Content area
Background
The effect of conservative treatments on sleep quality in carpal tunnel syndrome is unclear.
Purpose
Comparing the effect of splinting and kinesiotaping in carpal tunnel syndrome on functional status, pain, grip strength, nerve cross-sectional area and sleep quality.
Study Design
Randomized controlled study.
Methods
The participants were divided into three groups. One group was given night splint and nerve tendon gliding exercises, one group was given kinesiotaping and nerve tendon gliding exercises and one group was given only nerve tendon gliding exercises. The participants was evaluated with Visual Analog Scale (VAS), Boston Carpal Tunnel Syndrome Questionnaire, Pittsburgh Sleep Quality Index (PSQI), Jamar hand dynamometer, ultrasonography by a blind investigator in the treatment group at baseline and at 3 months.
Results
A total of 90 participants, 53 women and 37 men, with a mean age of 47.6
Conclusions
Both splinting and kinesiotaping are effective on pain, functional status, hand grip strength and median nerve cross-sectional area. This effect is greater in kinesiotaping. Splinting, kinesiotaping and nerve tendon gliding exercises treatments are effective in improving sleep quality, but this effect is greater in kinesiotaping.
Introduction
Carpal tunnel syndrome (CTS) occurs when the median nerve is compressed in the carpal tunnel as it passes through the wrist. It is the most common entrapment neuropathy with a prevalence of 10% (1). It is more common in women than men. Risk factors are obesity, diabetes mellitus, acromegaly, pregnancy, hypothyroidism, rheumatoid arthritis, vibratory tool use, advanced age and repetitive trauma. 1 It may cause distressing symptoms including dysesthesia, pain in the sensory area of the median nerve in the hand and night waking, and in later cases it can significantly impair motor function and lead to a weakening of the pinch grip.
Physical examination, electrodiagnostic tests and ultrasonography are used in the diagnosis of CTS. Electrodiagnostic tests have a sensitivity of 56%–85% and a specificity of 93%–98% and also distinguish it from radiculopathy and polyneuropathy. 2 With ultrasonography, which is a non-invasive and low-cost method, the cross-sectional area of the median nerve in the carpal tunnel can be measured, as well as determining tenosynovitis, mass and tendinopathy. Although it is affected by the experience of the evaluator, the measurement of the cross-sectional area of the median nerve in the carpal tunnel by ultrasonography has a sensitivity of 87.3% and a specificity of 83.3%. In cases where structural bone joint abnormalities or fractures are suspected, radiography is used.
In mild and moderate cases, conservative treatment takes precedence over aggressive interventions in advanced cases. The conservative treatments include pharmacological treatments, splint, laser, ultrasound therapy, nerve and tendon gliding exercises, manual soft tissue mobilization, paraffin therapy, acupuncture, kinesiotaping, extracorporeal shock waves. 3 There are studies on the effectiveness of conservative treatments. 4
Sleep quality and sleep duration are reduced in CTS due to nighttime symptoms. 5 After carpal tunnel release surgery, patients' sleep quality improves. 6 Rubin et al. showed that the splint reduces night awakenings in the treatment of CTS. 7 With the combination of steroid and local anesthetic injection, sleep quality is improved in patients with CTS. 8 In the literature, the effectiveness of splint and kinesiotaping treatments, which are frequently used in carpal tunnel syndrome, were examined in terms of pain, grip strength, electrodiagnostic and morphological changes.
In this study, we aimed to compare the effects of splint
Methods
The study was conducted as a hospital-based randomized controlled study. According to the power analysis conducted with the study “Comparison of splinting and Kinesiotaping in the treatment of carpal tunnel syndrome: a prospective randomized study”, it was calculated that the total sample size should be 60. A hundred participants diagnosed with mild and moderate carpal tunnel syndrome by electrodiagnostic method were included in the study.
Participants were divided into three groups by simple online randomization, one group was given night splint and nerve tendon gliding exercises for ONE month, kinesiotaping and nerve tendon gliding exercises were given to one group and only nerve tendon gliding exercises were given to the other group. Pain and numbness with Visual Analog Scale (VAS), functional status with Boston Carpal Tunnel Questionnaire (BCTQ), sleep quality with Pittsburg Sleep Quality Scale (PSQS), grip strength with Jamar hand dynamometer, median nerve cross-sectional area with ultrasonography were evaluated by a blind investigator to the treatment group at baseline and at 3 months.
