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Yoga-Based Intervention for Carpal Tunnel Syndrome
A Randomized Trial
Marian S. Garfinkel, EdD;
Atul Singhal, MD;
Warren A. Katz, MD;
David A. Allan, MD, PhD;
Rosemary Reshetar, EdD;
H. Ralph Schumacher, Jr, MD
JAMA. 1998;280:1601-1603.
Context.— Carpal tunnel syndrome is a common complication of repetitive activities and causes significant morbidity.
Objective.— To determine the effectiveness of a yoga-based regimen for relieving symptoms of carpal tunnel syndrome.
Design.— Randomized, single-blind, controlled trial.
Setting.— A geriatric center and an industrial site in 1994-1995.
Patients.— Forty-two employed or retired individuals with carpal tunnel syndrome (median age, 52 years; range, 24-77 years).
Intervention.— Subjects assigned to the yoga group received a yoga-based intervention consisting of 11 yoga postures designed for strengthening, stretching, and balancing each joint in the upper body along with relaxation given twice weekly for 8 weeks. Patients in the control group were offered a wrist splint to supplement their current treatment.
Main Outcome Measures.— Changes from baseline to 8 weeks in grip strength, pain intensity, sleep disturbance, Phalen sign, and Tinel sign, and in median nerve motor and sensory conduction time.
Results.— Subjects in the yoga groups had significant improvement in grip strength (increased from 162 to 187 mm Hg; P =.009) and pain reduction (decreased from 5.0 to 2.9 mm; P =.02), but changes in grip strength and pain were not significant for control subjects. The yoga group had significantly more improvement in Phalen sign (12 improved vs 2 in control group; P =.008), but no significant differences were found in sleep disturbance, Tinel sign, and median nerve motor and sensory conduction time.
Conclusion.— In this preliminary study, a yoga-based regimen was more effective than wrist splinting or no treatment in relieving some symptoms and signs of carpal tunnel syndrome.
From the Department of Medicine, Division of Rheumatology, University of Pennsylvania School of Medicine (Drs Garfinkel, Singhal, Katz, and Schumacher), the Arthritis-Immunology Center, Veterans Affairs Medical Center (Dr Schumacher), University of Pennsylvania Health System/Presbyterian Medical Center (Drs Katz and Allan), and the American Board of Internal Medicine (Dr Reshetar), Philadelphia, Pa. Dr Garfinkel is now with Cooper Health System and Center for Health and Wellness, Cherry Hill, NJ. Dr Singhal is now in private practice in Mesquite, Tex. Dr Reshetar is now with the Educational Testing Service, Princeton, NJ.
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