Graded Motor Imagery in Carpal Tunnel Syndrome
2026년 8월 30일 업데이트: Zeynep Yıldız Kızkın, Artvin Coruh University
Is There an Advantage to Incorporating a Central Nervous System-targeted Intervention Within an Exercise Program for Individuals Diagnosed With Carpal Tunnel Syndrome? A Randomized Controlled Trial
The aim of this study is to investigate whether the addition of Graded Motor Imagery (GMI) to progressive neurodynamic exercises is more effective than progressive neurodynamic exercises alone in individuals with carpal tunnel syndrome (CTS).
The objectives are to reduce pain and symptom severity, improve pain, sensorimotor function, physical performance, and grip strength through the addition of GMI.
연구 개요
상태
아직 모집하지 않음
상세 설명
46 voluntary patients with CTS, aged between 30-60 years will be randomly divided into two groups: GMI and progressive neurodynamic exercise group.
Interventions will be applied for 6 weeks, 2 times a week (12 sessions).
Both groups will receive progressive neurodynamic exercises and a nighttime resting splint.
The GMI group will additionally receive Graded Motor Imagery, while the control group will receive no additional intervention.
The patients will be assessed before, and after treatment.
Upper extremity function and disability will be assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, cognitive status will be screened using the Mini-Mental State Examination (MMSE), and symptom severity and functional status related to CTS will be evaluated using the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ).
Sensory function will be assessed using the Semmes-Weinstein Monofilament Test and the Two-Point Discrimination Test, fine manual dexterity will be evaluated using the Purdue Pegboard Test, and hand grip strength will be measured using a Jamar hand dynamometer.
연구 유형
중재적
등록 (추정된)
46
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 연락처
- 이름: Zeynep Yıldız Kızkın
- 전화번호: +905346945085
- 이메일: pt.zeynepyildiz@gmail.com
참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
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아니
설명
Inclusion Criteria:
- mild to moderate unilateral CTS based on the Bland classification of electrodiagnostic testing ;
- positive Phalen or Tinel tests;
- symptoms such as paresthesia and pain associated with CTS that last longer than 3 months;
- patients aged 30-60 years (when CTS becomes more prevalent);
- patients who achieved a minimum score of 24 on the Mini-Mental State Examination (MMSE).
Exclusion Criteria:
- bilateral CTS;
- history of prior CTS surgery;
- clinical indicators of cervical radiculopathy or polyneuropathy;
- pregnancy or cognitive impairment;
- the presence of orthopedic, neurological, or functional problems on the unaffected side that could affect hand function (e.g., history of trauma or surgery, peripheral nerve injury, tendinopathy, tenosynovitis, trigger finger, arthritis, sequelae of a fracture, etc.);
- receipt of any conservative treatment for CTS within the last month.
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Graded Motor Imagery
Each patient in the Graded Motor Imagery group will receive a treatment protocol consisting of Graded Motor Imagery, progressive neurodynamic exercises, and nighttime resting splints.
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GMI includes three stages. GMI program will span over 6 weeks. The first 2 weeks will focus on lateralization, followed by 2 weeks of motor imagery, and the final 2 weeks will involve mirror therapy. Lateralization: Patients will be asked to differentiate whether the hands shown in the Recognise™ Hand application belongs to the right or left side of their body. Motor Imagery: Patients will be instructed to imagine slowly and smoothly moving their affected extremities to the posture depicted in the photos in the Recognise™ Hand application and then returning to the starting position. Mirror Therapy: Using a mirror measuring 300 x 300 x 300 mm³ placed between the upper extremities, patients will be instructed to progressively move only their unaffected extremity, then their affected extremity, and finally both extremities.
The progressive neurodynamic exercises involved holding each position for 5 seconds.
Each session included two sets of 10 repetitions (2×10).
The treatment lasted for 30-minute sessions, conducted twice weekly over a total of 6 weeks.
The night splint was fitted with a wrist splint that keeps the wrist in a neutral position, permits finger flexion, maintains the wrist within a 0°-5° extension range, and ends just distal to the distal palmar crease.
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활성 비교기: Progressive Neurodynamic Exercises
Each patient in the progressive neurodynamic exercises group will receive a treatment protocol consisting of progressive neurodynamic exercises and nighttime resting splints.
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The progressive neurodynamic exercises involved holding each position for 5 seconds.