Participants aged 18–65 years who were diagnosed with mild and moderate carpal tunnel syndrome by conducting nerve conduction velocity studies for the median nerve were included in the study.
Exclusion criteria were;
As a result of the electrodiagnostic study (nerve conduction velocity studies), the fact that the distal motor latency of the median nerve is less than 4.2 ms and/or the distal sensory latency is less than 3.2 ms presence of severe electrodiagnostic findings (fibrotic changes in the median nerve), having inflammatory disease (rheumatoid arthritis, tendinitis, etc.), presence of osteoarthritis in the hand/wrist, presence of musculoskeletal conditions (hand, elbow, wrist), having thyroid dysfunction, diagnosis of chronic kidney failure and receiving treatment for it, CTS surgery, history of surgery and/or trauma to the upper extremity and neck. Being diagnosed with pregnancy or diabetes-related CTS, receiving any treatment for CTS (splint therapy, electrophysical agents, exercise, local corticosteroid injection) until 3 months before the tests.
Evaluation parameters
The following data were recorded for each participant: height, weight, gender (self-reported), comorbidities and medications.
The cross-sectional area of the median nerve was measured using ultrasonography. Ultrasonographic evaluation was performed by a physiatrist 5 years experienced in musculoskeletal ultrasound, blinded to the clinical and electrodiagnostic results of the participants. The measurement was made in all participants by placing the probe perpendicular to the long axis of the forearm just proximal to the pisiform level.
The severity of pain and/or numbness of the participants was evaluated using the 11-point Visual Analogue Scale before treatment and at follow-up (‘0’ = no pain and/or numbness, ‘10’ = pain and/or numbness of maximum severity). The patient was asked to mark the intensity of pain and/or numbness he/she felt on a 10 cm horizontal line. 9
The Boston Carpal Tunnel Syndrome Questionnaire, also known as the Levine scale, is one of the patient-reported outcome measures and was developed specifically for patients with CTS. 10 The Boston Carpal Tunnel Questionnaire has two separate scales: the symptom severity scale and the functional status scale. There are 11 questions in the symptom severity scale and each question is scored between one to five. There are eight items in the functional status scale and the patient is asked to rate the degree of difficulty in the activities included in these items between one to five. As a result of scoring each scale, the final score (total score divided by the number of items) is obtained and this final score will be between one to five. Higher scores indicate more disability.
The Pittsburgh Sleep Quality Index is an index developed in 1989 to evaluate the sleep quality of patients over a 1-month period in clinical studies. PSQI consists of 24 questions in total. Nineteen of these questions are self-evaluation questions. The remaining five questions are answered by the individual's roommate or spouse, if any. In the 19th question on the scale, it is questioned whether the participant has any roommates or spouses. The answer to this question is not included in the score calculation. The first 18 questions answered by the participant himself/herself are used in the calculation of the PSQI total score and component scores. The 18 questions answered by the participant provide information on seven components, including sleep quality (component one), sleep latency (component two), sleep duration (component three), habitual sleep efficiency (component four), sleep disturbance (component five), use of sleeping pills (component six) and daytime sleep dysfunction (component seven). Each component is evaluated over zero to three points. The sum of these seven component scores gives the total PSQI score. Total PSQI score varies between 0 and 21. The sleep quality of people with a total score of five or less is considered "good", while the sleep quality of individuals with a score above five is considered "poor". 11
Interventions
Kinesiotaping
Kinesiotaping was applied twice a week for a total of eight sessions for 4 weeks. Taping was performed with a “neural technique” for the median and “field correction technique” for releasing the carpal tunnel. The elbow was positioned in full extension, the forearm in supination, and the wrist in 30 extension. I tape was used for neural technique. Tape was applied to the skin along the median nerve from the second and third metacarpophalangeal joints to 5
Splint
The patient was asked to wear the fabricated splint that fixes the wrist in the neutral position every night and during the day as much as possible (
Nerve tendon gliding exercises
Nerve tendon gliding exercises were taught practically by an experienced physiotherapist. Participants were asked to do three sets of 10 repetitions every day for 1 month. Tendon gliding exercises were performed by bringing the hand into five different positions: regular grip, hook grip, punch, tabletop, and regular punch. Nerve gliding exercises were performed by bringing the fingers and wrist into six different positions: fingers and thumb in flexion with the wrist in neutral position, fingers and thumb in extension with the wrist in neutral position, thumb in neutral position with the wrist and fingers in extension, wrist, fingers, and thumb in extension, forearm in supination, and gentle stretching of the thumb with the other hand. Patients were given a 30-day exercise diary.
