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Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Abstract

Carpal tunnel syndrome is a syndrome that occurs in 1-4% of the total population worldwide. This condition causes disruption of function and motion in the wrist that spreads to the fingers. Physiotherapy intervention is necessary to reduce the severity of symptoms in patients with CTS. Neurodynamic Techniques are nerve mobilization techniques that aim to restore homeostasis in the nerves so as to reduce pain and improve functional ability. Materials and methods. This research was conducted through searching several databases, found 31 articles which were then filtered and selected as many as 10 articles. However, of the 11 articles, further screening was carried out again based on inclusion criteria. The final result after selection is 9 articles. Results. From the 9 articles that have been reviewed neurodynamic technique provides significant benefits to reduce pain and increase functional ability in patients with carpal tunnel syndrome. Conclusion. Good results can be obtained if the treatment is done regularly with a dose of 2-3 times a week as many as 3 sets of 20 repetitions per training session and accompanied by exercise therapy performed every day. Neurodynamic technique can produce a positive effect on the reduction of pain in cases of CTS so as to restore the function of motion in the wrist and fingers.

Keywords: Carpal tunnel syndrome, neurodynamic technique, grip strength, functional ability

References

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2. Duncan SFM, Kakinoki R. Carpal Tunnel Syndrome and Related Median Neuropathies: Challenges and Complications. Carpal Tunn Syndr Relat Median Neuropathies Challenges Complicat. 2017;1–315.

3. Setyawan H. Risk factors of carpal tunnel syndrome among food-packing workers in Karanganyar. Kesmas. 2017;11(3):123–6.

4. Tana L, Halim FS, Delima, Ryadina W. Carpal Tunnel Syndrome Pada Pekerja Garmen Di Jakarta. Indones Bull Heal Res. 2004;32(2):73–82.

5. Paramita, Tini K, Budiarsa IGNK, Samatra DPGP. Prevalensi dan Karakteristik Carpal Tunnel Syndrome pada Pekerja Garmen di Kota Denpasar. J Med Udayana [Internet]. 2021;10(2):6–11. Available from: https://ojs.unud.ac.id/index.php/eum

6. Talebi GA, Saadat P, Javadian Y, Taghipour M. Comparison of two manual therapy techniques in patients with carpal tunnel syndrome: A randomized clinical trial. Casp J Intern Med. 2020;11(2):163–70.

7. Duncan SFM, Kakinoki R. Carpal Tunnel Syndrome and Related Median Neuropathies. Carpal Tunnel Syndrome and Related Median Neuropathies. 2017.

8. Annisa D, Rianawati SB, Rahayu M, Risa N, Kurniawan SN. Carpal tunnel syndrome: Diagnosis and management. J Pain, Vertigo Headache. 2021;1:5–7.

9. Hamzeh H, Madi M, Alghwiri AA, Hawamdeh Z. The long-term effect of neurodynamics vs exercise therapy on pain and function in people with carpal tunnel syndrome: A randomized parallel-group clinical trial. J Hand Ther [Internet]. 2021;34(4):521–30. Available from: https://doi.org/10.1016/j.jht.2020.07.005

10. Ijaz MJ, Karimi H, Ahmad A, Gillani SA, Anwar N, Chaudhary MA. Comparative Efficacy of Routine Physical Therapy with and without Neuromobilization in the Treatment of Patients with Mild to Moderate Carpal Tunnel Syndrome. 2022;2022:1–8.

11. Wolny T, Linek P. Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial. Clin Rehabil. 2019;33(3):408–17.

12. Wolny T, Linek P. Neurodynamic Techniques Versus “Sham” Therapy in the Treatment of Carpal Tunnel Syndrome: A Randomized Placebo-Controlled Trial. Arch Phys Med Rehabil. 2018;99(5):843–54.

13. Goyal M, Mehta SK, Rana N, Singal R, Mittal A, Goyal K. Motor nerve conduction velocity and function in carpal tunnel syndrome following neural mobilization : A randomized clinical trial. 2016;(January).