Each session included two sets of 10 repetitions (2×10).
The treatment lasted for 30-minute sessions, conducted twice weekly over a total of 6 weeks.
The night splint was fitted with a wrist splint that keeps the wrist in a neutral position, permits finger flexion, maintains the wrist within a 0°-5° extension range, and ends just distal to the distal palmar crease.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Disabilities of the Arm, Shoulder, and Hand (DASH)
기간: Baseline
|
DASH is a 30-item self-report tool assessing upper-extremity disability and symptoms, including daily activities, pain, numbness, joint stiffness, weakness, sleep issues, and psychological effects.
Examples include turning a doorknob, changing a light bulb, and cutting food.
Scores range from 0 to 100; higher scores indicate more severe symptoms and impairment.
|
Baseline
|
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Disabilities of the Arm, Shoulder, and Hand (DASH)
기간: After the 6-week intervention
|
DASH is a 30-item self-report tool assessing upper-extremity disability and symptoms, including daily activities, pain, numbness, joint stiffness, weakness, sleep issues, and psychological effects.
Examples include turning a doorknob, changing a light bulb, and cutting food.
Scores range from 0 to 100; higher scores indicate more severe symptoms and impairment.
|
After the 6-week intervention
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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미니 정신 상태 검사
기간: 기준선
|
MMSE(Mini-Mental State Examination)는 환자의 인지 상태를 평가하는 데 사용됩니다.
총 11문항으로 구성되어 있으며 30점 만점으로 평가됩니다.
24~30점은 정상, 18~23점은 경도인지장애, 17점 이하면 중증 치매로 분류한다.
MMSE는 방향, 기억, 주의, 계산, 회상, 언어, 운동 기능, 지각 및 시공간 능력을 평가합니다.
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기준선
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Mini Mental State Examination
기간: After the 6-week intervention
|
The Mini-Mental State Examination (MMSE) will be used to assess the cognitive status of patients.
It consists of 11 questions and is evaluated on a scale of 30 points.
A score between 24-30 is considered normal, 18-23 indicates mild cognitive impairment, and a score of 17 or below is indicative of severe dementia.
The MMSE assesses orientation, memory, attention, calculation, recall, language, motor function, perception, and visuospatial abilities.
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After the 6-week intervention
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Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)
기간: Baseline
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A patient-reported assessment uses a 5-point Likert scale with two subscales: the 11-item Symptom Severity Scale (CTSQ-S) for symptom intensity like numbness and pain, and the 8-item Functional Status Scale (CTSQ-F) for ADL ability such as writing and dressing.
Higher scores mean more severe symptoms and impairment.
The BCTQ shows high reliability, validity, and sensitivity to clinical changes.
|
Baseline
|
|
Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)
기간: After the 6-week intervention
|
A patient-reported assessment uses a 5-point Likert scale with two subscales: the 11-item Symptom Severity Scale (CTSQ-S) for symptom intensity like numbness and pain, and the 8-item Functional Status Scale (CTSQ-F) for ADL ability such as writing and dressing.
Higher scores mean more severe symptoms and impairment.
The BCTQ shows high reliability, validity, and sensitivity to clinical changes.
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After the 6-week intervention
|
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The Semmes-Weinstein Monofilament Test
기간: Baseline
|
The assessment used a monofilament test (0.49-0.96), known for high sensitivity in diagnosing CTS.
Sensory thresholds were checked at the radial tips of the thumbs, index, middle, and ring fingers.
The monofilament was applied perpendicularly to the dorsal finger pads with eyes closed and the wrist in a neutral position.
Pressure was applied for 1 to 1.5 seconds until slight bending of the filament.
Lower readings indicate better sensory function; higher readings suggest worse light touch perception.
A gauge of 2.83 grams is the normal threshold, while 3.22 grams or higher indicates moderate-to-severe sensory impairment in CTS.
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Baseline
|
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The Semmes-Weinstein Monofilament Test
기간: After the 6-week intervention
|
The assessment used a monofilament test (0.49-0.96), known for high sensitivity in diagnosing CTS.
Sensory thresholds were checked at the radial tips of the thumbs, index, middle, and ring fingers.
The monofilament was applied perpendicularly to the dorsal finger pads with eyes closed and the wrist in a neutral position.
Pressure was applied for 1 to 1.5 seconds until slight bending of the filament.
