Effectiveness of Aquatic Therapy versus Neuro-dynamic Technique in patients with carpal tunnel syndrome patient: A Randomized Clinical

Background: Carpal Tunnel Syndrome (CTS) is a prevalent peripheral neuropathy resulting from compression of the median nerve within the carpal tunnel. It is characterized by pain, numbness, tingling, and weakness in the hand, often impairing daily function and quality of life. Conservative management is prioritized in mild-to-moderate cases, with physical therapy interventions gaining traction as non-invasive, cost-effective alternatives to surgery. This study explores the clinical effectiveness of Aquatic Therapy and Neuro-Dynamic Technique in managing CTS-related symptoms. Objective: To compare the effects of Aquatic Therapy and Neuro-Dynamic Technique on pain intensity, functional status, and grip strength in patients with Carpal Tunnel Syndrome. Methods: A randomized clinical trial was conducted involving 32 participants diagnosed with mild-to-moderate CTS. Participants were allocated into two groups: Group A received Aquatic Therapy, and Group B received Neuro-Dynamic Technique. Both interventions were administered thrice weekly over 8 weeks. Pain intensity was measured using the Numeric Pain Rating Scale (NPRS), functional status via the Boston Carpal Tunnel Questionnaire (BCTQ), and grip strength using a digital hand dynamometer. Normality of data was confirmed using the Shapiro-Wilk Test. Within-group analysis was conducted using paired sample t-tests, and between-group comparisons used independent t-tests. Results: In Group B (Neuro-Dynamic Technique), NPRS decreased from 7.88 ± 1.1 to 2.69 ± 1.4 (mean difference = 2.354), BCTQ improved from 3.97 ± 0.66 to 1.72 ± 0.43 (mean difference = 0.979), and grip strength increased from 34.07 ± 9.2 to 43.43 ± 8.7 (mean difference = -7.962). In Group A (Aquatic Therapy), NPRS decreased from 6.70 ± 1.4 to 5.04 ± 1.5 (mean difference = -1.178), BCTQ improved from 3.43 ± 0.44 to 2.70 ± 0.35 (mean difference = -5.45), and grip strength increased from 27.80 ± 6.5 to 35.47 ± 8.9 (mean difference = -6.271). All outcomes showed statistically significant improvements (p < 0.05). Conclusion: Both Aquatic Therapy and Neuro-Dynamic Technique were effective in reducing pain and improving hand function in CTS patients. However, Neuro-Dynamic Technique demonstrated greater efficacy in enhancing pain relief, functional ability, and grip strength, supporting its application as a superior conservative treatment option.