human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare the effects of manual therapy and stretching exercise on neck pain and disability . DESIGN An examiner-blinded r and omized cross-over trial . PATIENTS A total of 125 women with non-specific neck pain . METHODS PATIENTS were r and omized into 2 groups . Group 1 received manual therapy twice weekly and Group 2 performed stretching exercises 5 times a week . After 4 weeks the treatments were changed . The follow-up times were after 4 and 12 weeks . Neck pain ( visual analogue scale ) and disability indices were measured . RESULTS Mean value ( st and ard deviation ) for neck pain was 50 mm ( 22 ) and 49 mm ( 19 ) at baseline in Group 1 and Group 2 , respectively , and decreased during the first 4 weeks by 26 mm ( 95 % Confidence Interval 20 - 33 ) and 19 mm ( 12 - 27 ) , respectively . There was no significant difference between groups . Neck and shoulder pain and disability index decreased significantly more in Group 1 after manual therapy ( p=0.01 ) as well as neck stiffness ( p=0.01 ) . CONCLUSION Both stretching exercise and manual therapy considerably decreased neck pain and disability in women with non-specific neck pain . The difference in effectiveness between the 2 treatments was minor . Low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain , at least in the short-term STUDY DESIGN A prospect i ve r and omized clinical trial . OBJECTIVE To compare the effectiveness of 2 physical therapy treatment approaches for impingement syndrome of the shoulder . BACKGROUND Manual physical therapy combined with exercise is a commonly applied but currently unproven clinical treatment for impingement syndrome of the shoulder . METHODS AND MEASURES Thirty men and 22 women ( age 43 years + /- 9.1 ) diagnosed with shoulder impingement syndrome were r and omly assigned to 1 of 2 treatment groups . The exercise group performed supervised flexibility and strengthening exercises . The manual therapy group performed the same program and received manual physical therapy treatment . Both groups received the selected intervention 6 times over a 3-week period . The testers , who were blinded to group assignment , measured strength , pain , and function before treatment and after 6 physical therapy visits . Strength was a composite score of isometric strength tests for internal rotation , external rotation , and abduction . Pain was a composite score of visual analog scale measures during resisted break tests , active abduction , and functional activities . Function was measured with a functional assessment question naire . The visual analog scale used to measure pain with functional activities and the functional assessment question naire were also measured 2 months after the initiation of treatment . RESULTS Subjects in both groups experienced significant decreases in pain and increases in function , but there was significantly more improvement in the manual therapy group compared to the exercise group . For example , pain in the manual therapy group was reduced from a pretreatment mean ( + /- SD ) of 575.8 ( + /- 220.0 ) to a posttreatment mean of 174.4 ( + /- 183.1 ) . In contrast , pain in the exercise group was reduced from a pretreatment mean of 557.1 ( + /- 237.2 ) to a posttreatment mean of 360.6 ( + /- 272.3 ) . Strength in the manual therapy group improved significantly while strength in the exercise group did not . CONCLUSION Manual physical therapy applied by experienced physical therapists combined with supervised exercise in a brief clinical trial is better than exercise alone for increasing strength , decreasing pain , and improving function in patients with shoulder impingement syndrome OBJECTIVES The aim of this study was to investigate the effectiveness of an ergonomic intervention on  productivity loss at work caused by upper-extremity disorders ( UED ) . METHODS Workers with medically verified UED were invited to participate . The intervention consisted of a physician contacting the worker 's supervisor and an occupational physiotherapist conducting an ergonomic assessment at the worksite . Before and after the intervention , the employees self-assessed UED-related productivity loss ( ie , decreased quality and quantity of the daily work output ) . We tested for differences between groups at 8 and sub-sequently 12 weeks . We also applied generalized estimating equation ( GEE ) to analyze repeated measures data . RESULTS Altogether 177 employees were r and omized . The overall participation rate was 88 % . At baseline , 54 % of the intervention group and 58 % of the control group reported productivity loss . The magnitude of productivity loss was 17 % and 20 % , respectively . At 8 weeks , both the proportion and magnitude of productivity loss were lower in the intervention than the control group , but the differences were statistically