Lower readings indicate better sensory function; higher readings suggest worse light touch perception.
A gauge of 2.83 grams is the normal threshold, while 3.22 grams or higher indicates moderate-to-severe sensory impairment in CTS.
|
After the 6-week intervention
|
|
Purdue Pegboard Test
기간: Baseline
|
The Purdue Pegboard consists of 50 holes in two columns, with pins, washers, and sleeves in four recesses at the top.
Patients sat in front of the apparatus and performed four tests: the dominant hand, non-dominant hand, two-hand, and assembly test.
For the hand tests, they inserted pins into holes with their hands for 30 seconds each; the two-hand test used both hands.
In the assembly test, they placed materials in order: pin → washer → collars → washer within 60 seconds.
Each test was repeated three times, and scores were averaged.
This test assesses fine motor skills, coordination, finger dexterity, hand-eye coordination, and small object manipulation; lower scores indicate poorer hand skills.
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Baseline
|
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Purdue Pegboard Test
기간: After the 6-week intervention
|
The Purdue Pegboard consists of 50 holes in two columns, with pins, washers, and sleeves in four recesses at the top.
Patients sat in front of the apparatus and performed four tests: the dominant hand, non-dominant hand, two-hand, and assembly test.
For the hand tests, they inserted pins into holes with their hands for 30 seconds each; the two-hand test used both hands.
In the assembly test, they placed materials in order: pin → washer → collars → washer within 60 seconds.
Each test was repeated three times, and scores were averaged.
This test assesses fine motor skills, coordination, finger dexterity, hand-eye coordination, and small object manipulation; lower scores indicate poorer hand skills.
|
After the 6-week intervention
|
|
The Two-Point Discrimination Test
기간: Baseline
|
The two-point discrimination threshold was evaluated using an esthesiometer applied to the pulp of the thumb, index, and middle fingers.
During the evaluation, participants' eyes remained closed, and light stimuli, consisting of either one or two points, were randomly presented along the longitudinal axis of the fingers.
The procedure began at a distance of 5 mm, with 10 trials conducted at each specified interval.
If the participant failed to achieve at least seven correct responses, the distance was increased by 1 mm, and the test was repeated.
The discrimination threshold was defined as the smallest distance at which at least seven out of ten responses were correct.
Testing was discontinued at a maximum distance of 15 mm, with values below 6 mm considered within normal limits.
|
Baseline
|
|
The Two-Point Discrimination Test
기간: After the 6-week intervention
|
The two-point discrimination threshold was evaluated using an esthesiometer applied to the pulp of the thumb, index, and middle fingers.
During the evaluation, participants' eyes remained closed, and light stimuli, consisting of either one or two points, were randomly presented along the longitudinal axis of the fingers.
The procedure began at a distance of 5 mm, with 10 trials conducted at each specified interval.
If the participant failed to achieve at least seven correct responses, the distance was increased by 1 mm, and the test was repeated.
The discrimination threshold was defined as the smallest distance at which at least seven out of ten responses were correct.
Testing was discontinued at a maximum distance of 15 mm, with values below 6 mm considered within normal limits.
|
After the 6-week intervention
|
|
Grip Strength
기간: Baseline
|
Grip strength was measured using a hand dynamometer.
The participant sat comfortably with shoulder abducted, elbow at 90°, and forearm neutral.
The wrist was between 0° and 30° extension.
Each hand was tested three times with one-minute rests, and the average was recorded.
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Baseline
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Grip Strength
기간: After the 6-week intervention
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Grip strength was measured using a hand dynamometer.
The participant sat comfortably with shoulder abducted, elbow at 90°, and forearm neutral.
The wrist was between 0° and 30° extension.
Each hand was tested three times with one-minute rests, and the average was recorded.
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After the 6-week intervention
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수사관
- 수석 연구원: Zeynep Yıldız Kızkın, Artvin Coruh University
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (추정된)
2027년 3월 1일
기본 완료 (추정된)
2027년 7월 1일
연구 완료 (추정된)
2027년 12월 30일
연구 등록 날짜
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2026년 8월 30일
QC 기준을 충족하는 최초 제출
2026년 8월 30일
처음 게시됨 (실제)
2026년 9월 2일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 9월 2일
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2026년 8월 1일
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- Graded Motor Imagery in CTS
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
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