Effects of Power Ball Exercises in Addition to Routine Physical Therapy on Pain, Grip Strength and Functional Disability in Patients with Carpal Tunnel Syndrome
Power Ball Exercises in Carpal Tunnel Syndrome
DOI:
https://doi.org/10.55735/hjprs.v3i4.139Keywords:
carpal tunnel syndrome, functional disability, grip strength, pain, physical therapy, power ball exercisesAbstract
Background: Carpal tunnel syndrome is a common entrapment neuropathy that often presents with pain, numbness, tingling and weakness in the hand and arm. Delayed treatment may worsen the symptoms and progresses to permanent sensory loss and thenar paralysis in some cases. Objective: To determine the comparative effects of Powerball exercises and strength training on pain, functional disability and grip strength in patients having carpal tunnel syndrome. Methods: This controlled trial was done from March to December 2022 at Badar Medical Complex on 86 patients that were recruited through purposive sampling. group A received routine physical therapy only while group B received Powerball exercises and routine physical therapy. Participants of both gender with aged 45-60 years were clinically diagnosed syndrome with a time span of more than two months and numbness over the dorsum surface of the thumb, index, middle and lateral 1/3rd of ring fingers and positive Tinel’s sign with Phalen’s maneuver were included in the study. Pain, grip strength and functional status were the outcome measures, observed through a numeric pain rating scale, hand-held dynamometer and Boston carpal tunnel syndrome questionnaire at baseline, 2nd and 4th week. Independent t-test and mixed-design analysis of variance were used for between and within-group differences respectively. Results: The mean age of participants was 37.10 ± 7.85 and there were 50 (58%) females and 36 (42%) males in the study and 46 (54%) participants had normal body mass index, 44 (51%) had right-sided carpal tunnel syndrome. The results showed significant between-group differences in pain, and functional disability (p<0.05). However, no significant difference was observed for grip strength. The within-group difference was found significant in both groups for all variables (p<0.05). Conclusion: The addition of Powerball exercises with routine physical therapy is more effective in reducing pain and improving functional disability and grip strength in patients with carpal tunnel syndrome than physical therapy alone.
References
Ghasemi-Rad M, Nosair E, Vegh A, Mohammadi A, Akkad A, Lesha E, Mohammadi MH, Sayed D, Davarian A, Maleki-Miyandoab T, Hasan A. A handy review of carpal tunnel syndrome: From anatomy to diagnosis and treatment. World journal of radiology. 2014 Jun 6;6(6):284. doi: 10.4329/wjr.v6.i6.284
Yunoki M, Kanda T, Suzuki K, Uneda A, Hirashita K, Yoshino K. Importance of recognizing carpal tunnel syndrome for neurosurgeons: a review. Neurologia medico-chirurgica. 2017;57(4):172-183. DOI: https://doi.org/10.2176/nmc.ra.2016-0225
Shi Q, Bobos P, Lalone EA, Warren L, MacDermid JC. Comparison of the short-term and long-term effects of surgery and nonsurgical intervention in treating carpal tunnel syndrome: a systematic review and meta-analysis. Hand. 2020 Jan;15(1):13-22. DOI: https://doi.org/10.1177/1558944718787892
Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal tunnel syndrome: a review of literature. Cureus. 2020 Mar 19;12(3). DOI: 10.7759/cureus.7333
Ni'mah DN, Naufal AF, Wijayaningsih A. PHYSIOTHERAPY MANAGEMENT FOR CARPAL TUNNEL SYNDROME: A CASE STUDY. InAcademic Physiotherapy Conference Proceeding 2021.
Hidayati HB, Subadi I, Fidiana F, Puspamaniar VA. Current diagnosis and management of carpal tunnel syndrome: A review. Anaesthesia, Pain & Intensive Care. 2022 Jan 6;26(3):394-404. DOI: https://doi.org/10.35975/apic.v26i3.1902
Bahrami MH, Shahraeeni S, Raeissadat SA. Comparison between the effects of progesterone versus corticosteroid local injections in mild and moderate carpal tunnel syndrome: a randomized clinical trial. BMC Musculoskeletal Disorders. 2015 Dec;16:1-6. DOI: https://doi.org/10.1186/s12891-015-0752-6
Burton C, Chesterton LS, Davenport G. Diagnosing and managing carpal tunnel syndrome in primary care. British Journal of General Practice. 2014 May 1;64(622):262-263 DOI: https://doi.org/10.3399/bjgp14X679903
Omejec G, Kresal F. New insights into treatment of patients with carpal tunnel syndrome. Proceedings of Socratic Lectures. 2022;7:7-15.DOI:https://doi.org/10.55295/PSL.2022.D2
Kim PT, Lee HJ, Kim TG, Jeon IH. Current approaches for carpal tunnel syndrome. Clinics in Orthopedic Surgery. 2014 Sep 1;6(3):253-257. DOI: https://doi.org/10.4055/cios.2014.6.3.253
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology. 2016;15(12):1273-1284. DOI: https://doi.org/10.1016/S1474-4422(16)30231-9
