Rajiv Gandhi University of Health Sciences,



Rajiv Gandhi University of Health Sciences,

Bangalore, Karnataka

ANNEXURE II

Proforma for registration of subjects for Dissertation

| | | |

|1. |Name of the Candidate and Address |BHATT JAYKUMAR GAJANANDBHAI, |

| | |SHREE DEVI COLLEGE OF PHYSIOTHERAPY, BALLALBAGH, |

| | |MANGALORE-575003 |

| | |SHREE DEVI COLLEGE OF PHYSIOTHERAPY, BALLALBAGH, |

|2. |Name of the Institution |MANGALORE- 575003 |

| | |MASTER OF PHYSIOTHERAPY(MPT) |

|3. |Course of study and subject |2 YEARS DEGREE COURSE |

| | |(MUSCULOSKELETAL DISORDER AND SPORTS PHYSIOTHERAPY) |

|4. |Date of Admission to Course |31 OCT 2011 |

|5. |Title of the Topic : “ A COMPARATIVE STUDY ON THE EFFECT OF KINESIOTAPING WITH EXERCISE VERSUS ULTRASOUND WITH EXERCISE ON|

| |PAIN RELIEF IN CARPAL TUNNEL SYNDROME” |

| | |

| |Brief resume of the intended work : |

| | |

|6. |6.1 Need for the study : |

| | |

| |Carpal tunnel syndrome (CTS), or compression neuropathy of the median nerve at the wrist, is a cause of pain, numbness, and tingling in |

| |the upper extremities and an increasingly recognized cause of work disability. Carpal tunnel syndrome is the most common peripheral |

| |entrapment neuropathy with prevalence rates 21.5% (overall), 32.5% (technicians) and 12% (attenders). The rate increased with increasing|

| |age and years of employment and it affects women more than men.1 The prevalence of CTS was found to be 13.1% among computer |

| |professionals. Subjects with over 8 years of computer work, over 12 hrs of work per day and system administrators were at a higher risk |

| |for CTS. Flexed or extended hand position had higher risk for CTS.2 |

| |Carpal tunnel syndrome is a constellation of the paresthesias, numbness and muscle weakness in the hand caused when the median nerve |

| |gets compressed or impinched at the wrist.3 The condition was first noted in medical literature as early as the 20th century and the |

| |term “carpal tunnel syndrome” was coined in 1939. The pathology was identified by physician Dr. George S. Phalen after working with a |

| |group of patients in the 1950s and 1960s.4 |

| |. |

| |CTS is caused by various reasons like repetitive stress injury, trauma, pregnancy, rheumatoid arthritis, hypothyroidism, obesity, |

| |multiple myeloma, amyloidosis, acromegaly, mucopolysaccharidoses and idiopathic.5 The majority of people diagnosed with carpal tunnel |

| |syndrome carry out with some kind of repetitive task in the workplace or home involving the use of hands or fingers. Repeated pressure |

| |in the joint as well as increased size of muscles and tendons pressing on the median nerve in the wrist all serve to exacerbate the |

| |problem.6 |

| |The pathophysiology of CTS is not fully understood but mechanical aspects of |

| | |

| |injury with in carpal tunnel are most likely. CTS results in considerable discomfort and |

| | |

| |pain, limitation of activities of daily living, loss of sleep and work disability.7 CTS may |

| |be classified on the basis of symptoms and signs into three stages:8 |

| | |

| |First stage: Patients have frequent awakenings during the night with a sensation of swollen, |

| |Numb hand; furthermore, they report of severe pain that irradiates from the wrist to the shoulder, and an annoying tingling in their |

| |hand and fingers (brachialgia paraesthetia nocturna). Hand shaking brings relief. At morning, a sensation of hand stiffness usually |

| |persists. |

| | |

| |Second stage: Presence of symptoms also during the day, mostly when the patient remains in |

| |the same position for a long time, or performs repeated movements with hand and wrist. When motor deficit appears, the patient reports |

| |that objects often fall from his/her hands. |

| | |

| |Third stage: Final stage, hypo/atrophy of the thenar eminence. In this phase, sensory symptoms may diminish. |

| | |

| |Carpal tunnel syndrome can be treated either conservatively or surgically. Conservative treatment comprises of various electrical |

| |modalities like laser, ultrasound, TENS, exercises like nerve and tendon gliding exercise, Kinesio taping, carpal tunnel splints and |

| |anti inflammatory drugs. Open carpal tunnel release and endoscopic carpal tunnel release techniques are commonly used surgical |

| |intervention. The electrical modalities and nerve and tendon gliding exercise will assist in decreasing the pain, inflammatory process |

| |and assist in tendon and nerve gliding which has been restricted. |

| |Researchers claim that ultrasound to the wrist gives significant improvement of symptoms in people with CTS. A treatment process may |

| |consist of 20 sessions of 15 minutes of ultrasound applied to the area over the carpal tunnel at a frequency of 1 MHz, and a power of |

| |1.0 W/cm2.9 |

| |Kinesio taping is one of the newer approaches in treating the carpal tunnel syndrome. It uses a correction technique to lift the skin |

| |creating a space in the area of inflammation or pain to improve lymph or vascular movement, The movement of taped skin and soft tissue |

| |creates a massaging effect that promotes lymph and blood flow decreasing pressure on mechanoreceptors and thus pain and edema. Sensory |

| |receptors in the skin also act on ascending and descending neurologic pathways to decrease pain and assist in control of muscle tension |

| |via Golgi tendon input.10 |

| |This study is an attempt to evaluate the efficacy of ultrasound versus kinesio taping with exercise in common on pain relief on carpal |

| |tunnel syndrome. |

| |Research Question |

| |Whether there is a difference in pain relief in a group of patients with Carpal Tunnel Syndrome (CTS) treated by Kinesio taping with |

| |exercise versus Ultrasound Therapy with exercise ? |

| | |

| |Null hypothesis : |

| |There will be no difference in pain relief in a group of patients with Carpal Tunnel Syndrome (CTS) treated by Kinesio taping with |

| |exercise versus Ultrasound Therapy with exercise. |

| | |

| |Alternate hypothesis : |

| |It is assumed that there will be significant difference in pain relief in a group of patients with Carpal Tunnel Syndrome (CTS) treated |

| |by Kinesio taping versus Ultrasound Therapy with exercise in common. |

| | |

| |6.2 Review of literature : |

| | |

| | |

| |Gerold R Ebenbichler, Karl L Resch et al , conducted a study on 45 patients with mild to moderate bilateral carpal tunnel syndrome at |

| |Physical medicine and Rehabilitation in Vienna. 20 sessions of ultrasound treatment (1 MHz, 1.0 W/cm2, pulsed mode 1:4, 15 minutes per |

| |session) were carried out. Improvement was significantly more pronounced in actively treated than in sham treated wrists for both |

| |subjective symptoms (P ................
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