Acute clinical effects of dual-task resistance exercise on muscle endurance and pressure sensitivity in patients with carpal tunnel syndrome after surgery

Objective: To examine the acute effect of a self-regulated dual-task during resistance exercise on muscular endurance, pain intensity and pressure pain threshold (PPT) in patients undergoing carpal tunnel release (CTR). Methods: Participants were randomly assigned to resistance exercise combined with a self-regulated cognitive task (dual-task) or resistance exercise alone (single-task). Exercise was prescribed using elastic resistance until task failure with a prespecified intensity of 3 on the Borg CR10 scale. The primary outcome measure was muscular endurance (maximum number of repetitions to failure) for wrist flexors and extensors. Secondary outcomes included pain intensity (visual analogue scale) and pressure sensitivity (PPT). Covariates included: catastrophizing, kinesiophobia, self-efficacy and perceived difficulty. Results: Twenty-two participants (63.6% female) with a mean age of 47.8 ± 10.3 years. Participants performed a greater number of repetitions to failure under the dual-task condition compared with the single-task condition, with increases of 9.7 [95% CI: 5.7–13.8] repetitions for wrist flexion and 12.0 [95% CI: 7.7–16.2] repetitions for wrist extension. Pain intensity decreased in both conditions, with no significant condition or time × condition effects. PPTs increased following exercise at the unaffected hand and at the lateral epicondyle, whereas only a trend was observed at the affected hand. No significant time × condition interactions were identified for pain intensity or PPT. Catastrophizing and kinesiophobia were negatively associated with changes in PPT, whereas self-efficacy showed a positive association. Conclusion: In patients recovering from CTR surgery, dual-tasking as a cognitive distraction strategy acutely improved exercise capacity by increasing the number of repetitions to failure. Trial Registration: Protocol Registration Number: ClinicalTrials.gov (NCT05592184).