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Data Brief
Data Brief
Data in Brief
2352-3409
Elsevier

S2352-3409(24)00802-3
10.1016/j.dib.2024.110838
110838
Data Article
Dataset on bilateral idiopathic carpal tunnel syndrome: Crossover study of two combined physiotherapeutic treatment methods on chirurgical and clinical patients
Georgeto Sérgio Murilo abc
Rogers Pablo pablorogers@ufu.br
d⁎
Fernandes Karen Barros Parron e
Andraus Rodrigo Antônio Carvalho c
a Departamento de Neurocirurgia, Hospital da Santa Casa de Londrina, Londrina, PR, Brazil
b Departamento de Neurocirurgia, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
c Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Pitágoras Anhanguera, Londrina, PR, Brazil
d Faculdade de Gestão e Negócios, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
e Departamento de Estatística, Pontifícia Universidade Católica (PUC), Londrina, PR, Brazil
⁎ Corresponding author. pablorogers@ufu.br
13 8 2024
10 2024
13 8 2024
56 1108389 11 2023
2 8 2024
7 8 2024
© 2024 The Authors
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
This study presents a randomized controlled crossover experiment involving 73 patients with idiopathic bilateral Carpal Tunnel Syndrome (CTS). Patients received two combined physiotherapeutic treatments: myofascial mobilization (IASTM) and stretching. Participants were divided into two groups: one started with stretching followed by IASTM, and the other with IASTM followed by stretching. Of these, 43 underwent surgery and began physical therapy 30 days post-operation, while 30 received non-surgical treatment. The therapy sessions lasted four weeks, followed by a crossover of the treatment modalities and periodic reassessments up to six months. The dataset includes experimental design, patient demographics, diagnostic data, objective muscle strength tests, subjective sensitivity tests, clinical indicators, and self-reported measures. This data can be useful for researchers looking to replicate the study or compare outcomes between clinical and surgical CTS patients

Keywords

Muscle stretching exercises
Myofascial mobilization
Connective tissue techniques
Soft tissue techniques
Surgical decompression
Physical therapy
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pmcSpecifications TableSubject	Health and medical sciences, Physical Therapy and Rehabilitation.	
Specific subject area	Physical therapy and rehabilitation is a branch of medicine that focuses on bone and joint disorders, as well as the central nervous system. It assists individuals in optimizing their functioning and reducing impairment. Rehabilitation is a critical component of comprehensive health coverage. Physical therapy is a type of rehabilitation that using physical techniques to diagnose, treat, and manage injuries and diseases.	
Type of data	Table, Chart, Graph, Filtered, Processed	
Data collection	Data were obtained via a questionnaire, as specified in the data repository's additional information. This material contains detailed information regarding the variable names and labels, as well as the procedures used to gather and build them, which were based on the measurement instruments utilized. A flowchart demonstrating the experiment design (a crossover study) and sample allocation is also included in the data repository.	
Data source location	Institution: Irmandade da Santa Casa de Londrina
City/Town/Region: Londrina, Paraná
Country: Brazil	
Data accessibility	Repository name: Mendeley Data
Data identification number: 10.17632/47vj3yyb5v.1
Direct URL to data: https://data.mendeley.com/datasets/47vj3yyb5v/1	
Related research article	Georgeto, S.M., Andraus, R.A.C., de Oliveira Júnior, E., da Silva, R.A., Ngomo, S. and Fernandes, K.B.P. (2023), Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical-Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments. Orthop Surg, 15: 1654–1663. https://doi.org/10.1111/os.13705.	

1 Value of the Data

• There are few studies that evaluate the idiopathic bilaterality of carpal tunnel syndrome (CTS).

• There are few studies that compare samples from surgical and clinical patients affected by CTS.

• There are few studies that used a long-term cross-over experiment to evaluate the impact of two types of physiotherapeutic treatments on CTS.

• The data can be used by researchers seeking to evaluate the impact of myofascial mobilization (IASTM) and stretching on CTS.

• The data can be used by researchers seeking to compare clinical and surgical patients after physiotherapeutic intervention.

