Yagci Ilker, Elmas Ozlem, Akcan Eylem, Ustun Isil, Gunduz Osman Hakan, Guven Zeynep
Department of Physical Medicine and Rehabilitation, Marmara University Hospital, Istanbul, Turkey.
Clin Rheumatol. 2009 Sep;28(9):1059-65. doi: 10.1007/s10067-009-1213-0. Epub 2009 Jun 21.
This study aimed to compare the short-term efficacy of splinting (S) and splinting plus low-level laser therapy (SLLLT) in mild or moderate idiopathic carpal tunnel syndrome (CTS) with a prospective, randomized controlled study. The patients with unilateral, mild, or moderate idiopathic CTS who experienced symptoms over 3 months were included in the study. The SLLLT group received ten sessions of laser therapy and splinting while S group was given only splints. The patients were evaluated at the baseline and after 3 months of the treatment. Follow-up parameters were nerve conduction study (NCS), Boston Questionnaire (BQ), grip strength, and clinical response criteria. Forty-five patients with CTS completed the study. Twenty-four patients were in S and 21 patients were in SLLLT group. In the third-month control, SLLLT group had significant improvements on both clinical and NCS parameters (median motor nerve distal latency, median sensory nerve conduction velocities, BQ symptom severity scale, and BQ functional capacity scale) while S group had only symptomatic healing (BQ symptom severity scale). The grip strength of splinting group was decreased significantly. According to clinical response criteria, in SLLLT group, five (23.8%) patients had full and 12 (57.1%) had partial recovery; four (19%) patients had no change or worsened. In S group, one patient (4.2%) had full and 17 (70.8%) partial recovery; six (25%) patients had no change or worsened. Additionally, applied laser therapy provided better outcomes on NCS but not in clinical parameters in patients with CTS.
本研究旨在通过一项前瞻性随机对照研究,比较夹板固定(S)和夹板固定联合低强度激光治疗(SLLLT)对轻度或中度特发性腕管综合征(CTS)的短期疗效。纳入研究的患者为单侧轻度或中度特发性CTS,且症状持续超过3个月。SLLLT组接受十次激光治疗并使用夹板,而S组仅使用夹板。在基线和治疗3个月后对患者进行评估。随访参数包括神经传导研究(NCS)、波士顿问卷(BQ)、握力和临床反应标准。45例CTS患者完成了研究。S组有24例患者,SLLLT组有21例患者。在第三个月的对照中,SLLLT组在临床和NCS参数(运动神经远端潜伏期中位数、感觉神经传导速度中位数、BQ症状严重程度量表和BQ功能能力量表)方面均有显著改善,而S组仅有症状缓解(BQ症状严重程度量表)。夹板固定组的握力显著下降。根据临床反应标准,在SLLLT组中,5例(23.8%)患者完全恢复,12例(57.1%)部分恢复;4例(19%)患者无变化或病情恶化。在S组中,1例患者(4.2%)完全恢复,17例(70.8%)部分恢复;6例(25%)患者无变化或病情恶化。此外,对于CTS患者,应用激光治疗在NCS方面提供了更好的结果,但在临床参数方面并非如此。