Carpal Tunnel Syndrome: Causes, Prevention, Rehabilitation and Computer-Aided, Game-Based Physiotherapy


  • Diana Tsilidi Department of Informatics Engineering, Technological Educational Institute of Crete Heraklion, Crete, Greece
  • Ioannis Pachoulakis Department of Informatics Engineering, Technological Educational Institute of Crete Heraklion, Crete, Greece
  • Anastasia Analyti Institute of Computer Science, Foundation for Research and Technology – Hellas (FORTH) Vassilika Vouton, Heraklion, Crete, Greece



Carpal tunnel syndrome (CTS), Computer-aided rehabilitation, Game-based Rehabilitation


Carpal Tunnel Syndrome (CTS) is caused by improper computer posture and usage of the arms and hands. It expresses a conglomerate of symptoms caused by the compression of the median nerve as it passes through the carpal tunnel of the wrist. These include pain, numbness and tingling in affected parts of the hand. CTS treatment may take the form of surgery and/or physiotherapy. This paper revisits the causes of CTS and the common prevention tactics and focuses on the emerging role of rehabilitation via computer-aided, game-based physiotherapy which can augment a more traditional exercise curriculum.


(1) “Physical Therapist’s Guide to Carpal Tunnel Syndrome.” [Online]. Available: [Accessed: 05-Mar-2016].

(2) M. Chammas, J. Boretto, L. M. Burmann, R. M. Ramos, F. C. dos Santos Neto, and J. B. Silva, “Carpal tunnel syndrome – Part I (anatomy, physiology, etiology and diagnosis),” Rev. Bras. Ortop. (English Ed., vol. 49, no. 5, pp. 429–436, 2014.

(3) “Carpal tunnel anatomy.” [Online]. Available:

(4) “Carpal tunnel syndrome - Treatment.” [Online]. Available: [Accessed: 01-Jan-2017].

(5) A. J. Viera, “Management of carpal tunnel syndrome,” Am. Fam. Physician, vol. 68, no. 2, pp. 265–272, 2003.

(6) T. Gregory, D. Chamblin, J. Firestone, A. Friadman, H. Chirstopher, P. Douglas, M. Kliot, R. Lawrence, E. Thomas, B. Nicholas, D. Michael, T. Kjerulf, K. O’Bara, S. Carlson, and J. G, “Work-Related Carpal Tunnel Syndrome Diagnosis and Treatment Guideline,” Washingtonworkingsolutions.Net. Washington State Department of Labor & Industries, pp. 1–18, 2017.

(7) M. W. Keith, V. Masear, K. C. Chung, K. Maupin, M. Andary, P. C. Amadio, W. C. WattersIII, M. J. Goldberg, R. H. HaralsonIII, and C. M. Turkelson, “Clinical Practice Guideline on the Diagnosis of Carpal Tunnel Syndrome,” 2007.

(8) R. Garaka, “Nerve conduction study,” Health and Medicine, 2012. [Online]. Available:

(9) D. Kostopoulos, “Treatment of carpal tunnel syndrome: A review of the non-surgical approaches with emphasis in neural mobilization,” J. Bodyw. Mov. Ther., vol. 8, no. 1, pp. 2–8, 2004.

(10) A. H. Bakhtiary and A. Rashidy-Pour, “Ultrasound and laser therapy in the treatment of carpal tunnel syndrome,” Aust. J. Physiother., vol. 50, no. 3, pp. 147–151, 2004.

(11) S. L. Michlovitz, “Conservative Interventions for Carpal Tunnel Syndrome,” J. Orthop. Sport. Phys. Ther., vol. 34, no. 10, pp. 589–600, Oct. 2004.

(12) L. M. Rozmaryn, S. Dovelle, E. R. Rothman, K. Gorman, K. M. Olvey, and J. J. Bartko, “Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome,” J. Hand Ther., vol. 11, no. 3, pp. 171–179, Jul. 1998.

(13) A. M. D. C. Souza, M. a Gadelha, E. a G. Coutinho, and S. R. Santos, “A video-tracking based serious game for motor rehabilitation of post-stroke hand impairment,” SBC J. 3D Interact. Syst., vol. 3, no. 2, pp. 37–46, 2012.

(14) “Virtualrehab.” [Online]. Available:

(15) K. Lohse, N. Shirzad, A. Verster, N. Hodges, and H. F. M. Van der Loos, “Video Games and Rehabilitation,” J. Neurol. Phys. Ther., vol. 37, no. 4, pp. 166–175, Dec. 2013.

(16) F. Anderson, M. Annett, and W. F. Bischof, “Lean on Wii: Physical rehabilitation with virtual reality Wii peripherals,” Stud. Health Technol. Inform., vol. 154, pp. 229–234, 2010.

(17) A. Y. Wang, “Games for Physical Therapy,” SIGCHI Conf., pp. 4–8, 2012.

(18) M. E. Kho, A. Damluji, J. M. Zanni, and D. M. Needham, “Feasibility and observed safety of interactive video games for physical rehabilitation in the intensive care unit: a case series,” J. Crit. Care, vol. 27, no. 2, p. 219.e1-219.e6, Apr. 2012.

(19) A. de Mauro, “Virtual Reality Based Rehabilitation and Game Technology,” in 1st International Workshop on Engineering Interactive Computing Systems for Medicine and Health Care (EICSMed 2011), co-located with the ACM SIGCHI Symposium on Engineering Interactive Computing Systems (EICS 2011), 2011, pp. 48–52.

(20) M. Khademi, H. Mousavi Hondori, A. McKenzie, L. Dodakian, C. V. Lopes, and S. C. Cramer, “Free-hand interaction with leap motion controller for stroke rehabilitation,” in Proceedings of the extended abstracts of the 32nd annual ACM conference on Human factors in computing systems - CHI EA ’14, 2014, pp. 1663–1668.

(21) L. Geurts, V. Vanden Abeele, J. Husson, F. Windey, M. Van Overveldt, J.-H. Annema, and S. Desmet, “Digital games for physical therapy: fulfilling the need for calibration and adaptation,” in Proceedings of the fifth international conference on Tangible, embedded, and embodied interaction - TEI ’11, 2011, vol. 53, p. 117.

(22) “Kinect Physical Therapy – Boat Driving.” [Online]. Available:

(23) A. Gupta, “AXLR8R Spotlight: Making Physical Therapy Fun with Ten Ton Raygun,” 2017. [Online]. Available:




How to Cite

Tsilidi, D., Pachoulakis, I., & Analyti, A. (2018). Carpal Tunnel Syndrome: Causes, Prevention, Rehabilitation and Computer-Aided, Game-Based Physiotherapy. European Journal of Applied Sciences, 6(2), 57.