title: Effectiveness of Nerve Gliding Exercises on Carpal Tunnel Syndrome: A Systematic Review.
abstract: The objective of this study was to review the literature regarding the effectiveness of neural gliding exercises for the management of carpal tunnel syndrome (CTS).
  
  
  
  A computer-based search was completed through May 2014 in PubMed, Physiotherapy Evidence Database (PEDro), Web of Knowledge, Cochrane Plus, and CINAHL. The following key words were included: nerve tissue, gliding, exercises, carpal tunnel syndrome, neural mobilization, and neurodynamic mobilization. Thirteen clinical trials met the inclusion/exclusion criteria, which were: nerve gliding exercise management of participants aged 18 years or older; clinical or electrophysiological diagnostics of CTS; no prior surgical treatment; and absence of systemic diseases, degenerative joint diseases, musculoskeletal affectations in upper limbs or spine, or pregnancy. All studies were independently appraised using the PEDro scale.
  
  
  
  The majority of studies reported improvements in pain, pressure pain threshold, and function of CTS patients after nerve gliding, combined or not with additional therapies. When comparing nerve gliding with other therapies, 2 studies reported better results from standard care and 1 from use of a wrist splint, whereas 3 studies reported greater and earlier pain relief and function after nerve gliding in comparison with conservative techniques, such as ultrasound and wrist splint. However, 6 of the 13 studies had a quality of 5 of 11 or less according to the PEDro scale.
  
  
  
  Limited evidence is available on the effectiveness of neural gliding. Standard conservative care seems to be the most appropriate option for pain relief, although neural gliding might be a complementary option to accelerate recovery of function. More high-quality research is still necessary to determine its effectiveness and the subgroups of patients who may respond better to this treatment.
authors.affiliation: Departamento de Medicina Física y Rehabilitación, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Ballestero-Pérez
authors.affiliation: Departamento de Medicina Física y Rehabilitación, Facultad de Medicina, Universidad Complutense de Madrid; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Plaza-Manzano
authors.affiliation: Departamento de Rehabilitación y Fisioterapia, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Urraca-Gesto
authors.affiliation: Departamento de Rehabilitación y Fisioterapia, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
authors.forename: Flor
authors.initials: F
authors.lastname: Romo-Romo
authors.affiliation: Departamento de Medicina Física y Rehabilitación, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: María de Los Ángeles
authors.initials: MLÁ
authors.lastname: Atín-Arratibel
authors.affiliation: Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pecos-Martín
authors.affiliation: Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Madrid, Spain.
authors.forename: Tomás
authors.initials: T
authors.lastname: Gallego-Izquierdo
authors.affiliation: Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain. Electronic address: narf52@gmail.com.
authors.forename: Natalia
authors.initials: N
authors.lastname: Romero-Franco
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000628:therapy*; D005081:Exercise Therapy; D006801:Humans; D008475:Median Nerve; D016896:Treatment Outcome
keywords: Carpal Tunnel Syndrome; Exercise Therapy; Movement; Nerve Tissue; Stress, Mechanical