significant only at 12 weeks ( proportion 25 % versus 51 % , magnitude 7 % versus 18 % , P=0.001 for both ) . Using GEE analyses , we also found the differences to be statistically significant ( proportion 38 % versus 52 % , magnitude 12 % versus 18 % ) . The intervention only benefitted employees with 0 - 20 % loss of productivity at baseline , not those with a higher initial productivity loss . CONCLUSIONS Early ergonomic intervention , in addition to adequate medical care , is effective in preventing and restoring self-reported productivity loss associated with UED Background Arm , shoulder and neck symptoms are very prevalent among computer workers . In an attempt to reduce these symptoms , a large occupational health service in the Netherl and s developed a preventive programme on exposure to risk factors , prevalence of arm , shoulder and neck symptoms , and sick leave in computer workers . The purpose of this study was to assess the effectiveness of this intervention programme . Methods The study was a r and omised controlled trial . The participants were assigned to either the intervention group or the usual care group by means of cluster r and omisation . At baseline and after 12 months of follow-up , the participants completed the RSI QuickScan question naire on exposure to the risk factors and on the prevalence of arm , shoulder and neck symptoms . A tailor-made intervention programme was proposed to participants with a high risk profile at baseline . Examples of implemented interventions are an individual workstation check , a visit to the occupational health physician and an education programme on the prevention of arm , shoulder and neck symptoms . The primary outcome measure was the prevalence of arm , shoulder and neck symptoms . Secondary outcome measures were the scores on risk factors for arm , shoulder and neck symptoms and the number of days of sick leave . Sick leave data was obtained from the companies . Multilevel analyses were used to test the effectiveness . Results Of the 1,673 persons invited to participate in the study , 1,183 persons ( 71 % ) completed the baseline question naire and 741 persons participated at baseline as well as at 12-month follow-up . At 12-month follow-up , the intervention group showed a significant positive change ( OR = 0.48 ) in receiving information on healthy computer use , as well as a significant positive change regarding risk indicators for work posture and movement , compared to the usual care group . There were no significant differences in changes in the prevalence of arm , shoulder and neck symptoms or sick leave between the intervention and usual care group . Conclusions The effects of the RSI QuickScan intervention programme were small , possibly as a result of difficulties with the implementation process of the proposed interventions . However , some significant positive effects were found as to an increase in receiving education and a decrease in exposure to adverse postures and movements . With regard to symptoms and sick leave , only small and non-significant effects were found . Trial registration Netherl and s National Trial Register BACKGROUND This study exp and ed previous NIOSH-IRS research examining the effects of rest breaks and stretching exercises on symptoms and performance in data -entry workers . METHODS All workers spent 4 weeks with conventional breaks ( two 15 min breaks per day ) and 4 weeks with supplementary breaks ( two 15 min breaks plus four 5 min breaks per day ) . One-half were assigned at r and om to a group instructed to perform brief stretching exercises during breaks . The remainder comprised the " no stretching " ( control ) group . RESULTS 51 workers ( stretch group n = 21 ; no stretch group n = 30 ) completed the study symptom question naires . Discomfort and eyestrain were significantly lower with supplementary breaks , and supplementary breaks attenuated accumulation of discomfort and eyestrain during work sessions . Data -entry speed was significantly faster with supplementary breaks so that work output was maintained , despite replacing 20 min of work time with break time . In the stretch group , workers reported  stretching  during only 25 % of conventional breaks and 39 % of supplementary breaks , and no significant effects of stretching on discomfort or performance were observed . CONCLUSIONS These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity . Low compliance in performing stretches prevented valid assessment of stretching effects . Further research on stretching exercises and exercise compliance is warranted Objective : To investigate the effect of two contrasting physical activity worksite interventions versus a reference intervention ( REF ) on various health outcomes . Methods : A 1-year r and omized controlled trial was conducted with specific resistance training ( SRT ) , all-round