Improving sensory function after carpal tunnel surgery

ISRCTN ISRCTN60890411
DOI https://doi.org/10.1186/ISRCTN60890411
Secondary identifying numbers 15771
Submission date
16/01/2014
Registration date
16/01/2014
Last edited
09/08/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
This study is looking at the effect of a home based sensory relearning programme in patients who continue to have sensory loss after a surgery to treat carpal tunnel syndrome (numbness or tingling sensation in hands and fingers). Numbness or loss of finger sensation can continue after surgery especially in patients with a long duration of symptoms and more severe pre-surgical impairment. Patients find it difficult to use their hand in everyday tasks like picking up small objects. Sensory relearning can be taught to patients and has been shown in nerve injuries to improve the sensibility and function of the hand. The aim of this study is to find out the effect of sensory relearning in a large group of patients.

Who can participate?
Patients who have undergone carpal tunnel decompression surgery 12 months ago or more

What does the study involve?
Patients are sent a short screening questionnaire asking them to indicate whether they have sensory impairments and to rate the severity of it. Those who report mild or worse sensory impairments are invited for a clinical assessment of hand sensibility using validated tests of sensory function. Those in whom sensory impairment is confirmed by these tests are then invited to participate in the study. Consenting patients are randomly allocated to receive either sensory relearning for 6 weeks or standard practice. All patients are reassessed at 6 and 12 weeks after the initial assessment and the results between the two groups are compared to establish whether sensory relearning improves sensory function.

What are the possible benefits and risks of participating?
Those who receive sensory relearning may find improvement in their sensory function.

Where is the study run from?
The study is being undertaken at the Norwich Clinical Trials Unit (UK) in collaboration with the Department of Orthopaedics at the Norfolk and Norwich University Hospital (UK)

When is the study starting and how long is it expected to run for?
February 2014 to July 2015

Who is funding the study?
National Institute for Health Research (NIHR) (UK)

Who is the main contact?
Dr Christina Jerosch-Herold
c.jerosch-herold@uea.ac.uk

Contact information

Ms Julie Houghton
Scientific

Earlham Road
Norwich
NR4 7TJ
United Kingdom

Email J.Houghton@uea.ac.uk

Study information

Study designRandomised; Interventional; Design type: Not specified, Treatment
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleA pragmatic, assessor-blinded randomized trial of the clinical effectiveness of a 6-week sensory relearning home programme on tactile function of the hand after carpal tunnel decompression
Study acronymIMPACTS
Study objectivesIs a 6-week patient-led home programme of sensory relearning effective in improving tactile gnosis and function of the hand in patients with long-term sensory impairments after carpal tunnel decompression?
Ethics approval(s)East of England Norfolk REC, 23/12/2013, ref: 13/EE/0419
Health condition(s) or problem(s) studiedTopic: Musculoskeletal; Subtopic: Musculoskeletal (all Subtopics); Disease: Musculoskeletal
InterventionStratified blocked randomisation (random permuted block lengths of 2,4 and 6 stratified by STI score at baseline (≤3 points)) will be used. The randomised sequence will be generated independently by the Clinical Trials Unit data manager and held on a dedicated website.

Patients are randomised to two groups:
1. Sensory Re-learning: A standardised Sensory Relearning (SR) home programme will be given to patients including materials, instructions and a diary. Patients will be shown how to carry out the exercises and asked to practise these daily over 6 weeks. Short but frequent sessions (at least 3 times per day of around 10 minutes each) will be encouraged.

2. The control group will not be given any active treatment, which is current standard practice. They will be asked to continue using their hand as they have before.

At the end of their trial participation (final 12 week follow-up assessment) patients in the control group will be given a standardised information sheet which will enable them to replicate the materials from common items available at home and exercises if they wish.
Intervention typeOther
Primary outcome measureTactile gnosis assessed by Shape-texture identification test; Timepoint(s): 6 weeks and 12 weeks
Secondary outcome measures1. Locognosia; Timepoint(s): 6 and 12 weeks
2. Michigan Hand Questionnaire; Timepoint(s): 6 and 12 weeks
3. Moberg pick-up test; Timepoint(s): 6 and 12 weeks
4. Touch threshold; Timepoint(s): 6 and 12 weeks
Overall study start date15/02/2014
Completion date15/06/2015

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 124; UK Sample Size: 124
Key inclusion criteriaFor part 1 screening:
Patients who have had a carpal tunnel decompression at the NNUH Dept of Orthopaedics at least 12 months earlier, aged 18 or over.

For part 2 trial: patients who have had their hand sensation assessed, in whom at least 2 out of 3 sensory tests show results below normal and who have given fully informed consent
Key exclusion criteria1. Patients who do not appear to be able to give fully informed consent or do not consent to being randomised (that is those who express a strong preference for the treatment)
2. Patients in whom the sensory tests are within normal range
Date of first enrolment15/02/2014
Date of final enrolment15/06/2015

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of East Anglia
Norwich
NR4 7TJ
United Kingdom

Sponsor information

University of East Anglia (UK)
University/education

Earlham Road
Norwich
NR4 7TJ
England
United Kingdom

ROR logo "ROR" https://ror.org/026k5mg93

Funders

Funder type

Government

NIHR Senior Research Fellowship; Grant Codes: NIHR-SRF-2012-05-119

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/11/2016 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

09/08/2017: Publication reference added.