Clinical Research Directory

Effects of Repetitive Peripheral Magnetic Stimulation(rPMS) on CTS(Carpal Tunnel Syndrome)

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, resulting from compression of the median nerve at the wrist. It is particularly common in middle-aged women. In the early stages, these patients frequently experience pain and numbness in the hand, especially in the first three fingers, and paresthesias, which often worsen at night. As the disease progresses, muscle weakness and atrophy of the thenar muscles can occur, severely impacting patients' daily activities and functionality. Clinical evaluation and patient complaints are crucial for diagnosis. Electrophysiological assessment tools such as nerve conduction studies and electromyography (EMG) are highly sensitive and considered the gold standard for confirming the diagnosis, assessing nerve damage, and determining the severity of this damage. In addition to electrophysiological assessment, ultrasonographic evaluation offers an important opportunity to observe structural changes in the median nerve associated with CTS. In cases of mild to moderate CTS, nonsurgical treatments are the primary options for reducing symptoms; splinting, tendon-nerve gliding exercises, and physical therapy modalities are commonly preferred. Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive method that can be applied to various tissues, such as spinal nerves, peripheral nerves, or muscles, and is used to reduce pain and improve motor function. While its potential benefits for many neurological diseases and musculoskeletal problems have been demonstrated in recent years, there are limited studies on the effectiveness of rPMS in patients with CTS. The primary objective of this study is to evaluate the effectiveness of rPMS on pain in individuals diagnosed with mild to moderate CTS. Secondarily, the effects of rPMS on symptom severity, functional status, nerve conduction parameters, and median nerve ultrasonographic findings will be analyzed. The findings of our study suggest that objective evaluation of rPMS treatment will contribute to supporting the clinical practice of this treatment option in patients with CTS with more comprehensive data.

PRP Versus Saline Hydrodissection for CTS RCT

This single-center, single-blind, randomized controlled trial compared two injectates used for ultrasound-guided hydrodissection of the median nerve in adults with carpal tunnel syndrome: autologous platelet-rich plasma (PRP) and 0.9% normal saline (NS). Participants received a single hydrodissection with 5 mL of the allocated injectate per treated wrist; in participants with bilateral carpal tunnel syndrome, both wrists were treated with the same injectate. Symptom severity and functional status (Boston Carpal Tunnel Questionnaire), neuropathic pain (DN4 questionnaire), median nerve cross-sectional area on ultrasound, and grip strength parameters were assessed at baseline and at 3 and 6 months after the intervention. The study aimed to determine whether PRP provides benefit beyond the mechanical effect of hydrodissection with saline.

Effects of Technology-Assisted Rehabilitation on Pain and Hand Function in People With Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a common condition caused by compression of the median nerve at the wrist. It may cause pain, numbness, tingling, reduced hand function, decreased grip strength, and impaired quality of life. This randomized controlled trial compared the effects of a technology-assisted multimodal rehabilitation program with conventional physiotherapy in adults with mild-to-moderate carpal tunnel syndrome. A total of 40 participants were randomly allocated to two groups. The technology-assisted rehabilitation group used the ErgoActive system with Leap Motion sensor technology, while the conventional physiotherapy group received conventional physiotherapy. Both groups received 18 treatment sessions over six weeks. The primary outcome was symptom severity, assessed using the Symptom Severity Scale of the Boston Carpal Tunnel Questionnaire (BCTQ-SSS). Secondary outcomes included pain intensity, functional status, hand-related quality of life, and grip strength. Pain was assessed using a visual analogue scale (VAS), functional status using the Functional Status Scale of the Boston Carpal Tunnel Questionnaire (BCTQ-FSS), hand-related quality of life using the Michigan Hand Outcomes Questionnaire (MHQ), and grip strength using a grip strength measurement device. All outcomes were assessed before and after the treatment period. The study aimed to determine whether technology-assisted multimodal rehabilitation provides greater improvements in symptoms, pain, hand function, grip strength, and hand-related quality of life than conventional physiotherapy.

