title: A pilot study comparing two manual therapy interventions for carpal tunnel syndrome.
abstract: OBJECTIVE
  The purpose of this study was to determine the clinical efficacy of manual therapy interventions for relieving the signs and symptoms of carpal tunnel syndrome (CTS) by comparing 2 forms of manual therapy techniques: Graston Instrument-assisted soft tissue mobilization (GISTM) and STM administered with the clinician hands.
  
  
  METHODS
  The study was a prospective comparative research design in the setting of a research laboratory. Volunteers were recruited with symptoms suggestive of CTS based upon a phone interview and confirmed by electrodiagnostic study findings, symptom characteristics, and physical examination findings during an initial screening visit. Eligible patients with CTS were randomly allocated to receive either GISTM or STM. Interventions were, on average, twice a week for 4 weeks and once a week for 2 additional weeks. Outcome measures included (1) sensory and motor nerve conduction evaluations of the median nerve; (2) subjective pain evaluations of the hand using visual analog scales and Katz hand diagrams; (3) self-reported ratings of symptom severity and functional status; and (4) clinical assessments of sensory and motor functions of the hand via physical examination procedures. Parametric and nonparametric statistics compared treated CTS hand and control hand and between the treatment interventions, across time (baseline, immediate post, and at 3 months' follow-up).
  
  
  RESULTS
  After both manual therapy interventions, there were improvements to nerve conduction latencies, wrist strength, and wrist motion. The improvements detected by our subjective evaluations of the signs and symptoms of CTS and patient satisfaction with the treatment outcomes provided additional evidence for the clinical efficacy of these 2 manual therapies for CTS. The improvements were maintained at 3 months for both treatment interventions. Data from the control hand did not change across measurement time points.
  
  
  CONCLUSIONS
  Although the clinical improvements were not different between the 2 manual therapy techniques, which were compared prospectively, the data substantiated the clinical efficacy of conservative treatment options for mild to moderate CTS.
authors.affiliation: New York Chiropractic College, Department of Research, Seneca Falls, NY, USA. jburke@nycc.edu
authors.forename: Jeanmarie
authors.initials: J
authors.lastname: Burke
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Buchberger
authors.forename: M Terry
authors.initials: MT
authors.lastname: Carey-Loghmani
authors.forename: Paul E
authors.initials: PE
authors.lastname: Dougherty
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Greco
authors.forename: J Donald
authors.initials: JD
authors.lastname: Dishman
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D006225:Hand / Q000294:innervation* / Q000503:physiopathology; D018737:Hand Strength; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016896:Treatment Outcome