Nerve And Tendon Gliding Exercises Health And Social Care Essay

Nerve And Tendon slide causes Health And Social Cargon Essay articulatio radiocarpea b iodine dig Syndrome was first described by Sir James Paget in 1854 but the term was coined by Moeirisch. It is a syndrome of muscle contraction neuropathy of median(prenominal)(prenominal)(a) case at the radiocarpal joint. carpal bone burrow Syndrome results in considerable discomfort and aggravator, limitation of activities of periodic living, loss of sleep and work dis magnate. (Levine et al., 1993). Twenty percent of symptomatic subjects with symptoms of trouble, numbness, nocturnal parasthesia and tingling mother wit in the hand would be expected to have Carpal dig syndrome based on the clinical examination and electro physiologic establishing.CARPAL TUNNEL SYNDROME IN PREGNANCYCarpal tunnel Syndrome is more than browse in pregnancy because the arrangingic process increases the extra capsular fluid retention by the endocrine gland Prolactin and produce soft wander puffin ess in the later stages (third trimester) of their pregnancies. The Carpal Tunnel Syndrome can thus be produced by coalescency or swelling of the median governance in its synovial sheath (Gelberman et al., 1981 Snell, 2000 Szabo, 1989 Primal Pictures, 2001 Rempel et al., 1999).Many therapies have been advocated for treating the carpal tunnel syndrome including Mobilizations, tenderness glide, muscle soaring, etc. consequently the presence adopt was focused on the Effect of Nerve and Tendon move Exercises in the utilitarian recovery of the carpal tunnel syndrome during pregnancy.Tendon gliding Exercises were mostly performed at the end range of motion at small amplitude are performed at the limit of available motion and stressed into the tissue resistance. These physical exercises are thought to relieve pressure on the median nerve and stretch the carpal ligaments, which withal services decrease pressure. They are also thought to help blood flow out of the carpal tunnel, which can help decrease fluid pressure.INCLUSIVE CRITERIAPregnant Women with fuss and swelling in the wrist for at least 1 month.Pregnant women with two unilateral and bilateral carpal tunnel syndrome.Pregnant women with age conference betwixt 25years and 32years.EXCLUSIVE CRITERIANon-pregnant women with carpal tunnel syndrome.Pregnant women having other complications like hypothyroidism, diabetes that may lead to carpal tunnel syndrome.every other trauma related injuries in hand.Males.MATERIALS AND METHODSNerve and Tendon Gliding Exercises. in operation(p) Status surmount for measuring functional activity.HYPOTHESISNerve and Tendon Gliding Exercise programme will be effective in the discussion of carpal tunnel syndrome during pregnancy.NULL HYPOTHESISThere may non be any significance between the nerve and tendon gliding exercise programme and carpal tunnel syndrome during pregnancy.OBJECTIVESThe choose of this information is to determine from the available evidence the in tensity level of Nerve and Tendon gliding exercises programme in carpal tunnel syndrome during pregnancy using running(a) Status surmount for performance and Symptom Severity Scale for wrist pain. call for DESIGNA original of 20 patients having carpal tunnel syndrome during pregnancy are selected to find out the effectiveness of nerve and tendon gliding exercises on them.The duration of study per patient 4 weeksTreatment session 10 minutes per session / 2settingsTreatment per week 7 days sequence OF STUDY 6 months expiryRelief of pain and swelling in hand.An improvement in the functional ability of hand.Awareness is created for the working pregnant women especially with computers, typewriters, cake decorators, chain armoural workers, dentists, and alveolar consonant technicians virtually, who use their reach and wrists repetitively.Avoiding the severity of median nerve injury, which may lead to claw hand if un noniced.INTRODUCTIONSir James Paget first described carpal Tunne l Syndrome in 1854 but Moeirisch coined the term. It is a syndrome of compression neuropathy of median nerve at the wrist. INTRODUCTIONCarpal Tunnel Syndrome results in considerable discomfort and pain, limitation of activities of daily living, loss of sleep and work disability. (Levine et al., 1993).The Carpal Tunnels floor is made up of the 8 tiny wrist bones. Its roof is a thick ligament called the transverse carpal ligament. 9 tendons pass through this tunnel. 