Symptom Recovery Time After the Phalen Test in Carpal Tunnel Syndrome

Carpal tunnel syndrome can cause numbness, tingling, pain, and reduced hand function. The Phalen test is commonly used during clinical examination, but it is usually recorded only as positive or negative. The time needed for the symptoms caused by the test to return to their pre-test level may provide additional information about the clinical severity of carpal tunnel syndrome. This study will investigate the clinical meaning of symptom recovery time after the Phalen test in adults with electrodiagnostically confirmed carpal tunnel syndrome. During the test, participants will keep their wrists fully flexed for up to 60 seconds. If typical symptoms appear or clearly increase, the test will be stopped and the wrists will be returned to a neutral position. The time required for symptoms to return to their pre-test level will be recorded. Participants will also complete the Boston Carpal Tunnel Questionnaire and will be evaluated for nighttime symptoms and nerve conduction findings. The study will examine whether recovery time is related to hand function, symptom severity, nighttime complaints, symptom onset time during the Phalen test, and electrodiagnostic severity. A subgroup of participants with a positive Phalen test will repeat the test after 3-7 days to evaluate its test-retest reliability. No treatment will be assigned as part of this observational study.

Comparative Effects of Sensory Re-education and Neural Mobilization in CTS Patients

The aim of study is to compare the effects of sensory re-education and neural mobilization in CTS patients.

Investigation of the Effectiveness of Cervicothoracic Exercises in Individuals With Carpal Tunnel Syndrome

This randomized, parallel-group controlled clinical trial evaluated the effects of adding cervicothoracic exercises to conventional physiotherapy on symptoms, functional status, pain, grip strength, and wrist range of motion in individuals with carpal tunnel syndrome (CTS). Seventy adults diagnosed with CTS were randomly allocated to two groups: conventional physiotherapy (n=35) or cervicothoracic exercises combined with conventional physiotherapy (n=35). The conventional physiotherapy program included transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, median nerve mobilization, wrist range-of-motion exercises, and strengthening exercises. The intervention group received the same conventional physiotherapy program together with cervicothoracic exercises targeting cervical mobility, cervical muscle control, scapular stabilization, and thoracic mobility. Both groups received treatment five days per week for six weeks. Outcomes were assessed at baseline, at the end of the six-week intervention, and approximately three months after each participant completed the intervention. In this updated record, the Boston Carpal Tunnel Questionnaire (BCTQ) is designated as the primary outcome measure. Its Symptom Severity Scale and Functional Status Scale are scored and reported separately, with higher scores indicating greater symptom severity and functional limitations. The primary assessment time point is the end of the six-week intervention. Secondary outcome measures include pain intensity assessed using the Visual Analog Scale (VAS), upper extremity function assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, grip strength measured using a Jamar hand dynamometer, and wrist range of motion measured using a goniometer. All outcome measures were repeated at the three-month follow-up. The final post-intervention assessment was completed on 31 May 2026, and the final follow-up assessment was completed on 1 September 2026.

Effects of Peripheral Repetitive Peripheral Magnetic Stimulation on Individuals With Elbow or Wrist Chronic Pain

This pilot, randomized, sham-controlled, single-blind study will evaluate the effectiveness of repetitive peripheral magnetic stimulation (rPMS) in reducing pain in adults with tennis/golfer's elbow or carpal tunnel syndrome. Approximately 40 participants will be randomly assigned to active or sham stimulation delivered over two consecutive days. Outcomes, including pressure pain threshold, subjective pain ratings, and local tissue oxygenation (fNIRS), will be assessed at baseline, immediately post-intervention, and during follow-up up to 6 months to evaluate both clinical effects and underlying physiological mechanisms.

Measurement of Muscle Strength Using a Manual Muscle Tester in Women With Electrophysiologically Confirmed Carpal Tunnel Syndrome

The aim of this cross-sectional study is to evaluate muscle strength in female patients with carpal tunnel syndrome (CTS) who have only sensory involvement detected on electromyography. Muscle strength will be assessed using the "Lafayette Manual Muscle Tester®". The main questions of the study are: 1. Is there a difference in muscle strength between healthy individuals and female patients with carpal tunnel syndrome? 2. Is there a difference in muscle strength between female patients with carpal tunnel syndrome who have only sensory involvement and those who have both sensory and motor involvement? 3. Are there differences in the strength of thumb palmar abduction and adduction, radial adduction and abduction, thumb flexion, extension and opposition, and flexion of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints of the fingers between these groups? The investigators will measure the muscle strength associated with these movements using the "Lafayette Manual Muscle Tester®" in order to objectively evaluate motor involvement in female patients with carpal tunnel syndrome and to compare muscle strength between healthy individuals and patients with different degrees of electrophysiological involvement.

