Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome: An MRI study to reveal therapeutic mechanisms

Schmid, Annina B., Elliott, James M., Strudwick, Mark W., Little, Mary and Coppieters, Michel W. (2012) Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome: An MRI study to reveal therapeutic mechanisms. Journal of Orthopaedic Research, 30 8: 1343-1350. doi:10.1002/jor.22064

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Author Schmid, Annina B.
Elliott, James M.
Strudwick, Mark W.
Little, Mary
Coppieters, Michel W.
Title Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome: An MRI study to reveal therapeutic mechanisms
Journal name Journal of Orthopaedic Research   Check publisher's open access policy
ISSN 0736-0266
1554-527X
Publication date 2012-08-01
Sub-type Article (original research)
DOI 10.1002/jor.22064
Open Access Status
Volume 30
Issue 8
Start page 1343
End page 1350
Total pages 8
Place of publication Hoboken, NJ, U.S.A.
Publisher John Wiley & Sons
Language eng
Formatted abstract
Splinting and nerve and tendon gliding exercises are commonly used to treat carpal tunnel syndrome (CTS). It has been postulated that both modalities reduce intraneural edema. To test this hypothesis, 20 patients with mild to moderate CTS were randomly allocated to either night splinting or a home program of nerve and tendon gliding exercises. Magnetic resonance images of the wrist were taken at baseline, immediately after 10 min of splinting or exercise, and following 1 week of intervention. Primary outcome measures were signal intensity of the median nerve at the wrist as a measure of intraneural edema and palmar bowing of the carpal ligament. Secondary outcome measures were changes in symptom severity and function. Following 1 week of intervention, but not immediately after 10 min, signal intensity of the median nerve was reduced by ~11% at the radioulnar level for both interventions (p = 0.03). This was accompanied by a mild improvement in symptoms and function (p < 0.004). A similar reduction in signal intensity is not observed in patients who only receive advice to remain active. No changes in signal intensity were identified further distally (p > 0.28). Ligament bowing remained unchanged (p > 0.08). Intraneural edema reduction is a likely therapeutic mechanism of splinting and exercise.
Keyword MRI
Nerve and tendon gliding exercises
Splinting
Carpal tunnel syndrome
Neurodynamics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
Centre for Advanced Imaging Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 15 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 16 times in Scopus Article | Citations
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Created: Wed, 25 Jan 2012, 18:53:07 EST by Sandrine Ducrot on behalf of Physiotherapy