The effectiveness of nerve mechanical interface treatment for entrapment neuropathies in the limbs: A systematic review with metanalysis

Pietro Iogna Prat; Nicolò Milan; Jorg Huber; Colette Ridehalgh

doi:10.1016/j.msksp.2024.102907

The effectiveness of nerve mechanical interface treatment for entrapment neuropathies in the limbs: A systematic review with metanalysis

Pietro Iogna Prat, Nicolò Milan, Jorg Huber, Colette Ridehalgh

Population Health Sciences

Research output: Contribution to journal › Review article › peer-review

1 Citation (Scopus)

Abstract

Background: Neurodynamic approach employs neural mobilization and mechanical nerve interface techniques. While published studies investigated the efficacy of neural mobilization, it is currently unknown whether manual treatment of the nerve mechanical interface is effective in the treatment of people with entrapment neuropathies. Objectives: Assess the effectiveness of mechanical interface treatment, including joint and soft tissue techniques, on pain and function in people with peripheral entrapment neuropathies. Design: Intervention systematic review with metanalysis. Methods: the databases MEDLINE, CINAHL, AMED, APA PsycINFO, SPORTDiscus, PubMed and ScienceDirect were searched from their inception to October 2022. Randomized controlled trials investigating mechanical interface treatment in isolation in patients with peripheral entrapment neuropathies were included. Two independent reviewers performed study selection, data extraction and risk of bias assessment using the Cochrane RoB 2.0 tool. Certainty of evidence for each outcome was judged using the GRADE framework. Results: 11 studies were included in the review, all investigating carpal tunnel syndrome (CTS). Due to high heterogeneity of interventions and comparators, only five studies were pooled in a random-effects meta-analysis. There was evidence of mechanical interface techniques being more effective in reducing pain than sham (MD -2.47 [-3.94;-0.99]) and similarly effective as neural mobilization (MD -0.22 [-0.76; 0.33]) in CTS, albeit with low to very low certainty in the results. Conclusion: mechanical interface techniques are effective for improving pain and function in people with CTS. However, the marked heterogeneity of included interventions and comparators prevents clinical recommendation of specific treatments.

Original language	English
Article number	102907
Journal	Musculoskeletal Science and Practice
Volume	69
DOIs	https://doi.org/10.1016/j.msksp.2024.102907
Publication status	Published - 9 Jan 2024

Keywords

Mobilization
Entrapment neuropathy
Nerve mechanical interface
Carpal tunnel syndrome
Manual therapy

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10.1016/j.msksp.2024.102907

http://www.scopus.com/inward/record.url?scp=85182382873&partnerID=8YFLogxK

Cite this

@article{8af7e579d01a46b0a363b0f015932fa2,

title = "The effectiveness of nerve mechanical interface treatment for entrapment neuropathies in the limbs: A systematic review with metanalysis",

abstract = "Background: Neurodynamic approach employs neural mobilization and mechanical nerve interface techniques. While published studies investigated the efficacy of neural mobilization, it is currently unknown whether manual treatment of the nerve mechanical interface is effective in the treatment of people with entrapment neuropathies. Objectives: Assess the effectiveness of mechanical interface treatment, including joint and soft tissue techniques, on pain and function in people with peripheral entrapment neuropathies. Design: Intervention systematic review with metanalysis. Methods: the databases MEDLINE, CINAHL, AMED, APA PsycINFO, SPORTDiscus, PubMed and ScienceDirect were searched from their inception to October 2022. Randomized controlled trials investigating mechanical interface treatment in isolation in patients with peripheral entrapment neuropathies were included. Two independent reviewers performed study selection, data extraction and risk of bias assessment using the Cochrane RoB 2.0 tool. Certainty of evidence for each outcome was judged using the GRADE framework. Results: 11 studies were included in the review, all investigating carpal tunnel syndrome (CTS). Due to high heterogeneity of interventions and comparators, only five studies were pooled in a random-effects meta-analysis. There was evidence of mechanical interface techniques being more effective in reducing pain than sham (MD -2.47 [-3.94;-0.99]) and similarly effective as neural mobilization (MD -0.22 [-0.76; 0.33]) in CTS, albeit with low to very low certainty in the results. Conclusion: mechanical interface techniques are effective for improving pain and function in people with CTS. However, the marked heterogeneity of included interventions and comparators prevents clinical recommendation of specific treatments.",

keywords = "Mobilization, Entrapment neuropathy, Nerve mechanical interface, Carpal tunnel syndrome, Manual therapy",

author = "{Iogna Prat}, Pietro and Nicol{\`o} Milan and Jorg Huber and Colette Ridehalgh",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

month = jan,

day = "9",

doi = "10.1016/j.msksp.2024.102907",

language = "English",

volume = "69",

journal = "Musculoskeletal Science and Practice",

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T1 - The effectiveness of nerve mechanical interface treatment for entrapment neuropathies in the limbs