Combined Stellate Ganglion Block With Median Nerve Hydrodissection Versus Median Nerve Hydrodissection Only in Carpal Tunnel Syndrome

the study aims to compare clinical and electrophysiological outcomes of combined stellate ganglion block plus median nerve hydrodissection versus hydrodissection alone in carpal tunnel syndrome, assessing pain, function, autonomic predictors, and safety over time.

Ultrasound-Guided Injection of Carpal Tunnel Syndrome Using Hyaluronic Acid vs Corticosteroid vs Glucose 5%

Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder caused by compression of the median nerve at the wrist. This study is a comparative study designed to evaluate the efficacy of three ultrasound-guided injection treatments for patients with mild to moderate CTS: hyaluronic acid (HA), corticosteroid, and 5% glucose (D5W). A total of 60 adult patients with clinically and electrophysiologically confirmed mild to moderate CTS will be enrolled and divided into three groups of 20 patients each. Participants will receive a single ultrasound-guided injection using one of the three study interventions. Clinical assessment will include Phalen's test and Tinel's sign. Electrophysiological assessment will include median nerve sensory and motor nerve conduction parameters, while ultrasonographic assessment will include measurement of the median nerve cross-sectional area. Participants will be reassessed three months after the intervention using the same clinical, electrophysiological, and ultrasonographic measures. The study will compare changes in these outcomes among the three treatment groups to evaluate their relative efficacy in the management of mild to moderate CTS.

Understanding Patient Preferences When Deciding on a Voluntary Musculoskeletal Test

The goal of this clinical trial is to understand how people make decisions about imaging tests for common musculoskeletal problems (like arthritis, tendon problems, or nerve compression). The study involves adult patients attending a musculoskeletal specialty clinic. The main questions it aims to answer are: 1. Does having a structured conversation about the pros and cons of a test affect how much a person wants to have that test? 2. Does that conversation help people feel more confident and less conflicted about their decision? Researchers will compare patients who have a values-based discussion with a researcher to those who receive brief written information about the test, to see if these approaches affect how people feel about having the test. Participants will: * Read a brief scenario about a proposed diagnostic imaging test (like an X-ray, MRI, CT, or ultrasound). * Either take part in a short structured conversation or read brief information about the test. * Answer a short survey about their thoughts on the test. This study does not involve actual medical testing or affect your clinical care. It is for research purposes only.

Open vs. Ultrasound-Guided Carpal Tunnel Release

Carpal Tunnel Syndrome (CTS) is the most prevalent entrapment neuropathy. Open Surgical Carpal Tunnel Release (OSCTR) remains the gold standard, while minimally invasive Ultrasound-Guided Carpal Tunnel Release (USGCTR) offers potential advantages including reduced postoperative morbidity and faster recovery. This prospective, multicenter observational cohort study compares the clinical outcomes, patient-reported outcomes, and socioeconomic impact of USGCTR versus OSCTR. A total of 200 patients, with 100 patients per cohort, will be included. Patient assignment is based on the participating center's standard of care. Follow-up assessments are performed preoperatively and at 2 weeks, 6 weeks, 3 months, and 12 months after surgery.

Changes in Sleep, Fatigue, Kinesiophobia, and Upper Extremity Function After Carpal Tunnel Release

Carpal tunnel syndrome can cause hand pain, numbness, weakness, sleep disturbance, fatigue, fear of movement, and difficulty performing daily activities. Carpal tunnel release surgery is commonly performed when symptoms are severe or do not improve with conservative treatment. However, recovery after surgery may involve changes not only in hand symptoms but also in sleep, fatigue, fear of movement, pain, and upper extremity function. The aim of this prospective observational study is to evaluate how sleep quality, fatigue, kinesiophobia, pain, carpal tunnel syndrome-related symptoms, and upper extremity function change after carpal tunnel release surgery. Adults scheduled for unilateral primary carpal tunnel release surgery as part of their routine clinical care will be invited to participate. The researchers will not assign or modify the surgical procedure, medication, rehabilitation, or other clinical treatment. Participants will be evaluated before surgery and at 4 and 8 weeks after surgery. Sleep quality will be assessed using the Pittsburgh Sleep Quality Index. Fatigue, kinesiophobia, upper extremity function, carpal tunnel syndrome-related symptoms, and pain will be assessed using the Fatigue Severity Scale, Tampa Scale of Kinesiophobia, QuickDASH, Boston Carpal Tunnel Questionnaire, and Numeric Rating Scale, respectively. The study will examine changes in these outcomes over time and investigate whether improvements in sleep and fatigue are associated with reductions in pain, kinesiophobia, and carpal tunnel syndrome symptoms and with improvements in upper extremity function.