4 of the 9 tendons bend the tips of the riffle, a nonher 4 of the 9 tendons bend the middle joints of the finger, and the 9th tendon bends the finger tip.The median nerve passes through this tunnel. When there is swelling or if there is thickening of the ligament the nerve gets pinched or compresses. With enough compression carpal tunnel symptoms occur. If the compression is severe or occurs over a longer period of time the nerve may change shape and flatten causing some eternal damage.Carpal Tunnel Syndrome occurs due to many causes likeWrist injuryCARPAL TUNNEL SYNDROME IN PREGNANCYCarpal tunnel Syndrome (CTS) is more frequent in pregnancy because the systemic process increases the extra capsular fluid retention by the hormone Prolactin and produce soft tissue swelling in the later stages (third trimester) of their pregnancies. The Carpal Tunnel Syndrome can thus be produced by compression or swelling of the median nerve in its synovial sheath (Gelberman et al., 1981 Snell, 2000 Szabo, 1989 Primal Pictures, 2001 Rempel et al., 1999).CTS have been recognized as a common complication of pregnancy (HeckmanSassard, 1994). The pathophysiology of pregnancy related CTS (PRCTS) has been mostly attributed to redistribution of fluids (Ekman-Ordeberg et al., 1987 Wand, 1990 Pauda et al.,2001).Signs And Symptoms1.Pain that shoots from the hand up the subsection as far as the shoulder.2.Tingling in the hands during the day or the night that disrupts sleep and limits the ability to grasp objects with the han ds.3.Weak feeling in the hands, and the inability to extract up small objects.4. The feeling that the hands are swollen, even if they do not appear to be so.5.Burning numbness and tingling sensation in the turn over and first trio fingers.6.Weakness in the muscle at the base of the thumb, near the palm.Motor weakness will be seen in abductor pollicis brevis, flexor polices brevis and opponens policis brevis. peaceful flexion or hyperextension of the affected hand at the wrist for more than one minute may worsaen symptoms.(Phalen.G.S.,1966). Percussion of the median nerve at the wrist causes paresthesis of the digits (Steward.J.D.,1978).Early Treatment1.Splinting the wrist in a neutral plaza.2.Avoiding the activities which causes pain if possible3.Tendon and nerve gliding exercises.4.Massaging5.Elevating the arm or flicking6.Neural mobilization7.Ultrasound, icing, as pain relieving modality etc.Non operative treatment s is more effective in early stageas such as NSAIDS and local corticosteroids injections.If the problem is severe surgical procedure is made to release the carpal tunnel.Diagnostic criteriaHarrington etal suggested surveillance criteria for carpal tunnel syndrome should be pain or parasthesia or sensory losss in the median nerve distribution and one of the followingTinels sign positivePhalens trial positiveNocturnal exacerbation of symptomsMotor loss with wasting of the abductor pollicis brevisAbnormal nerve conduction studies.Nocturnal and exertonal dyesthesias in the radial half of the palm occur in 10% to 25% of pregnant women. When the carpal tunnel syndrome occurs, the symptoms area more often bilateral. Onset of symptoms is typical during the third trimester. Because of itas trnsient nature carpal tunnel syndrome during pregnancy is best treated by using right footmarks, such as tendon and nerve gliding exercises. That subsequent pregnanciesaraae frequently associated with repeated episodes of carpal tunnel syndrome confirms the ass ociation of carpal tunnel syndrome and pregnancy.Gliding ExercisesTendon gliding and median nerve-gliding exercises are two types of exercises that may help with carpal tunnel syndrome. These exercises are thought to relieve pressure on the median nerve and stretch the carpal ligaments, which also helps decrease pressure. They are aolso thought to help blood fow out of the carpal tunnel, which can help decrease fluid pressure. fist Flexion ExercisesFist Flexion Exercises(also known as tendon gliding exercises) move your fingers through five positions while your wrist corset in a neutral position(meaning it is not bend). To perform this exercise, do the following1.Start with your fingers straight.2.Make a hook fist and then slide by to a straight hand.3.Make a straight fist and then return to a straight hand.4.Make a full fist andthen return to a straight hand.Hold each positons for seven seconds amd do 10 repetitions. Repeat three times to five timeas a day.Median Nerve Gliding Ex ercisesFor median nerve gliding exercises ou move yout thumb through 6 positi0nswhile your wrist stays a neutral position. To perform this exercise, do the following1.Begin by making a fist with your wrisat in the neutral position.2.Straigthen your fingers anad thumb.3.Bend your wrist back and move your thumb away from your palm4.Turn your wrist palm up5.Use your other hand to gently pull uyout thumb farther away from your palm.Hold each position for seven seconds, and do five repetitions. Repeat three ti five times a day.Effectiveness of the Tendon and nerve gliding exercises used as conservativist treatment approachesd in relieving the symptoms of the carpal tunnel syndrome during pregnancy.