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Graded Motor Imagery in Carpal Tunnel Syndrome

30 августа 2026 г. обновлено: 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.

Обзор исследования

Статус

Еще не набирают

Условия

Вмешательство/лечение

Подробное описание

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.

Тип исследования

Интервенционный

Регистрация (Оцененный)

46

Фаза

  • Непригодный

Контакты и местонахождение

В этом разделе приведены контактные данные лиц, проводящих исследование, и информация о том, где проводится это исследование.

Контакты исследования

  • Имя: Zeynep Yıldız Kızkın
  • Номер телефона: +905346945085
  • Электронная почта: pt.zeynepyildiz@gmail.com

Критерии участия

Исследователи ищут людей, которые соответствуют определенному описанию, называемому критериям приемлемости. Некоторыми примерами этих критериев являются общее состояние здоровья человека или предшествующее лечение.

Критерии приемлемости

Возраст, подходящий для обучения

  • Взрослый

Принимает здоровых добровольцев

Нет

Описание

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.

Учебный план

В этом разделе представлена ​​подробная информация о плане исследования, в том числе о том, как планируется исследование и что оно измеряет.

Как устроено исследование?

Детали дизайна

  • Основная цель: Уход
  • Распределение: Рандомизированный
  • Интервенционная модель: Параллельное назначение
  • Маскировка: Одинокий

Оружие и интервенции

Группа участников / Армия
Вмешательство/лечение
Экспериментальный: 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.
Другой: Graded Motor Imagery (GMI)

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.

Другой: Progressive Neurodynamic Exercise
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.
Другой: Nighttime Resting Splint
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.
Активный компаратор: 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.
Другой: Progressive Neurodynamic Exercise
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.
Другой: Nighttime Resting Splint
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.

Что измеряет исследование?

Первичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Disabilities of the Arm, Shoulder, and Hand (DASH)
Временное ограничение: 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
Disabilities of the Arm, Shoulder, and Hand (DASH)
Временное ограничение: 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

Вторичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Мини-обследование психического состояния
Временное ограничение: Базовый уровень
Мини-тест психического состояния (MMSE) будет использоваться для оценки когнитивного статуса пациентов. Он состоит из 11 вопросов и оценивается по 30-балльной шкале. Результат от 24 до 30 баллов считается нормальным, 18–23 балла указывают на легкие когнитивные нарушения, а балл 17 и ниже указывает на тяжелую деменцию. MMSE оценивает ориентацию, память, внимание, счет, память, язык, двигательную функцию, восприятие и зрительно-пространственные способности.
Базовый уровень
Mini Mental State Examination
Временное ограничение: 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.
After the 6-week intervention
Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)
Временное ограничение: Baseline
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)
Временное ограничение: 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.
After the 6-week intervention
The Semmes-Weinstein Monofilament Test
Временное ограничение: 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.
Baseline
The Semmes-Weinstein Monofilament Test
Временное ограничение: 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
Временное ограничение: 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.
Baseline
Purdue Pegboard Test
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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
Временное ограничение: 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.
Baseline
Grip Strength
Временное ограничение: After the 6-week intervention
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.
After the 6-week intervention

Соавторы и исследователи

Здесь вы найдете людей и организации, участвующие в этом исследовании.

Спонсор

Artvin Coruh University

Следователи

  • Главный следователь: Zeynep Yıldız Kızkın, Artvin Coruh University

Даты записи исследования

Эти даты отслеживают ход отправки отчетов об исследованиях и сводных результатов на сайт ClinicalTrials.gov. Записи исследований и сообщаемые результаты проверяются Национальной медицинской библиотекой (NLM), чтобы убедиться, что они соответствуют определенным стандартам контроля качества, прежде чем публиковать их на общедоступном веб-сайте.

Изучение основных дат

Начало исследования (Оцененный)

1 марта 2027 г.

Первичное завершение (Оцененный)

1 июля 2027 г.

Завершение исследования (Оцененный)

30 декабря 2027 г.

Даты регистрации исследования

Первый отправленный

30 августа 2026 г.

Впервые представлено, что соответствует критериям контроля качества

30 августа 2026 г.

Первый опубликованный (Действительный)

2 сентября 2026 г.

Обновления учебных записей

Последнее опубликованное обновление (Действительный)

2 сентября 2026 г.

Последнее отправленное обновление, отвечающее критериям контроля качества

30 августа 2026 г.

Последняя проверка

1 августа 2026 г.

Дополнительная информация

Термины, связанные с этим исследованием

Ключевые слова

Дополнительные соответствующие термины MeSH

Другие идентификационные номера исследования

  • Graded Motor Imagery in CTS

Планирование данных отдельных участников (IPD)

Планируете делиться данными об отдельных участниках (IPD)?

НЕТ

Информация о лекарствах и устройствах, исследовательские документы

Изучает лекарственный продукт, регулируемый FDA США.

Нет

Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.

Нет

Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .

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