G. Manente, F. Torrieri, F. Di Blasio, A. Uncini1.

"S.Stefano" Institute of Rehabilitation, Porto Picena and Center for Neuromuscular Diseases,
University "G.D'Annunzio", Chieti, Italy
1 Clinica Neurologica, Policlinico Clinicizzato "S.S. Annunziata". Via dei Vestini 66100, Chieti, italy

The Italian Journal of Neurological Sciences Supplement to number 4, volume 20, 1999
XXXI National Congress of the Italian Neurological Society

Objective
We noticed that squeezing the distal heads of metacarpal bones (excluding the first) and stretching the III and IV finger relieved parethesias and pain in CTS. This manoeuvre was the rationale to design an innovative splint we called MANU (patented) and perform a controlled trial to assess efficacy and tollerability.

Materials and methods
The MANU is made of: 1) inelastic belt with a velcro adjustable closure positioned at the level of distal heads of metacarpal bones, 2) a rectangular shaped pad, made of soft material, positioned dorsally to the II and V finger producing a mild stretching of III and IV finger, 3) an elastic wrist band with a velcro adjustable closure, 4) an adjustable string, to connect component 1 and 3. Thirty patients with CTS symptoms and abnormal electrophysiological tests were instructed to wear MANU during the night for 1 month. Efficacy was assessed by the Levine scale and percentages of worsening or improvement. Twenty CTS patients served as control.

Results
In the MANU group of Levine score was at the entry 2.5 ± 0.6 and 1.4 ± 0.4 at the end of the study (p=0.000). All patients improved: meand 72% (range 25-100%). MANU was very well tolerated by all patients. In controls Levine score was at entry 2.5 ± 0.5 and 2.4 ± 0.6 at the end (p=0.6). Two patients worsened (15 and 40%), 5 improved (42%); 2 spontaneously, 3 changing or reducing manual work.

Conclusion
This short term study shows that MANU is highly efficient in
ameliorating bouts of positive symptoms in CTS and well tolerated.