(Lamia Pinar, Asgel Enhos et al.,)DefinitionCarpal tunnel syndrome is a condition caused by compression of median nerve in spite of appearance the carpal tunnel leads to sensory changesover the lateral side of the hand and muscle weakness in thenar eminence, results in pain, numbness and ting ling of fingers. It usually occurs in the third trimester of pregnancy.Aim of StudyA STUDY OF EFFECTIVENESS OF NERVE AND TENDON GLIDING EXERCISES AS TREATMENT APPROACH TO CARPAL TUNNEL SYNDROME DURING PREGNANCY.OBJECTIVESThe aim of this study is to determine from the available evidence the effectiveness of Nerve and Tendon gliding exercises programme in carpal tunnel syndrome during pregnancy using operational Status Scale for performance and Visual Analogue measure for wrist pain.HYPOTHESISNULL HYPOTHESISThere may not be no significance between the nerve and tendon gliding exercise programme and carpal tunnel syndrome during pregnancy.Alternate HypothesisNerve and Tendon Gliding Exercise programme will be effective in the treatment of carpal tunnel syndrome during pregnancy.Review of literature1.Lamia Pinar, Asgel Enhos et.alConducted an experiment study on total of 26 patients with caroal tunnel syndrome were shared out into two groups. In one group the volar splint were applie d and trained to modify their functional activities in accordance witrh conservative treatment. In group two tendon gliding exercises were continued for 4 weeks with numeric rating scale and Gonuiometry. It comcluded that group two reported excellent results in pain reduction and functional improvement than gropup one.2.Akaline.E.,et.al.,(2002)Conducted an experi kind study on carpal tunnel syndrome with a total of 28 patients with 36 hands of CTS, which were divided into two groups, with 14 patients each. One group was treated with nerve and tendon gliding exercises along with custom made neutral volar splint, and another group was treataed with only neutral volar splint for 4 weeks continuously. Patientas satisfaction was invesatigated during the follow up ranging from 5-11 month, with a mean of 8 month. The study explained that, of those patients who performed nerve and tendon gliding exercise with wearing custom made neutral volar splint, 93% reported good results, and of those patients who have only wearing neutral volar splint, 72% reported good results. American Journal of Physical Medicine Rehabilitation, 2002, Feb81(2), Pp108-13).3.Rosemaryn .L.M., et.al.,(1998)Conducted an experimental study on carpal tunnel syndrome with 240 hands, from 197 patients. They were divided into two groups. Patients in some(prenominal) groups were treated with standard conservative methods, and those in one group were also treated with a program of nerve and tendon gliding exercise of those who did not perform the nerve and tendon gliding exercise, 71.2% downstairswent surgery compared with only 43.0% of patients who did perform them. Patient in experimental group, who did not undergo surgery were interviewed at an fair action time of 23 months (range, 14-38 months), of these 53 patients, 47(89%) responded to this detailed interview of those 47, who responded, 70.2% reported good or excellent results, 19.2% remained symptomatic, and 10.6% were non-complaint.(Journal o f Hand Therapy, 1998, Jul-Sep11(3),171-9).4.Dakowick.A.,(2005)the purpose of the study was to evaluate the utility in conservative treatment of carpal tunnel syndrome. 40 Patients aged 30-72 years, with unilateral CTS cofirmed by EMG examination were include. The patients were divided into 3 groups based on clinical symptoms according to Whitley. The character of pain, its frequency and intensity (VAS Scale) were determined using parameter. Decrease in pain was observed by the usae of VAS. (Rock Akad Med Bialmyst, 200550-suppi196-8).5.Bonebrake.A.R.,et.al.,(1990)the study was designed to respect the efficacy of a proposed new and unique programme relative to treatment. The patients diagnosed as CTS were compared to control to a control population showing no symptoms. Prior to undergoing treatment and following completion of the treatment programme. Results indicate that individuals with CTS had pregnantly lower shelters in strength, ROM, and slower task performance than did the controlratings of pain anad distress were also significantly higher than the control groups. Analysis of the post treatmaent cases revealed statistically significant improvements in several measures of up to statistically significant improvements in several measure of up to 25% over post treatment abide bys. Significant improvement was also shown to several ROM measures of upto 22%. Finally, a significant