Statistical analysis
SPSS 25.0 software (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY, USA: IBM Corp.) was used for statistical analysis of the collected data. Shapiro-Wilk test was used for normality test. Normally distributed measurement data are presented as mean ± standard deviation, non-normally distributed measurement data are presented as median (minimum maximum). One Way ANOVA using Bonferroni correction was used for normally distributed measurement data to compare demographic data
. In the group analysis of the evaluation parameters, paired simples
t test was used for data with normal distribution, and Wilcoxon Signed Ranks test was used for data without normal distribution. One Way ANOVA using Bonferroni correction was used for normally distributed data in the between-group analysis, and Kruskal Wallis test was used for non-normally distributed data. The value of
p
Results
A total of 90 participants, 53 women and 37 men, with a mean age of 47.69
In addition to nerve tendon gliding exercises, a statistically significant decrease in the median nerve cross-sectional area and a statistically significant increase in the hand grip strength were detected in the control measurements in the splint group and the kinesiotaping applied group (
p
A statistically significant decrease was found in PSQI components (except Sleeping pill use component) and total scores in all groups (
p
The effectiveness of treatment methods according to gender is given in
Discussion
In this study, splint and kinesiotaping applications given in addition to nerve tendon gliding exercises were found to be effective on pain, functional status, symptom severity, hand grip strength and median nerve cross-sectional area, and kinesiotaping was found to be more effective than splint on functional status and symptom severity. It was determined that both nerve tendon gliding exercises, splint therapy and kinesiotaping were effective in sleep quality, but kinesiotaping was more effective than splint and exercises.
It has long been known that CTS causes frequent night wakings, increased fragmented sleep, and increased daytime sleepiness and dysfunction. 12 It has been reported that 80% of patients with CTS have decreased sleep quality. 5 In our study, it was determined that 64.44% of patients with CTS had poor sleep quality. Patients value the increase in sleep disturbances more than their functional improvement. 13 Sleep disorders have negative effects on human health. There is a correlation between sleep quality and the development of hypertension, obesity, metabolic syndrome, depression, diabetes mellitus. 14–17 It is a rational approach to consider the effects of treatment methods on sleep quality when planning the treatment of CTS, which is very important for health and significantly affects sleep quality. Injection therapy and surgical procedures for the carpal tunnel have been shown to improve sleep quality. 6,8,18,19 Although the effectiveness of conservative treatments on pain and quality of life in CTS has been the subject of research, there are limited studies on sleep quality. Rubin et al., in their study with 21 participants, found that splint and surgical treatment had similar efficacy on sleep quality in CTS. 7 In our study, it was determined that splint, kinesiotaping and exercise treatments increased sleep quality in CTS, however, this effect was higher in kinesiotaping. When planning treatment, it may be more beneficial to prefer kinesiotaping, especially for those with low sleep quality.
The most common conservative treatment method in CTS is splint used alone or in combination with other treatment methods. 20 Since carpal tunnel pressure increases in flexion and extension in CTS, splinting in the neutral position can reduce pressure and reduce symptoms. 21 A review of 29 randomized trials of 1937 participants with CTS concluded that there is limited evidence to support the use of splints in the treatment of CTS due to the small number of studies and conflicting data, concluding that splinting is a relatively inexpensive intervention without long-term harms that may provide minor improvements in CTS symptoms and hand function. 22 In our study, it was determined that splint therapy given in addition to nerve tendon gliding exercises was not superior to nerve tendon exercises. There are conflicting data in the literature regarding the effect of the splint on the cross-sectional area of the median nerve. In the study of Ural and Öztürk, no change was found in those using splints, while in the study of Soyupek et al. it was shown that the median nerve cross-sectional area decreased after the use of splints. In our study, it was determined that the median nerve area decreased after the use of splints. We think that this discrepancy is due to the fact that ultrasonographic measurements are a practitioner-dependent method.