• Researchers seeking to develop a cross-over research protocol with physical therapy interventions and more than two groups to evaluate results on CTS

2 Background

The dataset was compiled to investigate the efficacy of two combined physiotherapeutic treatments —myofascial mobilization (IASTM) and stretching — on patients with idiopathic bilateral Carpal Tunnel Syndrome (CTS). The motivation stemmed from the need to explore non-surgical treatment options and their potential benefits for both clinical and post-surgical patients. This study was conducted against the backdrop of limited research on the comparative effectiveness of these physiotherapeutic methods in a crossover design.

The methodological approach involved a crossover RTC, which allowed each participant to serve as their own control, thereby improving the reliability of the results. Participants were randomly divided into groups to receive the treatments in different sequences, ensuring that any observed effects could be attributed to the treatment rather than other variables.

This data article supports and extends the findings presented in the original research article, by providing detailed and accessible data, it enables other researchers to replicate the study, perform secondary analyses, and compare the outcomes with other CTS treatment studies. This enhances the transparency and reproducibility of the research, fostering further advancements in the field of physical therapy and rehabilitation for CTS

3 Data Description

The dataset is organized into six information blocks (BX_) that detail various aspects of the crossover experiment.• Block 0 (B0_): This block includes information identifying the experimental design, such as time periods (B0_PERIOD), sequence of treatments (B0_SEQUENCE), types of treatment (B0_TREATMENT), and carryover effects (B0_CARRYOVER).

• Block 1 (B1_): Contains sociodemographic information of the patients, categorized by treatment sequence and whether they were clinical or surgical patients. This includes variables like sex, ethnicity, marital status, occupation, education level, family income, dominant hand, age, and body mass index (BMI). See Table 1.Table 1 Sample profile by treatment sequence.

Table 1Variable	Category	Clinical Patients	Chirurgical Patients	
		Treatment sequence [n (%)]	Treatment sequence [n (%)]	
		S/M [n = 15]	M/S [n = 15]	Total [n = 30]	S/M [n = 21]	M/S [n = 22]	Total [n = 43]	
Sex	Female	14 (93.3)	13 (86.7)	27 (90.0)	19 (90.5)	21 (95.5)	40 (93.0)	
Ethnicity	White	7 (77.8)	11 (84.6)	18 (81.8)	13 (81.3)	14 (73.7)	27 (77.1)	
Marital status	Married	11 (78.6)	13 (92.9)	24 (85.7)	16 (80.0)	15 (71.4)	31 (75.6)	
Occupation	Housewife	4 (26.7)	5 (35.7)	9 (31.0)	6 (28.6)	11 (52.4)	17 (40.5)	
Education	High school	8 (57.1)	12 (85.7)	20 (71.4)	14 (73.7)	13 (61.9)	27 (67.5)	
Family income	Up to 1.000 BRL	8 (57.1)	8 (57.1)	16 (57.1)	9 (52.9)	14 (66.7)	23 (60.5)	
Dominant hand	Right	14 (93.3)	13 (86.7)	27 (90.0)	19 (90.5)	20 (90.9)	39 (90.7)	
Age	Years	51.73±11.61	52.33±13.37	52.03±12.31	50.52±7.86	52.45±12.57	51.51±10.46	
BMI	Kg/m2	31.69±8.83	29.72±5.43	30.67±7.21	30.65±5.66	30.08±5.69	30.36±5.62	
Note: S = Stretching; M = Myofascial Mobilization; BRL = Brazilian Real; BMI = Body Mass Index. The categories indicated in the table are the most frequent. Age and BMI are mean ± standard-deviation.

• Block 2 (B2_): Provides electrophysiological diagnostic data used to classify the severity of CTS at the baseline (time zero). This block includes parameters measured by electroneuromyography (ENMG) tests.

• Block 3 (B3_): Comprises objective outcome measures. This includes maximum force in isometric contraction of the palmar grip (B3_DYNAM) and digital pinch strength (B3_PINCH), measured with hydraulic devices. See Fig. 1.Fig. 1 Objective muscle strength tests. Note: Average of the variables B3_DYNAM (grip strength - above) and B3_PINCH (pinch gauge - below) for the right and left hands, over the four folow-up periods and for clinical and surgical patients.