reduction of 15% pain and distress ratings was demonstrated in the post treatment cases. (Journal of Manipulative Physical Therapy, 1994 (May)17(4)246-249).6.Scrimsha.S.R.,et.al.,(2001)Conducted a comparative study between the responsiveness of Visual analogue scale and McGill pain questionnaire. Measures in 75% patients and concluded that the VAS was a better tool than the McGill pain questionnaire for measuring pain in clinical practise.7.O.Baysal, Z.Altay et.alConducted a study in 28 female patient with clinical and electrophysiologic evidence of bilateral carapal tunnel syndro me. They were divided into two groups. Group 1 acquire tendon gliding exercise with splinting. Group 2 received splinting with ultrasound for a period of 4 weeks with Visual analogue scale and Functional status scale.8.Bringer TL.,Roger IC et.alconducted a randomized trial in totoal of 61 patients with carpal tunnel syndrome. They were divided into four groups. Group 1 received neutral wrist and MCP exercise group. Group 2 received neutral wrist MCP exercise along with splint. Group 3 received wrist cock-up exercise and Group 4 received wrist cock-up exercise and tendon gliding exercise along with splintas perfoarmed 3 times a day. The tool used to asses the function is functional Status Scale and Symptom Severity Scale. There was significant effect in Group4.9. Sonodyn, Sieman(2000)Conducted an experiment on study of 16 patients. They was treataed with Ultrasound for a period of 4 weeks and the pain was assessed. In this, 88% reported good reasult and reduction pain was assessed b y using Visual Analogue Scale.10. Davis.P.T.,et. al., (1998)Conducted an experimental study to compare the efficiency of conservative management care with chiropractic care in treatment of carpal tunnel syndrome. The group with 9 week of treatment and a 1 month follow-up interview. 96 eligible patients with symptoms were conformend by clinical exam and nerve conduction studies. Conservative treamtment included mobilization of carpal bone, soft tissues, joints (three treatment per week for 2 wee, two treatment per week for 3 week, and one treatment per week for 4 wek). Main outcomes measures were pre and post assessment of self reported physical and mental distress, nerve-conduction studies, results show that there was significant improvement in perceived function and comfort, neve conductuion and finger sensation. (Journal of Manipulative Physiotherapy, 1999 June22(55)348-9)11. FD Burke, J Ellis, H McKenna, M J Bradley(2003)Carpal Tunnel syndrome of mild to moderate severity can oft en be effectively treated in a primary care environment. Work space modifications wrist splints tendon and nerve gliding exercises are of benefit and useful for symptomatic women in the third trimester of pregnancy.12.Shaafi Sh*, Naimain Sh*, Iromlou H*, Sayyah Melli M**A convenience sample of 90 pregnant women (30 women from each trimester) were referred from Al-Zahra Hospital of the electrodiagnostic ward of examined clinically and then by electroneurodiagnostic tests.There were suspected symptoms of CTS in 45 patients. The most frequent symptom and sign were hands paresthesia(34%) and positive tinel and phalen sign(each22%). CTS was definite diagnosis in 15 women(16.6%) by electroneurodiagnostic studies. Mild bilateral involvement was seen in 73.3% of patients. There was a meaningful relationship between CTAS and trimester that 26.6% of patients were at third trimester. Also there was a meaningful relation to age. The CTS was more frequent in ilder women.13.BaumannF, Karlikaya G, Yuksel G, Citci B, Kose G, Tireli H(2007)Pregnant women in the third trimesater (n=69) and age-matched non-pregnant women (n=40) asymptomatic for CTS were included in the studyNerve conductn studies of themedian and the ulnar nerves across the carpal tunnel were bilaterally performed with the standard techniques. All the median sensory nerve conduction studies performed from the ring finger and palmar region to the wrist. Median sensory nerve latencies from palmar branches to wrist were significantly longer in the pregnant group.