Endocrine Abstracts

Background: Carpal Tunnel syndrome (CTS) was reported in 2.6 to 20% in diabetic patient’s population that may be as results of repeated undetected trauma, metabolic changes, and accumulation of fluid or edema within the confined space of the carpal tunnel and/or diabetic Cheiroarthropathy. Manual therapy is prescribed as a conservative treatment for CTS.

Objective: The aim of this study was to compare the effects of two manual therapy methods including (1) techniques for opening the surrounding space of the nerve and (2) neuromobilization techniques on diabetic patients with CTS.

Methods: 20 diabetic patients with CTS participated in this Randomized clinical Trial which assigned into two groups, namely mobilization for mechanical interface group and neuromobilization group. Patients received specific interventions, 3 times weekly for 10 sessions. In group 1, the patients received techniques containing distraction mobilization of the wrist joints, transverse carpal ligaments & palmar hand fascia stretching and tendon glide exercise. In group 2, gliding and tension techniques were used for neuromobilazation of the median nerve according to Battler method. Variables of visual analogue scale (VAS), symptom severity scale (SSS) and functional status scale (FSS) were measured in before and after intervention.

Results: Results showed that two groups were matched in terms of age, weight and severity of CTS at the beginning of the study. Outcome measures of VIS, SSS and FSS improved significantly within mechanical interface group 50.06, 33.69 and 27.81% (P=0.05) respectively, and also within neuromobilization group 52.67, 42.59 and 33.93% (P=0.05) respectively at the end of intervention period. But the differences between the two groups were not significant at the end of intervention (P=0.05).

Conclusion: It seems that two methods of manual therapy including techniques directed toward surrounding space of the nerve and specified neuromobilization techniques had significant and probably equal effects on subjective clinical findings in diabetic patients with CTS.

Keywords: Diabetics foot, peak plantar pressure, time pressure integral, metatarsal pad