Non-surgical Intervention for Carpal Tunnel Syndrome

Overview

This randomized controlled trial graduate student research study will explore the effect of non-surgical intervention of the dorsal application of Kinesio Tape for carpal tunnel syndrome, and forearm wrist hand pain.

Full Title of Study: “Effects on Occupational Performance Through Dorsal Application of Kinesio Tape for Musculoskeletal Disorder – Carpal Tunnel Syndrome”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Other
    • Masking: Single (Participant)
  • Study Primary Completion Date: October 23, 2018

Detailed Description

This randomized controlled trial graduate student research study will explore the effect of non-surgical intervention of the dorsal application of Kinesio Tape for carpal tunnel syndrome, and forearm wrist hand pain. Little evidence exists for an effective non-surgical intervention. Semi-structured interviews will be conducted to explore changes in occupational performance and compliance in order to understand if Kinesio Tape contributed to results and if so, how the participants perceived the interventions.

Interventions

  • Device: Kinesio 12 inch Tape
    • Kinesio Tape approximately 12-inch strip will be applied to the dorsal surface of the forearm of the affected side for three-day increments over three weeks of the study.
  • Device: Kinesio 4 inch Tape
    • Kinesio Tape for the control group will be a 4 inch Kinesio Tape applied to the scapular spine for three day increments over three weeks of the study.
  • Device: Cock up Splint and Lumbrical exercises
    • A general cock-up splint will be supplied, fitted, and checked on each of the four return visits by the researchers. Lumbrical exercises are also used and consist of active joint ranges for the wrist and hand. The exercises will be demonstrated by the researchers for 3-sets of 10 times each, daily, to be recorded in a log by the participants.

Arms, Groups and Cohorts

  • Experimental: Kinesio Tape
    • Dorsal application of Kinesio Tape to the affected extremity: Approximately 12 inches of Kinesio tape will be applied from the musculotendinous junction of the participant’s forearm over digits 1 and 5. Two – 2 inch strips of Kinesio Tape will be applied to the participant’s wrists over the volar and dorsal aspects. The Kinesio Tape will remain in place for three days, with the participants returning for skin check by the researchers and re-application by the researchers four times during the course of the study. A tape removal form will be provided should the participants want to remove it prior to the next visit.
  • Sham Comparator: Control group
    • Approximately 4 inch strip of Kinesio Tape will be applied to the scapular spine of the same side as the affected extremity. The Kinesio Tape will remain in place for three days, with the participants returning for skin check by the researchers and re-application four times during the course of the study by the researcher. A tape removal form will be provided should the participants want to remove it prior to the next visit.
  • Active Comparator: Standard of Care
    • Currently, the standard of care is a general cock-up splint and lumbrical exercises. A general cock-up splint will be supplied, fitted, and checked on each of the four return visits by the researchers. Lumbrical exercises are also used and consist of active joint ranges for the wrist and hand. The exercises will be demonstrated by the researchers for 3-sets of 10 times each, daily, to be recorded in a log by the participants.

Clinical Trial Outcome Measures

Primary Measures

  • Numerical Pain Rating Scale (NRS Pain)
    • Time Frame: change between baseline and 3 weeks
    • Numerical Pain Rating Scale (NRS Pain) involves patient circling a number from 0-10 with “0” meaning no pain and “5” moderate pain, and “10” is worst possible pain. The NRS is a segmented numeric scale, which a respondent selects a whole number (0-10 integers) that best reflects the intensity of their pain. Higher scores indicate greater pain intensity.
  • Visual Analog Scale for Pain (VAS Pain)
    • Time Frame: 3 weeks
    • The Visual Analogue Scale (VAS) is unidimensional measure of pain intensity, which has been widely used in diverse adult populations. The VAS measures participants perception of pain on a continuous scale. Individuals place a mark on a 10cm-long line. Using a ruler, the score is determined by measuring the distance (mm) on the 10-cm line between the “no pain” anchor and the patient’s mark, providing a range of scores from 0-100. A higher score indicates greater pain intensity. These are measured every 3 days for 3 weeks from baseline in the forearm, wrist and fingers.

Secondary Measures

  • Grip Strength and Pinch Strength
    • Time Frame: change between baseline and 3 weeks
    • Grip strength is measured by Jamar Dynamometer hydraulic gauge following standard protocol. A Jamar hydraulic pinch meter gauge is used to measure finger strength in the following positions: Lateral pinch, pad to pad, and 3 Jaw-chuck pinch positions are used. Grip and pinch strength will be measured every 3 days for 3 weeks from baseline.
  • Boston Carpal Tunnel Questionnaire Symptom Severity (BCTQ SS)
    • Time Frame: change between baseline and 3 weeks
    • The Boston Carpal Tunnel Questionnaire (BCTQ SS) is a standardised, patient-based outcome measure of symptom severity in patients with carpal tunnel syndrome. The questionnaire has 11 questions and uses a five-point rating scale. Each scale generates a final score (sum of individual scores divided by number of items) which ranges from 1 to 5, with a higher score indicating greater disability. It is measured every 3 days for 3 weeks from baseline.
  • Boston Carpal Tunnel Questionnaire Functional Scale (BCTQ FS)
    • Time Frame: 3-weeks
    • The Boston Carpal Tunnel Questionnaire Functional Scale (BCTQ FS) is self report 8-item questionnarie on functional activities for individuals with carpal tunnel, which have to be rated for degree of difficulty on a five-point scale. Each scale generates a final score (sum of individual scores divided by number of items) which ranges from 1 to 5, with a higher score indicating greater disability. It is measured every 3 days for 3 weeks from baseline.

Participating in This Clinical Trial

Inclusion Criteria

  • Adults > 18 years of age – Fluent in English – Report signs and symptoms of carpal tunnel syndrome – Pain, numbness, and tingling of the forearm, wrist, or hand, which worsen at night – Demonstrate positive Phalen's Test or Tinel's Test of the affected extremity Exclusion Criteria:

  • Currently receiving treatment for carpal tunnel syndrome – History of surgical carpal tunnel release – Pregnant – Diabetes not controlled by medication – Radiculopathy ie: cervical radiculopathy, diabetic radiculopathy – Thoracic outlet syndrome – Allergy to adhesives or compromised skin integrity – Past history of traumatic event, surgery, or congenital impairment of the forearm, wrist, or hand

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 99 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Loma Linda University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Heather Javaherian-Dysinger, Associate Professor – Loma Linda University
  • Overall Official(s)
    • Grenith Zimmerman, PhD, Study Chair, Loma Linda University

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