Effects of Neurodynamic and Carpal Bone Mobilization in Mild-to-Moderate Carpal Tunnel Syndrome

January 13, 2026 updated by: Merve Akdeniz Leblebicier, Kutahya Health Sciences University

Clinical and Morphological Effects of Neurodynamic Mobilization and Carpal Bone Mobilization Techniques in Patients With Mild-to-Moderate Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by compression of the median nerve at the wrist. Conservative interventions such as splinting and manual therapy are frequently used in individuals with mild-to-moderate CTS. Neurodynamic mobilization and carpal bone mobilization aim to improve neural and soft tissue mobility; however, their comparative effects on clinical outcomes and median nerve morphology are not fully understood.

This interventional, non-randomized clinical study aims to compare the clinical and ultrasonographic effects of neurodynamic mobilization plus splinting, carpal bone mobilization plus splinting, and splinting alone in patients with mild-to-moderate CTS. Ninety-three participants diagnosed with mild-to-moderate carpal tunnel syndrome based on electrodiagnostic criteria will be included. Participants will be allocated into three parallel groups without randomization. All participants will receive a neutral-position wrist splint as standard conservative care.

Two intervention groups will additionally receive either neurodynamic mobilization exercises or carpal bone mobilization techniques administered by a physiotherapist for four weeks. Clinical outcomes and median nerve morphology will be evaluated at baseline and immediately after the intervention period.

The primary outcome is the change in the Boston Carpal Tunnel Questionnaire score. Secondary outcomes include pain intensity, neuropathic pain, functional disability, muscle strength, pressure pain threshold, and ultrasonographic measurements of the median nerve.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

93

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Turkey (Türkiye)
    • Yoncalı
      • Kütahya, Yoncalı, Turkey (Türkiye), 43000
        • Kutahya Health Sciences University Yoncalı Physical Therapy and Rehabilitation Hospital
        • Contact:
        • Contact:
        • Principal Investigator:
          • Esengul Alıcı, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosis of mild-to-moderate carpal tunnel syndrome confirmed by electrodiagnostic testing
  • CTS symptoms for at least 3 months
  • Ability to provide informed consent

Exclusion Criteria:

  • Previous carpal tunnel surgery
  • Diabetes mellitus or polyneuropathy
  • Cervical radiculopathy
  • Pregnancy or breastfeeding
  • Central nervous system disorders

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: neurodynamic mobs in addition splint
Median nerve neurodynamic mobilization exercises administered by a physiotherapist for 4 weeks in addition to night-time wrist splint use
Other: Neurodynamic mobilization
Median nerve neurodynamic mobilization exercises performed 5 sessions per week for 4 weeks.
Other: Splint
Neutral-position wrist splint used during night-time for 4 weeks.
Experimental: Carpal Bone Mobilization + Splint
Carpal bone mobilization techniques administered by a physiotherapist for 4 weeks in addition to night-time wrist splint use.
Other: Splint
Neutral-position wrist splint used during night-time for 4 weeks.
Other: Carpal bone mobilization
Manual carpal bone mobilization techniques applied 5 sessions per week for 4 weeks.
Active Comparator: Splint only
Neutral-position wrist splint worn at night for 4 weeks.
Other: Splint
Neutral-position wrist splint used during night-time for 4 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Boston Carpal Tunnel Questionnaire (BCTQ) Total Score
Time Frame: Baseline to 4 weeks
Change in Boston Carpal Tunnel Questionnaire (BCTQ) Total Score
Baseline to 4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analog Scale (VAS)
Time Frame: Baseline to 4 weeks
Pain intensity measured using a 10-cm visual analog scale.
Baseline to 4 weeks
Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)
Time Frame: Baseline to 4 weeks
Change in Neuropathic Pain Score Assessed by Leeds Assessment of Neuropathic Symptoms and Signs (LANSS).
Baseline to 4 weeks
Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH)
Time Frame: Baseline to 4 weeks
Change in Upper Extremity Disability Assessed by Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH).
Baseline to 4 weeks
Grip Strength
Time Frame: Baseline to 4 weeks
Change Grip strength measured using a Jamar dynamometer.
Baseline to 4 weeks
Pinch Strength
Time Frame: Baseline to 4 weeks
Change in Pinch Strength measured using a Pinchmeter.
Baseline to 4 weeks
Pressure Pain Threshold
Time Frame: Baseline to 4 weeks
Change in pressure pain threshold assessed using J -Tech algometer.
Baseline to 4 weeks
Median Nerve Cross-Sectional Area
Time Frame: Baseline to 4 weeks
Change in Median Nerve Cross-Sectional Area Assessed by Ultrasonography.
Baseline to 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kutahya Health Sciences University

Investigators

  • Principal Investigator: Merve Akdeniz Leblebicier, MD, Kütahya Health Sciences University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 15, 2026

Primary Completion (Estimated)

January 15, 2027

Study Completion (Estimated)

March 15, 2027

Study Registration Dates

First Submitted

January 13, 2026

First Submitted That Met QC Criteria

January 13, 2026

First Posted (Actual)

January 22, 2026

Study Record Updates

Last Update Posted (Actual)

January 22, 2026

Last Update Submitted That Met QC Criteria

January 13, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Neurodynamic and Carpal Mobs

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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