14. Marryam M, Yasmeen R, Malik T, Malik A, PAFMJ IA, 2018 undefined. A comparision of the effectiveness of neurodynamics versus nerve and tendon gliding exercises alone for carpal tunnel syndrome. PafmjOrg [Internet]. 2018;68(4):924–53. Available from: http://www.pafmj.org/index.php/PAFMJ/article/view/31

15. Sadu B, Wicaksono U, Proyogo D. Providing Neurodynamic Mobilization Exercises is Better than Myofascial Release in Improving Complaints in Construction Workers with Carpal Tunnel Syndrome in Cahaya Dinar Housing. 2022;13(02):647–51.

16. Wolny T, Linek P. The Effect of Manual Therapy Including Neurodynamic Techniques on the Overall Health Status of People With Carpal Tunnel Syndrome: A Randomized Controlled Trial. J Manipulative Physiol Ther. 2018;41(8):641–9.

17. Talebi GA, Saadat P, Javadian Y, Taghipour M. Manual therapy in the treatment of carpal tunnel syndrome in diabetic patients: A randomized clinical trial. Casp J Intern Med. 2018;9(3):283–9.

18. Beddaa H, Kably B, Marzouk B, Mouhi I, Marfak A, Azemmour Y, et al. The effectiveness of the median nerve neurodynamic mobilisation techniques in women with mild or moderate bilateral carpal tunnel syndrome : A single-blind clinical randomised trial. South African J Physiother. 2022;78(1):1–8.

19. Kumar V, GoyalM, N R, D N. Effect of neural mobilization on monosynaptic reflex – a pretest posttestt experimental design. Int Journall Physiother Res. 2013;3:58–62.

20. Coppieters MW, Butler DS. Do “sliders” slide and “tensioners” tension? An analysis of neurodynamic techniques and considerations regarding their application. Man Ther. 2008;13(3):213–21.

21. Shacklock. Clinical Neurodynamics: a New System of Musculoskeletal Treatment. Edinburg, UK: Elsevier Health Sciences; 2005.

22. Beneciuk JM, Bishop MD, George SZ. Effects of upper extremity neural mobilization on thermal pain sensitivity: A sham-controlled study in asymptomatic participants. J Orthop Sports Phys Ther. 2009;39(6):428–38.

23. Nugraha, Susy, Irfan. Efektivitas SWD dan Neurodynamic Mobilization pada Radikulopati Lumbosakral. Sport Fit J. 2016;7(2):1–10.

24. Sahar A. Efficacy of Neural Mobilization in Treatment of Low Back Dysfunctions. 2016;7(4):1–23.

25. Basson A, Olivier B, Ellis R, Coppieters M, Stewart A, Mudzi W. The effectiveness of neural mobilization for neuromusculoskeletal conditions: A systematic review and meta-Analysis. J Orthop Sports Phys Ther. 2017;47(9):593–615.


Bahasa Abstract

Carpal tunnel syndrome merupakan sindrom yang terjadi pada 1-4% dari total populasi di seluruh dunia. Kondisi ini menyebabkan terganggunya fungsi dan gerak pada pergelangan tangan yang menjalar hingga jari. Intervensi fisioterapi sangat diperlukan untuk mengurangi keparahan gejala pada penderita CTS. Neurodynamic Techniques merupakan Teknik mobilisasi saraf yang bertujuan memulihkan homeostatis pada saraf sehingga dapat mengurangi nyeri dan meningkatkan kemampuan fungsional. Penelitian ini dilakukan melalui penelusuran beberapa database, ditemukan 31 artikel yang kemudian disaring dan dipilih sebanyak 10 artikel. Namun dari 11 artikel tersebut, dilakukan penyaringan lebih lanjut kembali berdasarkan kriteria inklusi. Hasil akhir setelah seleksi adalah 9 artikel. Hasil. Dari ke 9 artikel yang telah di-review neurodynamic technique memberikan manfaat yang signifikan terhadap penurunan nyeri dan peningkatan kemampuan fungsional pada penderita carpal tunnel syndrome. Simpulan. Hasil yang bagus bisa didapatkan apabila treatment dilakukan secara rutin dengan dosis 2-3 kali seminggu sebanyak 3 set 20 kali pengulangan per sesi latihan dan disertai dengan terapi latihan yang dilakukan setiap hari. Neurodynamic technique dapat menghasilkan efek yang positif terhadap berkurangnya nyeri pada kasus CTS sehingga dapat mengembalikan fungsi gerak pada pergelangan tangan dan jari.

Kata Kunci: Carpal tunnel syndrome, neurodynamic technique, grip strength, kemampuan fungsional

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