physical exercise ( APE ) , and REF . Results : SRT and APE compared with REF showed significant reductions in systolic blood pressure ( ∼6 mm Hg ) , body fat percentage ( ∼2.2 body fat% ) , as well as shoulder and back pain ( ∼30 % reduction in duration ) . Muscle strength ( APE and SRT ) and maximal oxygen uptake ( APE ) increased approximately 10 % . Conclusions : Worksite intervention with both SRT as well as APE is recommended , since these activities compared with REF result ed in clinical ly relevant reductions of cardiovascular and metabolic syndrome-related risk factors as well as musculoskeletal pain symptoms , in combination with minor increases in physical capacity Rapid force capacity of chronically painful muscles is inhibited markedly more than maximal force capacity and is therefore relevant to assess in rehabilitation setting s. Our objective was to investigate the effect of two contrasting types of physical exercise on rapid force capacity , as well as neural and muscular adaptations in women with chronic neck muscle pain . A group of employed women ( n = 42 ) with a clinical diagnosis of trapezius myalgia participated in a 10-wk r and omized controlled trial ; specific strength training of the neck/shoulder muscles , general fitness training performed as leg-bicycling ; or a reference intervention without physical activity . Maximal voluntary shoulder abductions were performed at static angles of 35 degrees and 115 degrees with simultaneous recording of electromyography ( EMG ) in the trapezius and deltoid . Maximal muscle strength and activation ( peak torque and peak EMG ) as well as rapid muscle strength and activation [ rate of torque development ( RTD ) and rate of EMG rise ] were subsequently determined . Trapezius muscle fiber characteristics were determined with ATPase histochemistry . Significant changes were observed only in the specific strength training group . Whereas peak torque increased 18 - 29 % ( P < 0.01 ) , RTD increased 61 - 115 % ( P < 0.001 ) . Peak EMG and rate of EMG rise increased correspondingly ( P < 0.05 - 0.001 ) , and trapezius type II muscle fibers hypertrophied 20 % ( P < 0.001 ) . In conclusion , rapid force capacity of chronically painful muscles is highly responsive to rehabilitation with specific strength training . The underlying mechanisms were related to both pain reduction and general neuromuscular adaptations to strength training . Potentially , the present method can be a useful clinical screening tool of muscle function in rehabilitation setting UNLABELLED We investigated the effectiveness of cupping , a traditional method of treating musculoskeletal pain , in patients with carpal tunnel syndrome ( CTS ) in an open r and omized trial . n = 52 out patients ( 58.5 + /- 8.0 years ) with neurologically confirmed CTS were r and omly assigned to either a verum ( n = 26 ) or a control group ( n = 26 ) . Verum patients were treated with a single application of wet cupping , and control patients with a single local application of heat within the region overlying the trapezius muscle . Patients were followed up on day 7 after treatment . The primary outcome , severity of CTS symptoms ( VAS ) , was reduced from 61.5 + /- 20.5 to 24.6 + /- 22.7 mm at day 7 in the cupping group and from 67.1 + /- 20.2 to 51.7 + /- 23.9 mm in the control group [ group difference -24.5 mm ( 95%CI -36.1 ; -2.9 , P < .001 ) ] . Significant treatment effects were also found for the Levine CTS-score ( -.6 pts : 95%CI -.9 ; -.2 , P = .002 ) , neck pain ( -12.6 mm ; 95%CI -18.8 ; -6.4 , P < .001 ) , functional disability ( DASH-Score ) ( -11.1 pts ; 95%CI -17.1 ; -5.1 , P < .001 ) , and physical quality of life ( .3 ; 95%CI .0 ; .3 , P = .048 ) . The treatment was safe and well tolerated . We conclude that cupping therapy may be effective in relieving the pain and other symptoms related to CTS . The efficacy of cupping in the long-term management of CTS and related mechanisms remains to be clarified . PERSPECTIVE The results of a r and omized trial on the clinical effects of traditional cupping therapy in patients with carpal tunnel syndrome are presented . Cupping of segmentally related shoulder zones appears to alleviate the symptoms of carpal tunnel syndrome Objective : To investigate the effect 
    Output:
    
agent
None of the ergonomic interventions was more beneficial for any outcome measures when compared with another treatment or with no treatment or with placebo .
Behavioural interventions had inconsistent effects on pain and disability , with some subgroups showing benefit and others showing no significant improvement when compared with no treatment , minor intervention controls or other behavioural interventions .In the eight studies that evaluated various other interventions , there was no evidence of a clear beneficial effect of any of the interventions provided .