Median and Ulnar Nerve Function in Tattoo Artists

This case-control study aims to investigate the effects of occupational hand-arm vibration exposure on median and ulnar nerve functions in tattoo artists. Chronic exposure to vibration generated by tattoo machines may lead to neurosensory impairment, reduced tactile sensitivity, and decreased hand strength. Objective assessments including nerve provocation tests, sensory threshold evaluation, two-point discrimination, vibration perception, grip and pinch strength measurements, and validated patient-reported outcome questionnaires will be used. Findings will be compared with age- and sex-matched healthy controls.

Electrophysiological and Functional Recovery After Carpal Tunnel Release

Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist. It can cause pain, numbness, tingling, reduced hand strength, and difficulty performing daily activities. Carpal tunnel release surgery is commonly performed when symptoms do not improve with conservative treatment or when nerve compression is severe. However, recovery after surgery may differ between patients, and improvement in nerve conduction may not occur at the same rate as improvement in symptoms and hand function. The purpose of this prospective observational study is to examine the relationship between electrophysiological recovery of the median nerve and clinical and functional recovery after carpal tunnel release surgery. Adults who are already scheduled to undergo primary carpal tunnel release as part of their routine clinical care will be invited to participate. The decision to perform surgery will be made by the treating physician independently of study participation. Participants will undergo clinical and functional assessments before surgery and at postoperative week 8 These assessments will include questionnaires about carpal tunnel symptoms and upper-extremity function, pain severity, grip and pinch strength, sensory testing, and clinical examination. Nerve conduction studies will be evaluated before surgery and at postoperative month 3. The study will assess whether changes in median nerve conduction are associated with changes in symptoms, upper-extremity function, pain, hand strength, and sensory function. The possible effects of age, sex, body mass index, symptom duration, diabetes, and preoperative electrophysiological severity on recovery will also be examined. No experimental drug, device, surgical technique, or additional treatment will be assigned as part of this study.

Graded Motor Imagery in Carpal Tunnel Syndrome

The aim of this study is to investigate whether the addition of Graded Motor Imagery (GMI) to progressive neurodynamic exercises is more effective than progressive neurodynamic exercises alone in individuals with carpal tunnel syndrome (CTS). The objectives are to reduce pain and symptom severity, improve pain, sensorimotor function, physical performance, and grip strength through the addition of GMI.

Evaluation of Dynavisc in Pain Reduction Following Revision Surgery for Persistent or Recurrent Carpal Tunnel Syndrome

The trial will evaluate the efficacy of DYNAVISC in subjects with a diagnosis of persistent or recurrent carpal tunnel syndrome. This is a prospective, multicenter, randomized, evaluator-blinded clinical trial. Results will be stratified based on the method used for median nerve coverage: Group 1 (standard of care surgery followed by DYNAVISC surrounding the median nerve, n=25 participants), Group 2 (standard of care surgery followed by coverage of the median nerve with a hypothenar fat pad flap, n=25

Radial Pressure Wave Therapy With or Without Parameter Modulation for Carpal Tunnel Syndrome.

This study aims to evaluate the clinical effects of radial pressure wave therapy in patients with a confirmed diagnosis of mild to moderate carpal tunnel syndrome. Participants will be randomly assigned to receive radial pressure wave therapy using either a modulated or a constant parameter dosing protocol. The intervention consists of three weekly sessions, and outcomes will be assessed at baseline, 2 months, and 4 months after the first session. The primary outcome is pain intensity measured by the Visual Analog Scale, while secondary outcomes include functional status evaluated with the Boston Carpal Tunnel Questionnaire, grip strength, and electrodiagnostic parameters of the median nerve. The study is conducted in the Physical Medicine and Rehabilitation Service of the Antiguo Hospital Civil de Guadalajara "Fray Antonio Alcalde," and has been approved by the hospital's Ethics Committee.

Thread-Embedding Acupuncture Versus Electroacupuncture for Mild-to-Moderate Carpal Tunnel Syndrome

This study compared thread-embedding acupuncture with electroacupuncture for adults with mild-to-moderate carpal tunnel syndrome confirmed by electrodiagnosis. Eighty participants were randomly assigned in a 1:1 ratio to receive either thread-embedding acupuncture or electroacupuncture. Both groups also received standard care, including lifestyle modification, nocturnal wrist splinting, nerve and tendon gliding exercises, and paracetamol as needed. Thread-embedding acupuncture was administered twice over two weeks, whereas electroacupuncture was administered 10 times over the same period. Participants were assessed at baseline, week 2, and week 4. The primary outcome was the change in paresthesia intensity from baseline to week 4, measured using a 100-mm visual analog scale. Secondary outcomes included pain intensity, symptom severity, functional status, paracetamol use, and adverse events.

