The effect of neurodynamic techniques and Electroacupuncture on pain, grip strength and hand function in subject with carpal tunnel syndrome: Randomized control trial

The purpose of this study is to investigate the effect of the Neurodynamic technique with electroacupuncture on pain, strength, and hand function in people with carpal tunnel syndrome.

A clinical trial, with a control group, with two parallel groups, double-blinded, randomized through blocking, was conducted on 38 people. The website https://www.randomizer.org/ will be used for randomization.

The study is performed in the rehabilitation faculty of Iran University of Medical Sciences. Then eligible participants sign an informed consent form and are randomly assigned to two groups of Electroacupuncture and placebo Electroacuouncture by Block-balanced randomization technique. Treatment and assessment are done by separate persons and the assessor and analyzer of data will be kept blind. The assessor is present only at the time of the assessment

Inclusion criteria: 1.18_60 year old. 2.Numbness and pain in the area of the median nerve (between 1 to 6 months). 3.Participants who have diminished nerve conduction values (<50 m/s), increased motor latency (>4 m/s), and increased sensory latency (> 3.5 m/s). 4.Positive phalen and tinel sign. Exclusion criteria: 1.Muscular atrophy. 2. Pregnancy. 3.Prior decompression surgery. 4.Post trauma to the wrist. 5.Diabetes Mellitus in case of taking insulin or suffering from diabetic neuropathy. 6.Cervical radiculopathy. 7.Any contraindication for needling such as local infection, bleeding tendency, or a history of needling shock. 8.Rheumatoid arthritis.

Neurodynamic techniques along with electroacupuncture are used in the treatment group, and in the control group, neurodynamic techniques along with electroacupuncture are used as a placebo.

Pain, hand function, hand grip strength

Correction following pilot study

After the completion of participant information and questionnaires, patients with carpal tunnel syndrome are randomly divided into two groups of treatment (group A) and control group (group B) with a ratio of one to one. Random allocation is done by variable blocks method, which will include four-letter blocks consisting of letters A and B. In each numbered envelope, one of the four-letter blocks containing two letters A and B is placed. Then, the treatment allocation list will be obtained at https://www.randomizer.org/.The letter A indicates electroacupuncture group and the letter B indicates non-real electroacupuncture. The random allocation process will be done by someone outside of the research team before the start of the study. After the initial evaluation of the patient by the examiner, numbered envelopes and stamps corresponding to the number of each person entered into the study will be given to him. Finally, after each patient enters the treatment sessions, the person providing the techniques will adjust the treatment interventions based on the letters inside the envelope. The examiners will be completely unaware of the letters inside the envelopes. Also, it should be noted that after placing the patients in the desired group, they are asked not to provide their grouping information to the examiner.

Evaluation and treatment will be done by two people. The person evaluating and analyzing the data are those who do not know about the grouping and will be unaware of which group each subject belongs to. The evaluator is present in the research only during the evaluation. The participants will not know which treatment group they have entered, in the treatment group, electroacupuncture along with neurodynamic techniques will be used, and in the control group, electroacupuncture placebo along with neurodynamic techniques will be used.