1. Table 2. Summary of Results
The Effectiveness of Gliding Exercises in Patients with Carpal Tunnel Syndrome. A Systematic Review
Α. Efstratiadis1, E. Kasapakis2, S. Marangos3, P. Rentzias4, P. Georgiadou5, D. Stasinopoulos6
1MSc Sports Rehabilitation in European University of Cyprus, Nicosia, Physiotherapist in Physiotherapy Center ‘’Efstratiadis Anastasios’’, Greece, Argos, Argolidos
Poster Title
BACKGROUND
OBJECTIVES
RESULTS
In this systematic review a total of 8 article titles were included. Through the studies, the sliding exercises were compared and combined with other therapies or control groups. There has been significant improvement in sliding exercises, mainly in pain and functionalities, as well as improvement from other therapies such as night nursing, standard physiotherapy, laser and ultrasound. However, based on the van Tulder scale, it was found that there is no strong evidence of the effectiveness of sliding exercises in the repair of carpal tunnel syndrome (Table 2).
Carpal tunnel syndrome (CTS) as reported by Briniger et al. (2007), is a neuropathic compression that occurs in the carpal tunnel and usually leads to sensory-kinetic disturbances in middle nerve distribution (Paget, 1854).
Although the most frequent neuropathic compression (Coppieters & Alshami, 2006, Moscony, 2007) accounts for 3.8% of the population (Coppieters & Alshami, 2006). , 2% (Alfonso, Jann, Massa & Torreggiani, 2010). Despite the men (Tal-Akabi & Rushton, 2000) 6% (Alfonso, Jann, Massa & Torreggiani, 2010). It has also been observed in Chammas et al. (2014) that the syndrome occurs between 40 and 60 years of age (Atroshi et al., 1999). The intervention of the nerve and tendon slip exercises is a therapeutic, non-invasive procedure, which is referred to in the literature as one of the approaches to the management of SCF (Shacklock, 2005; Coppieters, & Alshami, 2007; McKeon, & Yancosek, 2008).
The aim of this systematic review was to investigate the effectiveness of sliding exercises in patients with carpal tunnel syndrome.
METHODS
The research for international literature was carried out on the online databases: "PubMed, PEDro, ScienceDirect and EBSCO". The article was selected from 2006 to this day. Only randomized controlled trials selected, which were written in English. They were applied only to people in life, men and women from 18 years old. The participants were clinically diagnosed with neurodynamic dysfunction in the middle nerve or carpal tunnel syndrome, with symptoms lasted more than 3 months. The type of intervention was nervous tissue mobilization and middle nerve and tendon gliding exercises. The Furlan scale was used to evaluate the methodological quality (Table 1). 
CONCLUSION
This systematic review has shown a significant improvement in sliding exercises as well as other interventions, pain reduction, improved functioning, range of motion and improved symptoms. Finally, there is a need to conduct more qualitative studies, which clearly investigate the effectiveness of sliding exercises in CTS.
Table 2. Summary of Results
Studies
Type of Intervention
Duration
Results
Baysal et al., (2006)
Brace and gliding exercises (ν=12) Vs
Brace and ultrasound (ν=12)
Brace, gliding exercises and ultrasound (ν=12)
8 weeks
Improve pain in all 3 groups. Statistically significant improvement in symptoms, functionality, strength at 3 and 8 weeks.
Brininger et al.,(2007)
Brace in wrist neutral position-(MCP) and exercises (ν=16)
Brace in wrist neutral position- MCP (ν=17)
Cock-up brace and exercises (ν=16)
Cock-up brace (ν=12)
Improving the symptoms and functionality in the Narthex with exercises. Significant improvement in strength in all groups.
Heebner et al., (2008)
Typical care (ν=28)
Nerve gliding exercises and typical care (ν=32)
6 months
Statistically significant improvement for group A at 6 months for FSS (p=0.016).
Bardak et al., (2009)
Standard physiotherapy (ν=41)
Gliding exercises of median nerve and tendons and brace use (ν=35)
Nerve and tendons gliding exercises (ν=35)
1 week
At group A, STP symptoms statistically significant improved compared to group C (P<0.001), while group A and B showed no statistical differences (P>0.001).
Atya et al., (2011)
Low Level Laser Therapy (ν=15)
Nerve and tendons gliding exercises (ν= 15)
2 months
Same benefit in pain, power and speed.
Schmid, et al., (2011)
Gliding exercises (ν=10)
Brace night (ν=10)
Equal improvement in functionality and symptoms, pain and numbness.
Oskouei et al., (2014)
Gliding exercises (ν=16)
Control group (ν=16)
4 weeks
Significant improvement in pain, nerve tenderness, symptoms and functionalities in favor of the neuro-mobilization group.
Salian et al., (2014)
Buttler technique(ν=15)
Mettler technique (ν=15)
Control group (ν=30)
6 sec
Significant improvement in Mettler technique in reducing nerve tenderness.
Benefit in favor of Buttler technique in symptoms and range of motion.
Table 1. Furlan methodological quality assessment: risk sources of impartiality of RCTs.
Μελέτες 1 2 3 4 5 6 7 8 9 10 11 12
Maximum score
Study score
Percentages
Baysal et al., (2006) + - ?
58%
Brininger et al.,(2007)
Heebner et al., (2008)
Bardak et al., (2009)
67%
Atya et al., (2011)
Schmid, et al., (2011)
Oskouei et al., (2014)
Salianet al., (2014)
42%
+. "There are", - "There are not", ? "Not clear".
REFERENCES
Atya A.M., Mansour, W.T., Laser versus Nerve and Tendon Gliding Exercise in Treating Carpal Tunnel Syndrome. Life Science Journal,8(2), p
Bardak, Evaluation of the clinical efficacy of conservative treatment in the managment of carpal tunnel syndrome. Adv Ther, 26(1), p
Baysal, O., 2006.Comparison of three conservative treatment protocols in carpal tunnel syndrome. Int J Clin Pract, 60(7), p.820–828.
Brininger, T.L., Efficacy of a Fabricated Customized Splint and Tendon and Nerve Gliding Exercises for the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial. Arch Phys Med Rehabil, 88, p
5. Heebner, M.L. and Roddey, T. S., The Effects of Neural Mobilization in Addition to Standard Care in Persons with Carpal Tunnel Syndrome from a Community Hospital. J HAND THER, 21, p.229–241.
6. Oskouei, A.E., Talebi G.A., Shakouri, S.K. and Ghabili, K.,2014. Effects of Neuromobilization Maneuver on Clinical and Electrophysiological Measures of Patients with Carpal Tunnel Syndrome. J. Phys. Ther. Sci, 26, p.1017–1022.
Contact info:
Efstratiadis Anastasios
Kasapakis Emmanouil,