We found very low- quality evidence indicating that pain , recovery , disability and sick leave are similar after exercises when compared with no treatment , with minor intervention controls or with exercises provided as additional treatment to people with work-related complaints of the arm , neck or shoulder .
Low- quality evidence also showed that ergonomic interventions did not decrease pain at short-term follow-up but did decrease pain at long-term follow-up .
There was no evidence of an effect on other outcomes .
For behavioural and other interventions , there was no evidence of a consistent effect on any of the outcomes .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare the effects of manual therapy and stretching exercise on neck pain and disability . DESIGN An examiner-blinded r and omized cross-over trial . PATIENTS A total of 125 women with non-specific neck pain . METHODS PATIENTS were r and omized into 2 groups . Group 1 received manual therapy twice weekly and Group 2 performed stretching exercises 5 times a week . After 4 weeks the treatments were changed . The follow-up times were after 4 and 12 weeks . Neck pain ( visual analogue scale ) and disability indices were measured . RESULTS Mean value ( st and ard deviation ) for neck pain was 50 mm ( 22 ) and 49 mm ( 19 ) at baseline in Group 1 and Group 2 , respectively , and decreased during the first 4 weeks by 26 mm ( 95 % Confidence Interval 20 - 33 ) and 19 mm ( 12 - 27 ) , respectively . There was no significant difference between groups . Neck and shoulder pain and disability index decreased significantly more in Group 1 after manual therapy ( p=0.01 ) as well as neck stiffness ( p=0.01 ) . CONCLUSION Both stretching exercise and manual therapy considerably decreased neck pain and disability in women with non-specific neck pain . The difference in effectiveness between the 2 treatments was minor . Low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain , at least in the short-term STUDY DESIGN A prospect i ve r and omized clinical trial . OBJECTIVE To compare the effectiveness of 2 physical therapy treatment approaches for impingement syndrome of the shoulder . BACKGROUND Manual physical therapy combined with exercise is a commonly applied but currently unproven clinical treatment for impingement syndrome of the shoulder . METHODS AND MEASURES Thirty men and 22 women ( age 43 years + /- 9.1 ) diagnosed with shoulder impingement syndrome were r and omly assigned to 1 of 2 treatment groups . The exercise group performed supervised flexibility and strengthening exercises . The manual therapy group performed the same program and received manual physical therapy treatment . Both groups received the selected intervention 6 times over a 3-week period . The testers , who were blinded to group assignment , measured strength , pain , and function before treatment and after 6 physical therapy visits . Strength was a composite score of isometric strength tests for internal rotation , external rotation , and abduction . Pain was a composite score of visual analog scale measures during resisted break tests , active abduction , and functional activities . Function was measured with a functional assessment question naire . The visual analog scale used to measure pain with functional activities and the functional assessment question naire were also measured 2 months after the initiation of treatment . RESULTS Subjects in both groups experienced significant decreases in pain and increases in function , but there was significantly more improvement in the manual therapy group compared to the exercise group . For example , pain in the manual therapy group was reduced from a pretreatment mean ( + /- SD ) of 575.8 ( + /- 220.0 ) to a posttreatment mean of 174.4 ( + /- 183.1 ) . In contrast , pain in the exercise group was reduced from a pretreatment mean of 557.1 ( + /- 237.2 ) to a posttreatment mean of 360.6 ( + /- 272.3 ) . Strength in the manual therapy group improved significantly while strength in the exercise group did not . CONCLUSION Manual physical therapy applied by experienced physical therapists combined with supervised exercise in a brief clinical trial is better than exercise alone for increasing strength , decreasing pain , and improving function in patients with shoulder impingement syndrome OBJECTIVES The aim of this study was to investigate the effectiveness of an ergonomic intervention on  productivity loss at work caused by upper-extremity disorders ( UED ) . METHODS Workers with medically verified UED were invited to participate . The intervention consisted of a physician contacting the worker 's supervisor and an occupational physiotherapist conducting an ergonomic assessment at the worksite . Before and after the intervention , the employees self-assessed UED-related productivity loss ( ie , decreased quality and quantity of the daily work