Kinesiotaping increases the space between skin and muscle and reduces pressure at the application area. It helps reduce sensitivity in the damaged area by increasing blood circulation and lymphatic drainage. In addition, kinesiotaping reduces muscle spasm and facilitates tendon and fascia movement. 23These effects provide improvements in clinical and ultrasonographic measurements in CTS. 24 In the study of de Sire et al., it was determined that there was a decrease in symptoms and an increase in hand functions in the kinesiotaping group compared to the sham group. 25 Studies have shown that kinesiotaping is more effective in reducing symptoms and increasing hand functions compared to nerve tendon gliding exercises, splint therapy and paraffin therapy. 24,26 In our study, it was determined that kinesiotaping reduced CTS symptoms and median nerve cross-sectional area, and increased hand function and sleep quality. In addition, these effects were more than nerve tendon gliding exercises and splint therapy. In the light of these data, it can be said that kinesiotaping may be the conservative treatment method that should be considered in the treatment of CTS.
Adhesion to the surrounding tissue can be reduced by nerve tendon gliding exercises. 27 A review of the data from thirteen studies concluded that despite the controversial results of nerve gliding exercises in non-high-quality studies, adding them to conservative modalities in CTS had beneficial effects, and concluded that nerve gliding exercises may be a therapy that should be considered as an adjunct to conservative treatments. 28 In our study, it was determined that while nerve tendon gliding exercises were not effective on pain, functional status, median nerve cross-sectional area and hand grip strength, they were effective on sleep quality.
The results of this study should be evaluated with some limitations in mind. The first is that the follow-up period is limited to 3 months, preventing us from knowing about long-term activities. For a frequent case like CTS, our sample size may be somewhat small. The strength of the study is that both clinical and ultrasonographic evaluations were made and it was the first study to investigate the effectiveness of conservative treatments on sleep quality.
In this study, it has been determined that splint
Ethics approval
Ethics committee approval was obtained for the research (09.09.2022/2022/3953).
Funding
The authors have no relevant financial or non-financial interests to disclose. The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.
Author contributions
Mehmet Özkan: Writing – original draft, Methodology, Data curation. İlhan Çağlar Kaya: Methodology, Investigation, Data curation. Onur Bulut: Methodology, Investigation, Data curation, Conceptualization. Kemal Erol: Writing – review & editing, Methodology, Investigation, Conceptualization. Savaş Karpuz: Writing – original draft, Methodology, Investigation, Data curation, Conceptualization. Ramazan Yılmaz: Writing – original draft, Methodology, Data curation, Conceptualization. Halim Yılmaz: Writing – original draft, Supervision, Methodology, Data curation, Conceptualization.
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Journal of Hand Therapy] and was not involved in the editorial review or the decision to publish this article.
Table 1
| Splint group ( n = 30) | Kinezyotaping group ( n = 26) | Exercise group ( n = 26) | F | p | |
| x̄ ± sd | x̄ ± sd | x̄ ± sd | |||
| Age | 46.7± 10.9 | 47 ± 10.4 | 49.2 ± 10.4 | 0.505 | 0.605 |
| BMI | 27.4± 4.5 | 28.8 ± 4.1 | 27.9 ± 4.4 | 0.824 | 0.442 |
| Sex (% Female) | 60 | 56.6 | 63.3 | 0.044 | 0.957 |
| Sleeping disorder % | 46.6 | 40 | 53.3 | 0.524 | 0.594 |
Table 2
Paired samples t test.
One-way ANOVA test.
Wilcoxon Signed Ranks test.
Kruskal Wallis test.