Fig. 1

• Block 4 (B4_): Contains data on clinical signs and sensitivity tests. This includes the presence of Tinel's Sign (B4_TINEL), thenar muscle atrophy (B4_ATROPHY), tactile sensitivity measured by the Semmes-Weinstein Test (B4_SEMMES), and the Two-Point Discrimination Test (B4_2PTS). See Fig. 2.Fig. 2 Clinical signs. Note: Relative frequency of the variables B4_TINEL (tinel signal - above) and B4_ATROPHY (visible thenar atrophy - below) for the right and left hands, over the four folow-up periods and for clinical and surgical patients.

Fig. 2

• Block 5 (B5_): Includes subjective self-report measures. This consists of pain levels measured by the Visual Analog Scale (B5_VAS), functional status and symptom severity from the Boston Carpal Tunnel Questionnaire (B5_BCTQ), hand function from the Brief Michigan Hand Outcomes Questionnaire (B5_MHOQ), and quality of life from the SF-12 Health Survey (B5_SF12). See Fig. 3 and Fig. 4.Fig. 3 Subjective self-report measures I. Note: B5_VAS variable mean score (visual analogue scale - above) and the B5_MHOQ items (below) for the right and left hands, over the four folow-up periods and for clinical and surgical patients.

Fig. 3

Fig. 4 Subjective self-report measures II. Note: Average of the sum of the B5_BCTQ items (sensitive and function score - above) and the B5_SF12 items (physical and mental health score - below), over the four folow-up periods and for clinical and surgical patients.

Fig. 4

Each block of data is identified with a specific prefix (e.g., B0_, B1_, etc.), and information for each variable is presented in a long format. This means that there is a column for each variable and additional columns to identify the timing and sequence of the data collection. For instance, B0_PERIOD represents the time periods in which data was collected across the study timeline.

The data focuses on documenting the crossover experiment's design, the sample profile, and the visualization of outcome variables over five collection periods, separated by surgical and clinical patients. The raw data is highly reusable, particularly for researchers interested in replicating similar methods in CTS studies or comparing outcomes between clinical and surgical patient samples.

4 Experimental Design, Materials and Methods

4.1 Experimental and methods

This is a 2 × 4 crossover experiment that is prospective, randomized, and double-blind. The information in database block zero (B0_) identifies the experimental design.

The inclusion criteria for the participants were as follows: individuals aged 18 or over with idiopathic bilateral CTS, presenting one or more of the clinical criteria defined by Burton et al. (2014) [1], physical status I or II according to the American Society of Anesthesia (ASA) [2], normal laboratory test results to exclude associated pathology (blood count, renal function, glycemic curve, rheumatic profile, and thyroid profile), no limitations in the upper limbs or skin lesions that would prevent them from carrying out the proposed therapies, and an electroneuromyography (ENMG) test indicating severe impairment in one of the hands, according to the Stevens (1997) criteria [3], available in Block 2 of the database.

All ENMG tests were performed in the same laboratory, on the same machine (Dantec Ketpoint, Natus®, Pleasanton, USA), and by the same electrophysiologist with specialist qualifications, using the service's reference values based on the Stevens classification (1997) and the American Association of Electrodiagnostic Medicine [4].

Participants with a history of allergies to the medications used in this treatment, drug users, those with psychiatric disorders or mental retardation, pregnant women, and patients who had previously received treatment for CTS in the previous three months or who had been symptomatic for less than six months were all excluded.

Patients who matched the inclusion criteria were referred to Pitágoras/Unopar University's rehabilitation department, where they were randomly assigned to one of two groups in a 1:1 ratio. The opaque envelopes, which were numbered and sealed in a random order, were utilized. Each envelope contained a notation to begin with either the static active stretching technique or the IASTM technique. A member who was not participating in the research performed the randomization. After selecting the envelopes and determining the starting sequence, all participants were evaluated at time zero (T0).