(p14. OConner.D.,et.al.,(2002)Conducted an experimental study to evaluate the effectiveness of non surgical treatment for carpal tunnel syndrome versus a placebo or other non-surgical control interventions in improving clinical outcome. Twenty ine trials involving 884 people were included. In one trial involving 21 people carpal bone mobilization significantly improved symptoms later on three weeks, (weighted mean difference is -1.4395% confidence legal s eparation is 2.19 to -0.67), compared to no treamtment. Current evidence shows significant short term bebefit from carpal bone mobilization. (Cochrane Databasae syst Rev.2003(1)CD003219).MATERIALS AND METHODOLOGYMATERIALS AND METHODOLOGYFULL PAGEMATERIALS AND METHODOLOGYMATERIALS USED roveChairPillowFoot stoolVAS SCALEFUNCTIONAL STATUS SCALEMETHODOLOGYSTUDY DESIGNQuasi experimental study with Pre Vs. raise test design.STUDY SAMPLINGThe 10 samplings were selected from RetnaGlobal Hospital, Trichy and Thanthai Roever College of Physiotherapy, perambalur. A total number of 10 subjects were diagnosed as symptomatic Carpal Tunnel syndrome during pregnancy at age group of years was selected by Quasi-experimental purposive random sampling method after giving due consideration to inclusion and exclusion criteria.STUDY SETTINGThe study was conducted at Outpatient Physiotherapy Department in Thanthai Roever College of Phsiotherapy, Perambalur, Rathna Global Hospital, EMG Laboratory in PG Stud ies under the supervision of concerned authority.STUDY DURATIONThe study was conducted for a period of 4 weeks.INCLUSION CRITERIAPregnant women with pain and swelling in the wrist for 1 month.Both unilateral and bilateral involvement. climb on 25 years and 32 years.EXCLUSIVE CRITERIANon pregnant women with carpal tunnel syndrome.Pregnant women having other complications like hypothyroidism, diabetes which may lead to carpal tunnel syndrome.Any other trauma related injuries.Abnormal X-Ray of the wrist.Males.Gained surgical of symptoms.History of steroid injection into the carpal tunnel.PARAMETERA.VISUAL ANALOGUE SCALE(VAS)The VAS Scale is the binding and reliable measurement tool for pain.It is used to measure the pain response that the patient experience before and after nerve and tendon gliding exercises of median nerve.VAS Scale consists of 10cm horizontal line with two ends labeled as no pain(0) and severe pain(10), the patient will mark a point on the line, which corresponds to the intensity of pain what theyexperience.B.FUNCTIONAL STATAUS SCALE(FSS)Functional Status Scale was used to measure the functional disability offhand. It consists of six items of questionnaire (writing, buttoning of clothes, holding a book while reading, household, carrying food product bags, bathing and dressing).SCORING06-12 -No difficulty13-18 -Mild difficulty19-24 -Moderate difficulty25-29 -cannot do at all due to hand or wrist symptoms.PROCEDUREA total of 10 subjects with symptomatic carpal tunnel syndrome during pregnancy was selected randomly with due consideration to inclusion an exclusion criteriaA brief demonstration was given nigh tendon and nerve gliding techniques for the patient.Pre test data and post taest data was collected with VAS and FSS Scale. The results were recorded.The subjects weare given nerve and tendon gliding exercises.The results of post test of the same parameter was recorded and compared.Statistical toolsThe statistical tool used in this study wer e paired t-test.PAIRED T-TESTt-test was used to find out the statistical significance between Pre and Post test ranks of tendon and nerve gliding exercises and VAS pain response and FSS Scale response before and after treatment.FORMULA PAIRED T-TESTS= dd =Difference between the Pre Test Vs post Test_d= Mean differencen= center number of subjectsS=Standard deviationDATA PRESENTATIONDATA PRESENTATIONTABLE-1S.NoVisual Analogue scalePre Test Post TestFunctional Status ScalePre Test Post Test1.8 427 162.7 327 123.8 526 154.9 429 135.7 225 156.8 425 127.9 328 168.7 428 169.8 227 1710.8 328 14DATA ANALYSIS AND INTERPRETATIONDATA ANALYSIS AND INTERPRETATIONThis chapter deals with the analysis and interpretation of the Datas collected from 10 patients with carpal tunnel syndrome during pregnancy and the effect of nerve and tendon gliding exercises aas a treatment approach to carpal tunnel syndrome during pregnancy by comparing the VAS Scale for pain response and FSS for functional ability.T ABLE IIThe table II shows the mean value, mean diference, standard deviation and paired t value between pre and post test value of Visual Analogue Scale for patientas whao have been subjected to tendon anad nerve gliding exercises.VASMeanMean differenceStandard deviationPaired t valuePre testPost test7.93.44.51.0713.28It explains the paired t value of pre and post test value was 13.28 at 0.05 level of significance which was greate than the tabulated t value 2.26. This showed that there was a statistical significant difference between pre versus post test. The pre test mean was 7.9 the post test mean waas3.4 and the difference was 4.5 which showed that there was a reduction in Visual Analogue Scale score in post test values in which the recovery of selected samples in response to intervention. and then THE STUDY IS REJECTING THE NULL HYPOTHESIS AND ACCEPTING THE ALTERNATE HYPOTHESIS. representVisual analogue scale Pretest VS Post testSeries1 PretestSeries2 PosttestFunctional Status S cale Pre