Chen CC, Wu YT, Su YC, Shen YP, Chen FP. Efficacy of laser acupuncture for carpal tunnel syndrome: a study protocol for a prospective double-blind randomized controlled trial. Medicine. 2019 Jul;98(30). doi: 10.1097/MD.0000000000016516
Hofer M, Ranstam J, Atroshi I. Extended follow-up of local steroid injection for carpal tunnel syndrome: a randomized clinical trial. JAMA network open. 2021 Oct 1;4(10):e2130753-e2130753. doi:10.1001/jamanetworkopen.2021.30753
Huisstede BM, Fridén J, Coert JH, Hoogvliet P, European HANDGUIDE Group. Carpal tunnel syndrome: hand surgeons, hand therapists, and physical medicine and rehabilitation physicians agree on a multidisciplinary treatment guideline—results from the European HANDGUIDE Study. Archives of physical medicine and rehabilitation. 2014 Dec 1;95(12):2253-2263. DOI: https://doi.org/10.1016/j.apmr.2014.06.022
Lucado AM, Dale RB, Vincent J, Day JM. Do joint mobilizations assist in the recovery of lateral elbow tendinopathy? A systematic review and meta-analysis. Journal of Hand Therapy. 2019 Apr 1;32(2):262-276. DOI: https://doi.org/10.1016/j.jht.2018.01.010
Dabees N, El-Saadany H, El-Barbary A, Ammar AS. Ultrasound guided steroids injection for carpal tunnel syndrome. Int J Med Imaging. 2015;3(4):75-81. DOI: 10.11648/j.ijmi.20150304.12
Oskouei AE, Talebi GA, Shakouri SK, Ghabili K. Effects of neuromobilization maneuver on clinical and electrophysiological measures of patients with carpal tunnel syndrome. Journal of physical therapy science. 2014;26(7):1017-1022. DOI: https://doi.org/10.1589/jpts.26.1017
Kumar R, Jetly S. Comparison between myofascial release technique and cyriax manual therapy on pain and disability in subjects with lateral epicondylitis. Indian Journal of Physiotherapy and Occupational Therapy. 2016 Jul;10:12-17. DOI: 10.5958/0973-5674.2016.00075.7
Teo SJ, Saleh WN, Subramaniam RN, Hanapi NS, Yap YH. The Prevalence and Associated Risk Factors of Carpal Tunnel Syndrome among Private Dentists in Klang Valley, Malaysia: A Cross-sectional Study. Annals of Dentistry University of Malaya. 2022 Dec 28;29:52-59. DOI: https://doi.org/10.22452/adum.vol29no8
Ho TY, Chen SR, Li TY, Li CY, Lam KH, Chen LC, Wu YT. Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study. International Journal of Medical Sciences. 2021;18(9):1960. DOI: 10.7150/ijms.56142
Savage NJ, Albano J. Marrying Tendon and Nerve Gliding Exercises with Hydrodissection Following Injection for Carpal Tunnel Syndrome–A New Treatment Approach?. Journal of Orthopaedic Case Reports. 2020 Dec;10(9):38-46. DOI: 10.13107/jocr.2020.v10.i09.1896
Sheereen FJ, Sarkar B, Sahay P, Shaphe MA, Alghadir AH, Iqbal A, Ali T, Ahmad F. Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome. Pain Research and Management. 2022 Jun 8;2022. DOI: https://doi.org/10.1155/2022/1975803
Vladeva EP. The Boston Carpal Tunnel Questionnaire/Bctq/− a Reliable Method for Diagnosis and Assessment of the Treatment of Carpal Tunnel Syndrome. International Academy Journal Web of Scholar. 2020(2 (44)):58-63. DOI: https://doi.org/10.31435/rsglobal_wos/28022020/6920
Haque A. Effectiveness of hand therapy intervention for carpal tunnel syndrome patients at CRP (Doctoral dissertation, Bangladesh Health Professions Institute (The academic institute of CRP), University of Dhaka). URI: http://hdl.handle.net/123456789/171
Unver S, Akyolcu N. The effect of hand exercise on reducing the symptoms in hemodialysis patients with carpal tunnel syndrome. Asian journal of neurosurgery. 2018 Mar;13(01):31-36. DOI: 10.4103/ajns.AJNS_343_16
Ren YM, Wang XS, Wei ZJ, Fan BY, Lin W, Zhou XH, Feng SQ. Efficacy, safety, and cost of surgical versus nonsurgical treatment for carpal tunnel syndrome: a systematic review and meta-analysis. Medicine. 2016 Oct;95(40). DOI: 10.1097/MD.0000000000004857
Asadi MR, Saremi H, Radinmehr H, Rahbar S, Talimkhani A, Hajvalie G, Majidi L. Effect of Low-Level Laser Therapy Combined with Therapeutic Ultrasound on Hand Pain and Function Following Carpal Tunnel Syndrome: A Randomized Controlled Trial. Middle East Journal of Rehabilitation and Health Studies. 2021 Oct 31;8(4). DOI: 10.5812/mejrh.116063
Salman Roghani R, Holisaz MT, Tarkashvand M, Delbari A, Gohari F, Boon AJ, Lokk J. Different doses of steroid injection in elderly patients with carpal tunnel syndrome: a triple-blind, randomized, controlled trial. Clinical interventions in aging. 2018 Jan 18:117-124. DOI: https://doi.org/10.2147/CIA.S151290
Paquette P, Higgins J, Danino MA, Harris P, Lamontagne M, Gagnon DH. Effects of a preoperative neuromobilization program offered to individuals with carpal tunnel syndrome awaiting carpal tunnel decompression surgery: A pilot randomized controlled study. Journal of Hand Therapy. 2021 Jan 1;34(1):37-46. DOI: https://doi.org/10.1016/j.jht.2019.12.012
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