Of the 73 patients, 43 had surgery on the hand with the most severe ENMG involvement; however, when the degree of involvement was bilaterally severe, the hand with the more symptomatic involvement was chosen. The surgical approach was AC, with a palmar incision and local anesthesia using a solution of 1 % lidocaine, 1:100,000 adrenaline, and 8 % sodium bicarbonate in a 1:10 ratio, as described in WALANT [5]. Anesthetic infiltration was performed using the Hole-in-one approach [6]. All individuals were operated on using the same procedure by a single neurosurgeon, with no splints or restrictions on hand usage following surgery.

After a 30-day post-operative period, the individuals were divided into randomized groups and sent to begin therapy. They either began with stretching and then IASTM (S/M group) or with IASTM and then stretching (M/S group). Fig. 5 summarizes the subjects assigned to surgery and subsequently the two physiotherapy treatments, whereas Fig. 6 displays exclusively the two physiotherapy therapies.Fig. 5 Chirurgical sample allocation flowchart [7].

Fig. 5

Fig. 6 Clinical sample allocation flowchart.

Fig. 6

Participants from both the S/M and M/S groups were given the same therapy on both upper limbs. In the orthostatic posture, 15 exercise sequences were conducted on six muscle groups situated in the cervical region, shoulder, wrist, and fingers. Each workout sequence consisted of a series of 40-second stretches separated by a 1-minute rest time between each muscle group. Stretching was done to reach the largest amplitude feasible up to the point of discomfort but not pain, and the position was kept for 40 s. For four weeks, supervised stretching was done twice a week for 45 min each time.

IASTM was conducted without any cosmetics on the skin on the exposed region to be manipulated. The procedure included mobilizing the anterior and posterior chest muscles, shoulder muscles, and anterior and posterior arm and forearm muscles in the dorsal, ventral, and lateral decubitus postures. Up to five different types of instruments (crochets) were utilized in myofascial mobilization, with the right opening and inclination for each muscle group, allowing for optimum coupling between the crochet and the part of myofascial tissue to be mobilized. The IASTM method was centripetal and consisted of three stages: digital palpation, instrumental palpation using crochets, and mobilization.

Following the completion of the crochet mobilization, superficial scraping was performed on the insertions of the major pectoral and trapezius muscles at the level of the sternum and occipital bone, respectively, utilizing the convex part of the crochets.

After a week's rest (wash-out 1), the participants were reassessed with the outcome instruments (T1). Subsequently, those who had started with stretching proceeded to receive IASTM and vice versa, following the same schedule as described above. At the end of the fourth week, after another week of rest (wash-out 2), the participants were reassessed (T2). The participants were then referred for outpatient follow-up, with further reassessments at 3 months (T3) and 6 months (T4) after T2. Throughout the treatment period, no recommendations were made for the use of orthoses, analgesic medication, or restrictions regarding the use of hands.

The professionals involved in the study were blinded to the outcome of the randomization, the collection of the results at the different times, and the data analysis.

4.2 Materials

The result analyses were carried out using objective (Block 3) and subjective (Block 4 and Block 5) variables, following the principles established by Erickson and colleagues (2019) [8]:i) Maximum force in isometric contraction of the palmar grip (B3 DYNAM) and digital pinch (B3 PINCH) were measured three times with a 30-second break between measurements using a Hydraulic Hand Dynamometer and Hydraulic Pinch Gauge (both Jamar ® Patterson Medical, Warrenville, IL, USA). These measurements were taken according to the directions in their individual manuals. Both devices were brand new, calibrated, and only used for this research.

ii) Atrophy (B4 ATROPHY) and Tinel's Sign (B4 TINEL): A positive sign Tinel's sign is recognized when percussion on the wrist causes pain or tingling in the median nerve innervated region on the volar surface of the palm. The weakening of the principal muscle in this area, the abductor pollicis brevis, which is entirely innervated by the median nerve, causes atrophy in the thenar eminence region of the hand.

