Does sensory relearning improve tactile function after carpal tunnel decompression? A pragmatic, assessor-blinded, randomized clinical trial

J Hand Surg Eur Vol. 2016 Nov;41(9):948-956. doi: 10.1177/1753193416657760. Epub 2016 Sep 28.

Abstract

Despite surgery for carpal tunnel syndrome being effective in 80%-90% of cases, chronic numbness and hand disability can occur. The aim of this study was to investigate whether sensory relearning improves tactile discrimination and hand function after decompression. In a multi-centre, pragmatic, randomized, controlled trial, 104 patients were randomized to a sensory relearning ( n = 52) or control ( n = 52) group. A total of 93 patients completed a 12-week follow-up. Primary outcome was the shape-texture identification test at 6 weeks. Secondary outcomes were touch threshold, touch localization, dexterity and self-reported hand function. No significant group differences were seen for the primary outcome (Shape-Texture Identification) at 6 weeks or 12 weeks. Similarly, no significant group differences were observed on secondary outcomes, with the exception of self-reported hand function. A secondary complier-averaged-causal-effects analysis showed no statistically significant treatment effect on the primary outcome. Sensory relearning for tactile sensory and functional deficits after carpal tunnel decompression is not effective.

Level of evidence: II.

Keywords: Sensory relearning; carpal tunnel syndrome; cortical plasticity; nerve compression; sensory retraining.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Carpal Tunnel Syndrome / physiopathology
  • Carpal Tunnel Syndrome / rehabilitation*
  • Carpal Tunnel Syndrome / surgery*
  • Decompression, Surgical*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recovery of Function
  • Single-Blind Method
  • Touch*
  • Treatment Outcome