Department of Physical Therapy and Rehabilitation, Ministry of Health Ankara Diskapi Yildirim Beyazit Education and Research Hospital, P.O. Box 06010, Ankara, Turkey.
Rheumatol Int. 2012 Mar;32(3):717-22. doi: 10.1007/s00296-010-1706-9. Epub 2010 Dec 14.
To define the role of phonophoresis and iontophoresis of corticosteroids in conjunction with wrist splint use in the treatment of carpal tunnel syndrome (CTS) compared to wrist splint use alone, 52 CTS subjects were analyzed based on clinical and electrophysiological criteria. A prospective, randomized controlled trial was carried out to assess symptom severity, motor skills, and hand function according to the Boston Symptom Severity Scale (BSSS), grip strength, and nine-hole peg test (NHPT), respectively, on the initial visit and in the 3rd month after treatment. The patients underwent conservative interventions randomly as follows: (1) 3 weeks of phonophoresis with betamethasone in conjunction with wrist splint use (group I, n: 18) or (2) 3 weeks of iontophoresis with betamethasone in conjunction with wrist splint use (group II, n: 16) or (3) wrist splint use alone (control, group III, n: 18). The mean age of the patients was 43.7 ± 8.4 (range 24-57) years. Groups I, II, and III showed a significant and further improvement in BSSS at the 3rd month evaluations compared with baseline (P < 0.001, P = 0.001, P < 0.001, respectively), but no significant change was observed in grip strength or NHPT (P > 0.05). There was a statistically significant difference between the phonophoresis and control groups after treatment only regarding BSSS, in favor of phonophoresis (P = 0.012). We recommend the use of wrist splints especially with phonophoresis for relief of symptoms in patients with CTS. Our results demonstrated no superiority among the treatment groups. Further, transdermal steroid treatments are not key determinants of efficacy with respect to motor skills and hand dexterity.
为了确定在腕管综合征（CTS）治疗中，与单独使用腕夹板相比，经皮电离子导入皮质类固醇联合声透疗法的作用，根据临床和电生理标准，对 52 名 CTS 患者进行了分析。进行了一项前瞻性、随机对照试验，以根据波士顿症状严重程度量表（BSSS）、握力和九孔钉测试（NHPT）分别评估治疗初始访视和治疗后第 3 个月时的症状严重程度、运动技能和手部功能，BSSS 用于评估症状严重程度，握力和 NHPT 用于评估运动技能和手部功能。患者随机接受以下保守干预措施：（1）3 周的甲泼尼龙经皮电离子导入联合腕夹板使用（I 组，n = 18）或（2）3 周的甲泼尼龙声透疗法联合腕夹板使用（II 组，n = 16）或（3）单独使用腕夹板（对照组，III 组，n = 18）。患者的平均年龄为 43.7 ± 8.4 岁（范围 24-57 岁）。与基线相比，I 组、II 组和 III 组在第 3 个月的评估中 BSSS 均显著进一步改善（P < 0.001，P = 0.001，P < 0.001），但握力或 NHPT 无明显变化（P > 0.05）。仅在 BSSS 方面，声透组与对照组之间存在统计学上的显著差异，且声透组更优（P = 0.012）。我们建议特别是在 CTS 患者中使用腕夹板联合声透疗法缓解症状。我们的结果表明治疗组之间没有优势。此外，经皮类固醇治疗对于运动技能和手部灵巧度的疗效不是关键决定因素。
