Shooshtari S M J, Badiee V, Taghizadeh S H, Nematollahi A H, Amanollahi A H, Grami M T
Shiraz University of medical science, Shiraz, Iran.
Electromyogr Clin Neurophysiol. 2008 Jun-Jul;48(5):229-31.
Carpal tunnel syndrome (CTS) is the most common neuropathy that can be diagnosed with confidence by the nerve conduction study (NCS). One of the recent treatments of CTS is the application of low power laser (LPL) therapy. The present study evaluates the effects of LPL irradiation through NCS and clinical signs and symptoms.
A total of 80 patients were included in this study. Diagnosis of CTS was based on both clinical examination and electromyographic (EMG) findings. Patients were randomly assigned into two groups. Test group (group A) underwent laser therapy (9-11 joules/cm2) over the carpal tunnel area. Control group (group B) received sham laser therapy. Pain, hand grip strength, median proximal sensory and motor latencies, transcarpal median sensory nerve conduction (SNCV) were recorded. After fifteen sessions of irradiation (five times per week), parameters were recorded again and clinical symptoms were measured in both groups. Pain was evaluated by Visual Analog Scale (VAS; day-night). Hand grip was measured by Jamar dynometer. Paired t-test and independent sample t-test were used for statistical analysis.
There was a significant improvement in clinical symptoms and hand grip in group A (p < 0.001). Proximal median sensory latency, distal median motor latency and median sensory latencies were significantly decreased (p < 0.001). Transcarpal median SNCV increased significantly after laser irradiation (p < 0.001). There were no significant changes in group B except changes in clinical symptoms (p < 0.001).
Laser therapy as a new conservative treatment is effective in treating CTS paresthesia and numbness and improves the subjects' power of hand grip and electrophysiological parameters.
腕管综合征（CTS）是最常见的一种可通过神经传导研究（NCS）确诊的神经病变。腕管综合征的最新治疗方法之一是低功率激光（LPL）疗法。本研究通过神经传导研究以及临床体征和症状来评估低功率激光照射的效果。
本研究共纳入80例患者。腕管综合征的诊断基于临床检查和肌电图（EMG）检查结果。患者被随机分为两组。试验组（A组）在腕管区域接受激光治疗（9 - 11焦耳/平方厘米）。对照组（B组）接受假激光治疗。记录疼痛、握力、正中神经近端感觉和运动潜伏期、经腕部正中感觉神经传导速度（SNCV）。在进行15次照射（每周5次）后，再次记录参数并测量两组的临床症状。通过视觉模拟量表（VAS；白天 - 夜晚）评估疼痛。用Jamar测力计测量握力。采用配对t检验和独立样本t检验进行统计分析。
A组的临床症状和握力有显著改善（p < 0.001）。正中神经近端感觉潜伏期、远端正中运动潜伏期和正中感觉潜伏期显著缩短（p < 0.001）。激光照射后经腕部正中感觉神经传导速度显著增加（p < 0.001）。B组除临床症状有变化外（p < 0.001）无显著变化。
激光疗法作为一种新的保守治疗方法，在治疗腕管综合征的感觉异常和麻木方面有效，并可提高受试者的握力和电生理参数。