iii) Semmes-Weinstein Test (B4_SEMMES) and Two-Point Discriminator Touch-Test (2PTS) (B4_2PTS): The Semmes-Weinstein test uses monofilaments of increasing thickness to measure the tactile sensitivity of the skin on the digital pulp of the fingers of the investigated hand. The 2PTS assesses the density of sensitive innervation at 1 and 25 mm distances, with an emphasis on the distal phalanx of the first, second, and fifth fingers.

iv) The Visual Analog Scale (B5 VAS), adapted from the Wong-Baker face scale [9], was used to assess the present state of pain, with a value of 0 indicating no pain and a value of 10 indicating the greatest possible pain.

v) The Boston Carpal Tunnel Questionnaire (B5 BCTQ) was employed, which has 5-point Likert-type response alternatives. The number of suffixes denotes the item's position in the original questionnaire [10] or its Portuguese translation [11]. The questions concern symptoms encountered in a typical 24-hour period over the last two weeks.

vi) For both hands, the Brief Michigan Hand Outcomes Questionnaire (B5 MHOQ) included 5-point Likert-type answer alternatives. The number of suffixes denotes the item's position in the original questionnaire validation work [12] or its Portuguese translation [13]. The questions concern the individual's ability to carry out everyday tasks and operate with their hands for professional, household, and schoolwork.

vii) The SF-12 (B5 SF12) (12-item health survey quality of life assessment questionnaire) was utilized. The number of suffixes denotes the item's position in the original questionnaire validation work [14] or its Portuguese translation [15]. The questions concern how the respondent assesses aspects of his or her health throughout the last four weeks.

Limitations

1. Sample Size: The study includes a relatively small sample size of 73 participants, which may limit the generalizability of the findings. Larger studies are needed to confirm the results and ensure broader applicability.

2. Homogeneity of the Sample: The participants were all recruited from a single geographic region (Londrina, Paraná, Brazil), which may introduce regional biases and limit the applicability of the results to other populations.

3. Follow-up Duration: The follow-up period, although extending up to six months, may not be sufficient to observe long-term effects and sustainability of the treatment outcomes. Longer follow-up studies are necessary to evaluate the enduring impact of the interventions.

4. Blinding: While the study was double-blind, the effectiveness of blinding could be compromised if participants or clinicians inadvertently learned about the treatment assignments. This could introduce bias in the outcomes.

5. Treatment Specificity: The study focuses on two specific physiotherapeutic treatments (IASTM and stretching), which may not represent the full range of available treatments for CTS. The findings may not be applicable to other treatment modalities.

6. Data Completeness: Although extensive, the dataset may have missing or incomplete data for some variables, which could affect the robustness of the analyses.

7. Self-Reported Measures: The inclusion of subjective self-reported measures, such as pain and functional status, could be influenced by individual perceptions and reporting biases, potentially impacting the accuracy of these outcomes.

8. Inter-Individual Variability: Variations in individual responses to treatments due to differences in baseline characteristics, adherence to treatment protocols, and other personal factors could influence the results and reduce the consistency of the findings.

Ethics Statement

From January 2018 to February 2019, the Neurosurgery team at Irmandade da Santa Casa de Londrina recruited all participants in the carpal tunnel outpatient clinic. The study was authorized by the Irmandade Santa Casa de Londrina ethics committee under number 3.276.439, registered on ClinicalTrials.gov (NCT04347746), and all participants completed the Informed Consent Form.

CRediT authorship contribution statement

Sérgio Murilo Georgeto: Conceptualization, Methodology, Writing – original draft, Supervision. Pablo Rogers: Data curation, Visualization. Karen Barros Parron Fernandes: Validation, Writing – review & editing. Rodrigo Antônio Carvalho Andraus: Validation.

Appendix Supplementary materials

Image, application 1

Data Availability

Dataset on Bilateral Idiopathic Carpal Tunnel Syndrome: Crossover Study of Two Combined Physiotherapeutic Treatment Methods on Chirurgical and Clinical Patients (Original data) (Mendeley Data).

Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.dib.2024.110838.
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