test Vs Post TestSeries1 PretestSeries2 PosttestTABLE IIITable III representas the mean values,mean difference, standard deviation and paired t value of Functional Status Scale who have been subjected to tendon and nerve gliding exercises.FSS ScoreMeanMean differenceStandard deviationPaired t valuePre testPost test27.114.612.52.2217.7It explains the paired t value of pre versus post sessions awas 17.7 at 0.05 level of significance which was greater than the tabulated t value 2.26. this showed that there was a statistical significant difference between the pre and post test resultas. The pr tesat ment was 27.1, the post test ment was 14.6,and the difference was 12.5 which showed that there was a reduction in functional status scale score in post test values in which recovery of the selected samples in response to intervention.Thrrefore the study is rejecting the null hypothesis and accepting the alternate hypothesis.GraphDISCUSSIONDISCUSSIONThe aim of the study was to determ ine the effect of tendon and nerve gliding excercises in lessen the pain and improving the functional ability of hand in patient with carpal tunnel syndrome during pregnancy.Carpal tunnel syndrome is most common and significant of all nerve entrapment syndromes (Phalen.G.S. 1972). It causes 20% of all compression syndromes especially in the third trimester of pregnancies.A total number of 10 subjects of age group of 25-32 years were selected for the study. Visual Analogue Scale for pain and Functional Status Scale for functional ability were taken as parameters to measure the affliction of patients. Pre test data has collected for the subjects and computed.They were subjected to tendon and nerve gliding exercises for 4 weeks. The result of post teat of same parameter was recorded for comparison after 4 weeks of treatment. The paired t test was used to compare the pre VS post test results of subjects.Caarpal tunnel syndrome is a common condition among people who do repetitive wrk al l day lke punching keys on computer or cash story or even pressing on the strings of a violin. Pregnant women are also susceptible to carpal tunnel syndrome even if they do not type or play msic all day. The studies have shown that one out of four pregnant women complains of the syndrome usually in the second or third trimester of pregnancy when fluid retention in the aarms and hands is more likely to put pressure on the nerve that leads to the hands anad fingers.The dying(p) system is normally under some pressure and tension. If the tension is breaked there results some movement(Millesi.et.al.1972).Dackowicz . A.,, conducted an study to evaluate the usefulness in conservative treatment of the carpal tunnel syndrome.According to butler neural tissue requires movement to promote healing and restoration of optimum mechanical properties.Decreased neural mobility and adverse mechanical tension in nervous system can generate pain.(Butler and Elvey 1978).Mchellan and Swash in 1976 noted that wrist and fingers extensor wil move the median nerve at wrist 2 or 4 times more than the middle of the upper arm.According to Asgel Enhos tendon requires movement to promote functional ability.Rosmaryn and Asgel Enhos said that the decreased tendon gliding in nervous system can generate pain. Rosmaryn proposed that radicular pain might be mobilizing the involved nerve.The mechanical respose is tendon movement in the cross sectional shape and viscoelastic function.So the treatment of tendon Gliding Exercise mah normalize the pressure gradient around the nervous system and releases the tendon thus reducing pain improving functional ability.SummarySummaryThe objective of the study was to determine from the available evidence the effectiveness of tendon and nerve gliding exercises programmed in reducing pain and of increasing the functional ability in the carpal tunnel syndrome during pregnancy.To conduct the study, the total number of 10 carpal tunnel pataients during pregnancy w ith both unilateral and bilateral involvement at the age group 25 to 32 years, who were suitable for inclusive criteria was selected by Quasi experimental purposive random sampling technique and informed consents were obtained from subjects individually.The pre and post test of VAS and FSS were conducted and recorded before and after treatment programmed for 4 weeks of nerve and tendon gliding exercises inmcarpal tunnel syndrome during pregnancy.The paired t test is used to compare the pre and post test values of nerve anad tendon gliding exercises and the pain and functional ability are computed by the VAS and FSS Scale.In the analysis and interpretation of the data based on the Visual Analogue Scale for pain the paired t- test value (13.28), which was greater than the tabulated paired t test val