output ) . We tested for differences between groups at 8 and sub-sequently 12 weeks . We also applied generalized estimating equation ( GEE ) to analyze repeated measures data . RESULTS Altogether 177 employees were r and omized . The overall participation rate was 88 % . At baseline , 54 % of the intervention group and 58 % of the control group reported productivity loss . The magnitude of productivity loss was 17 % and 20 % , respectively . At 8 weeks , both the proportion and magnitude of productivity loss were lower in the intervention than the control group , but the differences were statistically significant only at 12 weeks ( proportion 25 % versus 51 % , magnitude 7 % versus 18 % , P=0.001 for both ) . Using GEE analyses , we also found the differences to be statistically significant ( proportion 38 % versus 52 % , magnitude 12 % versus 18 % ) . The intervention only benefitted employees with 0 - 20 % loss of productivity at baseline , not those with a higher initial productivity loss . CONCLUSIONS Early ergonomic intervention , in addition to adequate medical care , is effective in preventing and restoring self-reported productivity loss associated with UED Background Arm , shoulder and neck symptoms are very prevalent among computer workers . In an attempt to reduce these symptoms , a large occupational health service in the Netherl and s developed a preventive programme on exposure to risk factors , prevalence of arm , shoulder and neck symptoms , and sick leave in computer workers . The purpose of this study was to assess the effectiveness of this intervention programme . Methods The study was a r and omised controlled trial . The participants were assigned to either the intervention group or the usual care group by means of cluster r and omisation . At baseline and after 12 months of follow-up , the participants completed the RSI QuickScan question naire on exposure to the risk factors and on the prevalence of arm , shoulder and neck symptoms . A tailor-made intervention programme was proposed to participants with a high risk profile at baseline . Examples of implemented interventions are an individual workstation check , a visit to the occupational health physician and an education programme on the prevention of arm , shoulder and neck symptoms . The primary outcome measure was the prevalence of arm , shoulder and neck symptoms . Secondary outcome measures were the scores on risk factors for arm , shoulder and neck symptoms and the number of days of sick leave . Sick leave data was obtained from the companies . Multilevel analyses were used to test the effectiveness . Results Of the 1,673 persons invited to participate in the study , 1,183 persons ( 71 % ) completed the baseline question naire and 741 persons participated at baseline as well as at 12-month follow-up . At 12-month follow-up , the intervention group showed a significant positive change ( OR = 0.48 ) in receiving information on healthy computer use , as well as a significant positive change regarding risk indicators for work posture and movement , compared to the usual care group . There were no significant differences in changes in the prevalence of arm , shoulder and neck symptoms or sick leave between the intervention and usual care group . Conclusions The effects of the RSI QuickScan intervention programme were small , possibly as a result of difficulties with the implementation process of the proposed interventions . However , some significant positive effects were found as to an increase in receiving education and a decrease in exposure to adverse postures and movements . With regard to symptoms and sick leave , only small and non-significant effects were found . Trial registration Netherl and s National Trial Register BACKGROUND This study exp and ed previous NIOSH-IRS research examining the effects of rest breaks and stretching exercises on symptoms and performance in data -entry workers . METHODS All workers spent 4 weeks with conventional breaks ( two 15 min breaks per day ) and 4 weeks with supplementary breaks ( two 15 min breaks plus four 5 min breaks per day ) . One-half were assigned at r and om to a group instructed to perform brief stretching exercises during breaks . The remainder comprised the " no stretching " ( control ) group . RESULTS 51 workers ( stretch group n = 21 ; no stretch group n = 30 ) completed the study symptom question naires . Discomfort and eyestrain were significantly lower with supplementary breaks , and supplementary breaks attenuated accumulation of discomfort and eyestrain during work sessions . Data -entry speed was significantly faster with supplementary breaks so that work output was maintained , despite replacing 20 min of work time with break time . In the stretch group , workers reported  stretching  during only 25 % of conventional breaks and 39 % of supplementary breaks , and no significant