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.