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This project aims to analyze the use of hyperthermia within a treatment protocol for Carpal Tunnel Syndrome (CTS), as well as to determine the difference between two and three sessions per week. Study participants will be divided into four intervention groups: the first will receive two sessions per week for a period of six months, while the second will receive three sessions per week for the same period. The treatment protocol will consist of therapeutic physical exercise focused on the hand flexor muscles and neural stretching, the application of hyperthermia to the carpal tunnel and adjacent areas, and the use of a night splint. The third and fourth intervention groups will receive the same treatment as mentioned above, but without hyperthermia. The third group will receive three sessions per week, while the second group will receive two sessions per week. Two different types of measurement variables will be used: objective variables will be used to measure hand flexor muscle strength and wrist free range of motion. Subjective variables will also be used through validated questionnaires covering physical activity, perceived functional limitations, upper limb functional assessment, neuropathic pain, and a visual analogue scale for pain perception.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hyperthermia 2 times per week | Experimental |
| |
| Hyperthermia 3 times per week | Experimental |
| |
| Non-hyperthermia 2 times per week | Experimental |
| |
| Non-hyperthermia 3 times per week | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| hyperthermia | Radiation | hyperthermia over the carpal tunnel area and adjacent areas |
|
| Measure | Description | Time Frame |
|---|---|---|
| Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) | Minimum: 19. Maximum: 95. A higher score indicates a higher degree of disability | Baseline and up to one year |
| Disabilities of arm, shoulder and hand (DASH) | Minimum: 30 points. Maximum: 150 points A higher score indicates a higher intensity of symptoms | Baseline and up to one year |
| Neuropathic Pain Scale (DN4) | Minimum: 0 Maximum: 10 The diagnosis of neuropathic pain is established with a total scale of 4 out of 10 | Baseline and up to one year |
| International Physical Activity Questionnaire (IPAQ) | 9 items. Minimum: 9 Maximum: 36 A higher score indicates a sedentary life | Baseline and up to one year |
| Visual Analogue Scale (VAS) | Minimum: 1 Maximum: 10 A higher score indicates a higher intensity of pain | Baseline and up to one year |
| Hand grip strength | A handheld dynamometer will be used and three consecutive measurements will be obtained with the patient sitting and the elbow flexed at 90 degrees and in a neutral position. | Baseline and up to one year |
| WRIST JOINT RANGE OF MOBILITY | With the patient seated in a relaxed position, the various free movements of the wrist joint will be assessed bilaterally using an electronic goniometer. To do this, the goniometer will be placed on the dorsal side of the wrist, with the proximal part on the midline between the radius and ulna and the distal part on the third metacarpal. Flexion, extension, and radial and ulnar deviation ranges will be assessed, both with the elbow flexed and extended. |
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Inclusion Criteria:
Exclusion Criteria:
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| physical exercise | Other | Performing therapeutic physical exercise focused on the flexor muscles of the hand and neural stretching |
|
| splint | Other | imposition of a night splint |
|
| Baseline and up to one year |
| WRIST FLEXION EVALUATION TEST | With the patient seated in a relaxed position, wrist flexion will be tested in isometric contraction, both with the hand open and closed, and with the wrist in a neutral position. The therapist will manually resist wrist flexion from the hand area. This test will be performed three times in a row with the hand open, followed by a five-minute rest and then repeating the procedure, this time with the hand open. This measurement will be taken with the elbow flexed or extended. | Baseline and up to one year |
| ID | Term |
|---|---|
| D002349 | Carpal Tunnel Syndrome |
| D000084462 | Hyperthermia |
| ID | Term |
|---|---|
| D020423 | Median Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D012090 | Cumulative Trauma Disorders |
| D013180 | Sprains and Strains |
| D014947 | Wounds and Injuries |
| D001832 | Body Temperature Changes |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D018882 | Heat Stress Disorders |
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| ID | Term |
|---|---|
| D003972 | Diathermy |
| D015444 | Exercise |
| D013165 | Splints |
| ID | Term |
|---|---|
| D006979 | Hyperthermia, Induced |
| D013812 | Therapeutics |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D016267 | External Fixators |
| D009984 | Orthopedic Fixation Devices |
| D009983 | Orthopedic Equipment |
| D013523 | Surgical Equipment |
| D004864 | Equipment and Supplies |
| D053831 | Surgical Fixation Devices |
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