| Variable | (1) Splint Group ( n = 27) | (2) Knesiotaping Group ( n = 26) | (3) Exercise group ( n = 26) | Between-group analysis ( p) | |
| VAS | |||||
| T0 | 5.8 ± 1.5 | 6.7 ±1.6 | 6.1 ±1.8 | ||
| T1 | 4 ± 2 | 4.4 ±1.8 | 4.8 ±2.1 | ||
|
|
6.9 | 8.7 | 5.1 | ||
|
|
<0.001 | <0.001 | 0.829 | ||
| T0-T1 | 1.8 ± 1.4 | 2.2 ±1.4 | 1.3 ±1.4 | 0.044 † | |
| Cohen's d 1−2 | −0.28 | 2-3 | |||
| Boston symptom severity scale | |||||
| T0 | |||||
| T1 | 1.9 ± 0.6 | 2.5 ±0.7 | 2.1 ±0.5 | ||
|
|
1.6 ± .05 | 1.9 ±0.6 | 1.9 ±0.5 | ||
|
|
6 | 10.3 | 4 | ||
| <0.001 | <0.001 | <0.001 | |||
| T0-T1 | - | ||||
| Cohen's d 1−2 | 0.3 ±0.3 | 0.5 ±0.2 | 0.2 ±0.2 | <0.001 † | |
| −0.78 | 2−1; 2−3 | ||||
| Boston functional status scale | |||||
| T0 | 2 ±1 | 2.5 ±1 | 2 ±0.8 | ||
| T1 | 1.7 ±0.9 | 2 ±0.8 | 1.8 ±0.8 | ||
|
|
3.1 | 6.8 | 4.3 | ||
|
|
0.004 | <0.001 | <0.001 | ||
| - | |||||
| T0-T1 | 0.12 (−0.25 2.3) | 0.62 (0 1.5) | 0.12 (−0.25 0.63) | 0.005 † | |
| 2−1; 2−3 | |||||
| CSA | |||||
| T0 | 14.5 (12−23) | 15 (12−20) | 14 (11−28) | ||
| T1 | 13.9 (12−21) | 14 (12−18) | 13.9 (11−30) | ||
|
|
0.001 | <0.001 | 0.829 | ||
| - | |||||
| T0-T1 | 0.5 (−1 −2) | 0.9 (−1 5) | 0.1 (−2 1.2) | 0.01 § | |
| 2-3 | |||||
| Hand grip strength | |||||
| T0 | 36.4 ±10 | 33.6 ±8.8 | 29.8 ±7.4 | ||
| T1 | 37.8 ±10.8 | 35.1 ±9.3 | 30.2 ±7.5 | ||
|
|
−2.6 | −2.21 | −0.881 | ||
|
|
0.012 | 0.034 | 0.385 | ||
| - | |||||
| T0-T1 | −1.3 ±2.8 | −1.5 ±3.7 | −0.4 ±2.4 | 0.316 † | |
| Cohen's d 1−2 | −0.06 |
Table 3
Paired samples t test.
One-way ANOVA test.
Wilcoxon Signed Ranks test.
Kruskal Wallis test.
| Variable | (1) Splint group ( n = 27) | (2) Knesiotaping group ( n = 26) | (3) Exercise group ( n = 26) | Between-group analysis ( p) | |
| Subjective sleep quality | |||||
| T0 | 1.5 ±0.8 | 1.5 ±0.8 | 1.6 ±0.5 | ||
| T1 | 1 ±0.7 | 0.9 ±0.6 | 1.3 ±0.7 | ||
|
|
|||||
|
|
4.7 | 5.8 | 3.2 | ||
| <0.001 | <0.001 | 0.003 | |||
| T0-T1 | |||||
| Cohen's d 1−2 | −0.4 | 0.4 ±0.5 | 0.6 ±0.5 | 0.3 ±0.6 | 0.26 † |
| Sleep latency | |||||
| T0 | 1.7 ±1.3 | 1.9 ±1 | 1.5 ±1.3 | ||
| T1 | 1.2 ±1.2 | 1 ±1 | 1.1 ±1 | ||
|
|
4.2 | 5.9 | 3.2 | ||
|
|
<0.001 | <0.001 | 0.003 | ||
| 0.037 † | |||||
| T0-T1 | 0.5 ±0.7 | 0.9 ±0.8 | 0.4 ±0.6 | 2−3 | |
| Cohen's d 1−2 | −0.53 | ||||
| Sleep duration | |||||
| T0 | 0.8 ±0.8 | 1.1 ±0.8 | 1.1 ±0.9 | ||
| T1 | 0.7 ±0.8 | 0.6 ±0.6 | 1 ±0.9 | ||
|
|
2.4 | 5.7 | 2.4 | ||
|
|
0.023 | <0.001 | 0.023 | ||
| T0-T1 | 0.1 ±0.3 | 0.5 ±0.5 | 0.1 ±0.3 | 0.001 † | |
| Cohen's d 1−2 | −0.97 | 2−1; 2−3 | |||
| Habitual sleep activity | |||||
| T0 | 1.1 ±1 | 1.2 ±1 | 0.9 ±0.9 | ||
| T1 | 0.9 ±1 | 0.7 ±0.8 | 0.6 ±0.8 | ||
|
|
2.2 | 4.5 | 3.2 | ||
|
|
