Peripheral and Central Adaptations After a Median Nerve Neuromobilization Program Completed by Individuals With Carpal Tunnel Syndrome: An Exploratory Mechanistic Study Using Musculoskeletal Ultrasound Imaging and Transcranial Magnetic Stimulation
| Autor: | Johanne Higgins, Philippe Paquette, Dany H. Gagnon |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Musculoskeletal ultrasound Wrist Conservative Treatment 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Surveys and Questionnaires Medicine Humans Intervention Duration Carpal tunnel syndrome Ultrasonography 030222 orthopedics business.industry Middle Aged medicine.disease Carpal Tunnel Syndrome Musculoskeletal Manipulations Transcranial Magnetic Stimulation Median nerve Peripheral Exercise Therapy Median Nerve Transcranial magnetic stimulation medicine.anatomical_structure Upper limb Female Chiropractics business 030217 neurology & neurosurgery |
| Zdroj: | Journal of manipulative and physiological therapeutics. 43(6) |
| ISSN: | 1532-6586 |
| Popis: | Objective Neuromobilization exercises are increasingly advocated in the conservative management of individuals with carpal tunnel syndrome (CTS), as they may mitigate CTS-related signs and symptoms via potential peripheral (ie, musculoskeletal) and central (ie, neurophysiological) adaptations. However, the mechanisms underlying these adaptations have not been studied extensively. Hence, this exploratory and mechanistic study aims to evaluate the potential peripheral and central adaptations that may result in individuals with CTS who have completed a neuromobilization program. Methods Fourteen individuals with CTS were evaluated before and 1 week after the completion of a 4-week neuromobilization program that incorporated median nerve sliding exercises. Pain and upper limb functional abilities were assessed using standardized questionnaires. The biological integrity and mechanical properties of the median nerve and the corticospinal excitability were quantified using musculoskeletal ultrasound imaging and transcranial magnetic stimulation, respectively. Results Upon completion of the program, participants reported both large and moderate improvements in pain (P ≤ .03) and upper limb functional abilities (P = .02), respectively. The biological integrity and mechanical properties of the median nerve remained unchanged (P ≥ .22), whereas a small significant increase in corticospinal excitability (P = .04) was observed. Conclusion The proposed neuromobilization program appears promising to improve pain and upper limb functional abilities in individuals with CTS. These improvements may be preferentially mediated via central, rather than peripheral, adaptations. Future studies, especially with a larger sample size, longer intervention duration, and additional measurement times, are needed to strengthen current evidence. |
| Databáze: | OpenAIRE |
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