Graded Motor Imagery in Carpal Tunnel Syndrome
2026年8月30日 更新者：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.
研究概览
地位
尚未招聘
条件
详细说明
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.
研究类型
介入性
注册 (估计的)
46
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习联系方式
- 姓名：Zeynep Yıldız Kızkın
- 电话号码：+905346945085
- 邮箱：pt.zeynepyildiz@gmail.com
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
接受健康志愿者
不
描述
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.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：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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有源比较器：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.
|
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.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Disabilities of the Arm, Shoulder, and Hand (DASH)
大体时间：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)
大体时间：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
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
简易精神状态检查
大体时间：基线
|
简易精神状态检查（MMSE）将用于评估患者的认知状态。
它由 11 个问题组成，评分标准为 30 分。
24-30 之间的分数被认为是正常的，18-23 表示轻度认知障碍，17 或以下的分数表示严重痴呆。
MMSE 评估方向、记忆、注意力、计算、回忆、语言、运动功能、感知和视觉空间能力。
|
基线
|
|
Mini Mental State Examination
大体时间：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)
大体时间：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)
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Zeynep Yıldız Kızkın、Artvin Coruh University
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (估计的)
2027年3月1日
初级完成 (估计的)
2027年7月1日
研究完成 (估计的)
2027年12月30日
研究注册日期
首次提交
2026年8月30日
首先提交符合 QC 标准的
2026年8月30日
首次发布 (实际的)
2026年9月2日
研究记录更新
最后更新发布 (实际的)
2026年9月2日
上次提交的符合 QC 标准的更新
2026年8月30日
最后验证
2026年8月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.