0.031 | <0.001 | 0.003 | ||
| T0-T1 | |||||
| Cohen's d 1−2 | 0.2 ±0.4 | 0.5 ±0.6 | 0.2 ±0.4 | 0.026 † | |
| −0.58 | 2-1 | ||||
| Sleep disturbance | |||||
| 1 (0−5) | 1 (0−7) | 2 (1−5) | |||
| T0 | 1 (0−2) | 1 (0−4) | 1 (1−3) | ||
| T1 | |||||
|
|
0.007 | 0.001 | 0.002 | ||
| T0-T1 | |||||
| 0 (0 4) | 0 (0 6) | 0 (0 2) | 0.575 § | ||
| Sleeping pill use | |||||
| 0 (0−8) | 0 (0−2) | 0 (0−3) | |||
| T0 | 0 (0−4) | 0 (0−2) | 0 (0−3) | ||
| T1 | |||||
|
|
0.109 | 0.317 | 0.317 | ||
| T0-T1 | |||||
| 0 (0 4) | 0 (−1 0) | 0 (0 1) | 0.087 § | ||
| Daytime dysfunction | |||||
| T0 | 1.1 ±1.2 | 1.4 ±1.5 | 1.2 ±0.8 | ||
| T1 | 0.9 ±1 | 0.7 ±1 | 1 ±0.7 | ||
|
|
2.2 | 4 | 1.8 | ||
|
|
0.030 | <0.001 | 0.07 | ||
| T0-T1 | 0 (0 3) | 0 (0 3) | 0 (−1 3) | 0.023 § | |
| 2-3 | |||||
| Total | |||||
| T0 | 8.6 ±4.9 | 9.1 ±4.2 | 8.8 ±4.3 | ||
| T1 | 6.3 ±4.5 | 5.3 ±3.8 | 7 ±4.3 | ||
|
|
5.1 | 8.8 | 4.5 | ||
|
|
<0.001 | <0.001 | <0.001 | ||
| T0-T1 | 2.2 ±2.3 | 3.8 ±2.3 | 1.8 ±2.2 | 0.003 † | |
| Cohen's d 1−2 | −0.69 | 2−1; 2−3 |
Table 4
Paired samples t test.
One-way ANOVA test.
Wilcoxon Signed Ranks test.
Kruskal Wallis test.
| Variable | (1) Splint group ( n = 12) | (2) Knesiotaping group ( n = 11) | (3) Exercise group ( n = 10) | Between-group analysis ( p) |
| VAS | ||||
| T0 | 5.25 ±1.4 | 6.7 ±1.8 | 5.8 ±1.8 | |
| T1 | 3.5 ±2.2 | 4.6 ±2.1 | 3.8 ±1.7 | |
|
|
4.4 | 7.2 | 5.2 | |
|
|
0.001 | <0.001 | <0.001 | |
| T0-T1 | 1.7 ±1.3 | 2.1 ±1 | 2 ±1.2 | 0.714 † |
| Boston symptom severity scale | ||||
| T0 | ||||
| T1 | 1.5 ±0.4 | 1.5 ±0.6 | 1.9 ±0.5 | |
|
|
1.4 ±0.3 | 2 ±0.7 | 1.8 ±0.5 | |
|
|
0.4 | −1.4 | 0.3 | |
| 0.649 | 0.163 | 0.726 | ||
| T0-T1 | - | |||
| 0.05 ±0.3 | 0.4 ±1 | 0.07 ±0.6 | 0.196 † | |
| Boston functional status scale | ||||
| T0 | ||||
| T1 | 1.6 ±0.5 | 2.4 ±0.9 | 1.7 ±0.6 | |
|
|
1.5 ±0.6 | 1.9 ±0.9 | 1.6 ±0.6 | |
|
|
2 | 3.8 | 2.5 | |
| 0.06 | 0.003 | <0.031 | ||
| T0-T1 | - | |||
| 0.12 ±0.2 | 0.4 ±0.4 | 0.17 ±0.2 | 0.033 † | |
| 2-1 | ||||
| CSA | ||||
| T0 | 14.5 (13−18) | 15 (13−17) | 15 (12−28) | |
| T1 | 14.2 (12−17.5) | 14 (13−16.8) | 14 (12−30) | |
|
|
0.019 | 0.015 | 0.856 | |
| T0-T1 | 0.5 (−1 −2) | 0.9 (−1 5) | 0.1 (−2 1.2) | 0.277 § |
| Hand grip strength | ||||
| T0 | 45.5 ±7.7 | 32.7 ±10.6 | 32.3 ±6.1 | |
| T1 | 47.7 ±7.2 | 32.1 ±11.2 | 32.4 ±5.7 | |
|
|
−3 | −0.9 | −0.1 | |
|
|
0.011 | 0.380 | 0.921 | |
| T0-T1 | −2.1 ±2.4 | 0.6 ±2.4 | −0.09 ±2.9 | 0.033 † |
| 1-2 | ||||
| PSQI | ||||
| T0 | 7.8 ±3.5 | 9.9 ±5 | 9 ±3.8 | |
| T1 | 5.7 ±3.2 | 6.5 ±5 | 6.6 ±2.9 | |
|
|
5 | 5.3 | 3.8 | |
|
|
<0.001 | <0.001 | 0.003 | |
| T0-T1 | 2 ±1.4 | 3.3 ±2.2 | 2.4 ±2.1 | 0.255 † |
Table 5
Paired samples t test.
