Systematic Review Neural Gliding Techniques for the Treatment of Carpal Tunnel Syndrome: A Systematic Review

Context: There are discrepancies regarding the efficacy of neural gliding exercises for the management of carpal tunnel syndrome (CTS). Objective: To conduct a systematic review assessing the efficacy of neural gliding in comparison to alterna­tive nonsurgical treatment for the management of CTS. Evidence Acquisition: A computerized search was performed in April 2008. Criteria for inclusion required that studies (1) were written in English, (2) examined the efficacy of neural glid­ing techniques for treatment of CTS, and (3) included at least one of the selected patient-oriented outcomes. Effect sizes, relative risk, and 95% confidence intervals were calculated to compare neural gliding to alternative treatment. Evidence Syn­thesis: Six studies met inclusion criteria. For all variables, none were consistently favorable toward neural gliding over alternative treatment. However, comparisons across studies revealed a possible trend toward improved outcomes with the use neural gliding. Conclusions: The efficacy of neural gliding is not clear. More research is necessary to determine the population that may respond optimally to this treatment. Keywords: mobilization, decompression, wrist