effects of stretching on discomfort or performance were observed . CONCLUSIONS These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity . Low compliance in performing stretches prevented valid assessment of stretching effects . Further research on stretching exercises and exercise compliance is warranted Objective : To investigate the effect of two contrasting physical activity worksite interventions versus a reference intervention ( REF ) on various health outcomes . Methods : A 1-year r and omized controlled trial was conducted with specific resistance training ( SRT ) , all-round physical exercise ( APE ) , and REF . Results : SRT and APE compared with REF showed significant reductions in systolic blood pressure ( ∼6 mm Hg ) , body fat percentage ( ∼2.2 body fat% ) , as well as shoulder and back pain ( ∼30 % reduction in duration ) . Muscle strength ( APE and SRT ) and maximal oxygen uptake ( APE ) increased approximately 10 % . Conclusions : Worksite intervention with both SRT as well as APE is recommended , since these activities compared with REF result ed in clinical ly relevant reductions of cardiovascular and metabolic syndrome-related risk factors as well as musculoskeletal pain symptoms , in combination with minor increases in physical capacity Rapid force capacity of chronically painful muscles is inhibited markedly more than maximal force capacity and is therefore relevant to assess in rehabilitation setting s. Our objective was to investigate the effect of two contrasting types of physical exercise on rapid force capacity , as well as neural and muscular adaptations in women with chronic neck muscle pain . A group of employed women ( n = 42 ) with a clinical diagnosis of trapezius myalgia participated in a 10-wk r and omized controlled trial ; specific strength training of the neck/shoulder muscles , general fitness training performed as leg-bicycling ; or a reference intervention without physical activity . Maximal voluntary shoulder abductions were performed at static angles of 35 degrees and 115 degrees with simultaneous recording of electromyography ( EMG ) in the trapezius and deltoid . Maximal muscle strength and activation ( peak torque and peak EMG ) as well as rapid muscle strength and activation [ rate of torque development ( RTD ) and rate of EMG rise ] were subsequently determined . Trapezius muscle fiber characteristics were determined with ATPase histochemistry . Significant changes were observed only in the specific strength training group . Whereas peak torque increased 18 - 29 % ( P < 0.01 ) , RTD increased 61 - 115 % ( P < 0.001 ) . Peak EMG and rate of EMG rise increased correspondingly ( P < 0.05 - 0.001 ) , and trapezius type II muscle fibers hypertrophied 20 % ( P < 0.001 ) . In conclusion , rapid force capacity of chronically painful muscles is highly responsive to rehabilitation with specific strength training . The underlying mechanisms were related to both pain reduction and general neuromuscular adaptations to strength training . Potentially , the present method can be a useful clinical screening tool of muscle function in rehabilitation setting UNLABELLED We investigated the effectiveness of cupping , a traditional method of treating musculoskeletal pain , in patients with carpal tunnel syndrome ( CTS ) in an open r and omized trial . n = 52 out patients ( 58.5 + /- 8.0 years ) with neurologically confirmed CTS were r and omly assigned to either a verum ( n = 26 ) or a control group ( n = 26 ) . Verum patients were treated with a single application of wet cupping , and control patients with a single local application of heat within the region overlying the trapezius muscle . Patients were followed up on day 7 after treatment . The primary outcome , severity of CTS symptoms ( VAS ) , was reduced from 61.5 + /- 20.5 to 24.6 + /- 22.7 mm at day 7 in the cupping group and from 67.1 + /- 20.2 to 51.7 + /- 23.9 mm in the control group [ group difference -24.5 mm ( 95%CI -36.1 ; -2.9 , P < .001 ) ] . Significant treatment effects were also found for the Levine CTS-score ( -.6 pts : 95%CI -.9 ; -.2 , P = .002 ) , neck pain ( -12.6 mm ; 95%CI -18.8 ; -6.4 , P < .001 ) , functional disability ( DASH-Score ) ( -11.1 pts ; 95%CI -17.1 ; -5.1 , P < .001 ) , and physical quality of life ( .3 ; 95%CI .0 ; .3 , P = .048 ) . The treatment was safe and well tolerated . We conclude that cupping therapy may be effective in relieving the pain and other symptoms related to CTS . The efficacy of cupping in the long-term management of CTS and related mechanisms remains to be clarified . PERSPECTIVE The results of a r and omized trial on the clinical effects of traditional cupping therapy in patients with carpal tunnel syndrome are presented . Cupping of segmentally related shoulder zones appears to alleviate the symptoms of carpal tunnel syndrome Objective : To investigate the effect 
    Output:
    