One-way ANOVA test.
Wilcoxon Signed Ranks test.
Kruskal Wallis test.
| Variable | (1) Splint group ( n = 16) | (2) Knesiotaping group ( n = 15) | (3) Exercise group ( n = 15) | Between-group analysis ( p) |
| VAS | ||||
| T0 | 6.2 ±1.5 | 6.7 ±1.6 | 6.3 ±1.9 | |
| T1 | 4.4 ±1.8 | 4.3 ±1.5 | 3.8 ±1.7 | |
|
|
5.1 | 5.8 | 2.9 | |
|
|
<0.001 | <0.001 | 0.008 | |
| T0-T1 | 1.8 ±1.5 | 2.3 ±1.6 | 1 ±0.9 | 0.025 † |
| 2-3 | ||||
| Boston symptom severity scale | ||||
| T0 | ||||
| T1 | 2.1 ±0.7 | 2.5 ±0.7 | 2.1 ±0.5 | |
|
|
1.7 ±.0.6 | 1.95 ±0.5 | 1.9 ±0.5 | |
|
|
4.9 | 8.5 | 2.9 | |
| <0.001 | <0.001 | 0.008 | ||
| T0-T1 | - | |||
| 0.3 ±0.3 | 0.5 ±0.2 | 0.16 ±0.2 | <0.001 † | |
| 2-3 | ||||
| Boston functional status scale | ||||
| T0 | ||||
| T1 | 2.3 ±1.1 | 2.6 ±1.1 | 2.1 ±0.8 | |
|
|
1.9 ±1 | 2 ±0.8 | 2 ±0.8 | |
|
|
2.7 | 5.7 | 3.4 | |
| 0.014 | <0.001 | 0.003 | ||
| T0-T1 | - | |||
| 0.36 ±0.5 | 0.6 ±0.4 | 0.14 ±0.18 | 0.007 † | |
| 2-3 | ||||
| CSA | ||||
| T0 | 14.5 (12−23) | 15 (12−20) | 14 (11−22) | |
| T1 | 13.7 (12−21) | 14 (12−18) | 13.6 (11−23) | |
|
|
0.014 | 0.007 | 0.932 | |
| T0-T1 | 0.5 (−1 −2) | 0.8 (−1 5) | 0 (−2 1.2) | 0.023 § |
| 2-3 | ||||
| Hand grip strength | ||||
| T0 | 30.3 ±5.8 | 34.3 ±7.5 | 28.3 ±7.8 | |
| T1 | 31.2 ±7.1 | 37.4 ±7 | 28.8 ±8.2 | |
|
|
−1.1 | −3.4 | −1.1 | |
|
|
0.251 | 0.003 | 0.276 | |
| T0-T1 | −0.8 ±2.9 | −3.1 ±3.7 | −0.5 ±2.2 | 0.03 † |
| 2-3 | ||||
| PSQI | ||||
| T0 | 9.1 ±5.7 | 8.5 ±3.5 | 8.6 ±4.7 | |
| T1 | 6.7 ±5.2 | 4.3 ±2.2 | 7.2 ±5 | |
|
|
3.4 | 7 | 2.8 | |
|
|
0.003 | <0.001 | 0.01 | |
| T0-T1 | 2.3 ±2.8 | 4.1 ±2.4 | 1.4 ±2.2 | 0.009 † |
| 2−3 |
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