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Short-term Effects of Neurodynamic Techniques for Treating Carpal Tunnel Syndrome: A Systematic Review With Meta-analysis

2021; American Physical Therapy Association; Volume: 51; Issue: 12 Linguagem: Inglês

10.2519/jospt.2021.10533

1938-1344

Sergio Núñez de Arenas‐Arroyo, Iván Cavero‐Redondo, Ana Torres‐Costoso, Sara Reina‐Gutiérrez, Celia Álvarez‐Bueno, Vicente Martínez‐Vizcaíno,

Musculoskeletal pain and rehabilitation

Objectives We aimed (1) to estimate the short-term effect (postintervention period) of neurodynamic techniques on pain, symptom severity, functional status, electrophysiological status, grip strength, and pinch strength in people with carpal tunnel syndrome (CTS); and (2) to estimate the effect of neurodynamic techniques compared to other physical therapy modalities and surgical interventions. Design Intervention systematic review with meta-analysis. Literature Search We searched the MEDLINE, Cochrane Database of Systematic Reviews, Web of Science, Physiotherapy Evidence Database, and Scopus databases from their inception to September 2020. Study Selection Criteria We included randomized controlled trials reporting the effect of neurodynamic techniques on pain, symptom severity, function, distal motor latency, grip strength, and pinch strength in people with CTS. Data Synthesis Using the DerSimonian-Laird method, we estimated pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development and Evaluation approach to judge the certainty of the evidence of each pairwise comparison. Results There were 22 trials included (n = 1203 people with CTS; mean age, 26.0 to 57.9 years; mean symptom duration, 4.1 to 62.8 months). There was very low–certainty evidence of neurodynamic techniques improving pain (SMD, −0.54; 95% CI: −0.95, −0.13) and function (SMD, −0.35; 95% CI: −0.61, −0.09). There was no significant effect on symptom severity (very low certainty), distal motor latency (very low certainty), and grip and pinch strength (low certainty). Conclusion Neurodynamic techniques were effective for improving pain and function in people with CTS, albeit with very low–certainty evidence. J Orthop Sports Phys Ther 2021;51(12):566–580. Epub 16 Nov 2021.doi:10.2519/jospt.2021.10533