T2 - A systematic review with metanalysis

AU - Iogna Prat, Pietro

AU - Milan, Nicolò

AU - Huber, Jorg

AU - Ridehalgh, Colette

PY - 2024/1/9

Y1 - 2024/1/9

N2 - Background: Neurodynamic approach employs neural mobilization and mechanical nerve interface techniques. While published studies investigated the efficacy of neural mobilization, it is currently unknown whether manual treatment of the nerve mechanical interface is effective in the treatment of people with entrapment neuropathies. Objectives: Assess the effectiveness of mechanical interface treatment, including joint and soft tissue techniques, on pain and function in people with peripheral entrapment neuropathies. Design: Intervention systematic review with metanalysis. Methods: the databases MEDLINE, CINAHL, AMED, APA PsycINFO, SPORTDiscus, PubMed and ScienceDirect were searched from their inception to October 2022. Randomized controlled trials investigating mechanical interface treatment in isolation in patients with peripheral entrapment neuropathies were included. Two independent reviewers performed study selection, data extraction and risk of bias assessment using the Cochrane RoB 2.0 tool. Certainty of evidence for each outcome was judged using the GRADE framework. Results: 11 studies were included in the review, all investigating carpal tunnel syndrome (CTS). Due to high heterogeneity of interventions and comparators, only five studies were pooled in a random-effects meta-analysis. There was evidence of mechanical interface techniques being more effective in reducing pain than sham (MD -2.47 [-3.94;-0.99]) and similarly effective as neural mobilization (MD -0.22 [-0.76; 0.33]) in CTS, albeit with low to very low certainty in the results. Conclusion: mechanical interface techniques are effective for improving pain and function in people with CTS. However, the marked heterogeneity of included interventions and comparators prevents clinical recommendation of specific treatments.

AB - Background: Neurodynamic approach employs neural mobilization and mechanical nerve interface techniques. While published studies investigated the efficacy of neural mobilization, it is currently unknown whether manual treatment of the nerve mechanical interface is effective in the treatment of people with entrapment neuropathies. Objectives: Assess the effectiveness of mechanical interface treatment, including joint and soft tissue techniques, on pain and function in people with peripheral entrapment neuropathies. Design: Intervention systematic review with metanalysis. Methods: the databases MEDLINE, CINAHL, AMED, APA PsycINFO, SPORTDiscus, PubMed and ScienceDirect were searched from their inception to October 2022. Randomized controlled trials investigating mechanical interface treatment in isolation in patients with peripheral entrapment neuropathies were included. Two independent reviewers performed study selection, data extraction and risk of bias assessment using the Cochrane RoB 2.0 tool. Certainty of evidence for each outcome was judged using the GRADE framework. Results: 11 studies were included in the review, all investigating carpal tunnel syndrome (CTS). Due to high heterogeneity of interventions and comparators, only five studies were pooled in a random-effects meta-analysis. There was evidence of mechanical interface techniques being more effective in reducing pain than sham (MD -2.47 [-3.94;-0.99]) and similarly effective as neural mobilization (MD -0.22 [-0.76; 0.33]) in CTS, albeit with low to very low certainty in the results. Conclusion: mechanical interface techniques are effective for improving pain and function in people with CTS. However, the marked heterogeneity of included interventions and comparators prevents clinical recommendation of specific treatments.

KW - Mobilization

KW - Entrapment neuropathy

KW - Nerve mechanical interface

KW - Carpal tunnel syndrome

KW - Manual therapy

UR - http://www.scopus.com/inward/record.url?scp=85182382873&partnerID=8YFLogxK

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DO - 10.1016/j.msksp.2024.102907

M3 - Review article

SN - 2468-7812

VL - 69

JO - Musculoskeletal Science and Practice

JF - Musculoskeletal Science and Practice

M1 - 102907

ER -

The effectiveness of nerve mechanical interface treatment for entrapment neuropathies in the limbs: A systematic review with metanalysis

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