Low-Level Laser Therapy for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy, caused by compression of the median nerve within the carpal tunnel at the wrist. It typically presents with paresthesia, numbness, and pain in the median nerve distribution, and in advanced cases may lead to thenar atrophy and reduced grip strength. Conservative treatment options for mild-to-moderate CTS include wrist splinting, exercise programs, and physical therapy modalities such as low-level laser therapy (LLLT) and paraffin bath therapy; however, the comparative efficacy of these modalities has not been well established. This study aims to compare the efficacy of low-level laser therapy (LLLT), paraffin bath therapy, and sham LLLT, each combined with standard conservative care (night wrist splinting and tendon/nerve gliding exercises), in patients with mild-to-moderate CTS. Participants will be randomly assigned in a 1:1:1 ratio to receive LLLT, paraffin bath therapy, or sham LLLT, each administered 5 days/week for 3 weeks (15 sessions), in addition to wrist splinting and a home exercise program continued throughout the study. The primary outcome is the change in symptom severity and functional status, assessed using the Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the Boston Carpal Tunnel Questionnaire. Secondary outcomes include electrophysiological parameters from median nerve conduction studies, median nerve cross-sectional area on ultrasonography, grip and pinch strength, pain (Visual Analog Scale), and hand function (QuickDASH). Assessments will be performed before treatment, immediately after completing 15 sessions, and at 3 months after treatment completion. Outcome assessors will be blinded to treatment allocation. The investigators hypothesize that LLLT will result in greater improvement in clinical, electrophysiological, and morphological parameters compared with sham LLLT, and will provide comparative data on its efficacy relative to paraffin bath therapy.

Hematological and Metabolic Markers in Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, but the severity of symptoms experienced by patients does not always correspond to abnormalities detected by nerve conduction studies. This prospective cross-sectional study investigates whether routinely available metabolic, hematological, and inflammatory markers are associated with CTS and with patient-reported symptom and functional burden. Adults referred for evaluation of suspected CTS were enrolled. Participants with electrodiagnostically confirmed CTS were compared with symptomatic individuals whose nerve conduction studies were normal. Clinical findings, Boston Carpal Tunnel Questionnaire scores, electrophysiological severity, and blood-based metabolic and inflammatory measures were evaluated. The study aims to better understand whether systemic metabolic and inflammatory factors contribute to the clinical expression of CTS beyond the degree of large-fiber nerve conduction abnormality.

Effect of Neural Mobilization on Carpal Tunnel Syndrome

The study group (G1) consisted of 15 patients treated by neural mobilization techniques targeting the median nerve, in addition to a selected physical therapy program including transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, and strengthening exercises for the wrist and hand muscles. The control group (G2) consisted of 15 patients treated only by the same selected physical therapy program as in G1, without neural mobilization. All outcome variables (median nerve cross-sectional area, flattening ratio, and flexor retinaculum bowing measured by diagnostic ultrasound; hand grip strength measured by handheld dynamometer; and symptom severity and functional status measured by the Boston Carpal Tunnel Questionnaire) were assessed pre-treatment and after 6 weeks of intervention, for comparison within and between groups.

The Effectiveness of Pain Neuroscience Education for Patients With Carpal Tunnel Syndrome

The goal of this clinical trial is to investigate the effects of Pain Neuroscience Education applied in the treatment of mild and moderate carpal tunnel syndrome (CTS). The main question it aims to answer is: Does PNE have a therapeutic effect on carpal tunnel syndrome in clinical and ultrasonographic terms? Researchers will compare whether PNE creates a synergistic effect alongside home based exercise programs and splint application in mild to moderate CTS, and will objectively demonstrate potential benefits such as relief from pain and numbness.

Comparative Efficacy of Therapeutic Ultrasound and Neurodynamic Techniques for Carpal Tunnel Syndrome

This randomized controlled trial compares the efficacy of therapeutic ultrasound alone, neurodynamic techniques alone, and combined therapeutic ultrasound and neurodynamic techniques in patients with mild to moderate carpal tunnel syndrome.