperthermia. The third group will receive three sessions per week, while the second group will receive two sessions per week. Two different types of measurement variables will be used: objective variables will be used to measure hand flexor muscle strength and wrist free range of motion. Subjective variables will also be used through validated questionnaires covering physical activity, perceived functional limitations, upper limb functional assessment, neuropathic pain, and a visual analogue scale for pain perception.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
160
hyperthermia over the carpal tunnel area and adjacent areas
Performing therapeutic physical exercise focused on the flexor muscles of the hand and neural stretching
imposition of a night splint
Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)
Minimum: 19. Maximum: 95. A higher score indicates a higher degree of disability
Time frame: Baseline and up to one year
Disabilities of arm, shoulder and hand (DASH)
Minimum: 30 points. Maximum: 150 points A higher score indicates a higher intensity of symptoms
Time frame: Baseline and up to one year
Neuropathic Pain Scale (DN4)
Minimum: 0 Maximum: 10 The diagnosis of neuropathic pain is established with a total scale of 4 out of 10
Time frame: Baseline and up to one year
International Physical Activity Questionnaire (IPAQ)
9 items. Minimum: 9 Maximum: 36 A higher score indicates a sedentary life
Time frame: Baseline and up to one year
Visual Analogue Scale (VAS)
Minimum: 1 Maximum: 10 A higher score indicates a higher intensity of pain
Time frame: Baseline and up to one year
Hand grip strength
A handheld dynamometer will be used and three consecutive measurements will be obtained with the patient sitting and the elbow flexed at 90 degrees and in a neutral position.
Time frame: Baseline and up to one year
WRIST JOINT RANGE OF MOBILITY
With the patient seated in a relaxed position, the various free movements of the wrist joint will be assessed bilaterally using an electronic goniometer. To do this, the goniometer will be placed on the dorsal side of the wrist, with the proximal part on the midline between the radius and ulna and the distal part on the third metacarpal. Flexion, extension, and radial and ulnar deviation ranges will be assessed, both with the elbow flexed and extended.
Time frame: Baseline and up to one year
WRIST FLEXION EVALUATION TEST
With the patient seated in a relaxed position, wrist flexion will be tested in isometric contraction, both with the hand open and closed, and with the wrist in a neutral position. The therapist will manually resist wrist flexion from the hand area. This test will be performed three times in a row with the hand open, followed by a five-minute rest and then repeating the procedure, this time with the hand open. This measurement will be taken with the elbow flexed or extended.
Time frame: Baseline and up to one year
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