Effects of diacutaneous fibrolysis in patients with mild to moderate symptomatic carpal tunnel syndrome: a randomized controlled trial

• Published in: Clinical rehabilitation 2018-12, Vol.32 (12), p.1645-1655
• Main Authors: Jiménez del Barrio, Sandra, Estébanez de Miguel, Elena, Bueno Gracia, Elena, Haddad Garay, María, Tricás Moreno, José Miguel, Hidalgo García, César
• Format: Article
• Language: English
• Subjects: Adult; Carpal tunnel syndrome; Carpal Tunnel Syndrome - complications; Carpal Tunnel Syndrome - physiopathology; Carpal Tunnel Syndrome - rehabilitation; Clinical trials; Confidence intervals; Double-Blind Method; Evidence-based medicine; Female; Functional status; Humans; Latency; Male; Massage - methods; Middle Aged; Neural Conduction; Physical therapy; Questionnaires; Recovery of Function; Repetitive strain injuries; Symptom Assessment; Treatment Outcome; Wrists
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215518787316

Objective: To compare the effects of diacutaneous fibrolysis with sham in patients with mild to moderate carpal tunnel syndrome. Design: Double-blind (patient and evaluator) randomized controlled trial. Setting: Miguel Servet University Hospital, Zaragoza, Spain. Subjects: A total of 52 patients (72 wrists) with carpal tunnel syndrome, 41 women and 11 men, mean age was 46.9 (8.8) years. They were divided into two groups: diacutaneous fibrolysis group and sham group. Interventions: Real diacutaneous fibrolysis in diacutaneous fibrolysis group and sham diacutaneous fibrolysis in sham group. Both groups received five sessions in the forearm, wrist and hand. Main measures: Neurophysiological parameters assessed at baseline and at the end of the treatment. Intensity of nocturnal symptoms (visual analogue scale (VAS)) and upper limb functional capacity (Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire) at baseline, at the end of the treatment and one month after treatment. Results: Diacutaneous fibrolysis group (n = 30 wrists) improved in nerve conduction distal motor latency (mean difference: –0.26, 95% confidence interval (CI): –0.49/–0.26), sensory conduction velocity (mean difference: 6.52, 95% CI: 3.52/9.51), intensity of nocturnal symptoms (mean difference: –2.24, 95% CI: –4.08/–2.04) and upper limb functional capacity (mean difference: –19, 95% CI: –26.1/–11.9) compared to the sham group (n = 30 wrists) (P