Koca Irfan, Boyaci Ahmet, Tutoglu Ahmet, Ucar Mehmet, Kocaturk Ozcan
Department of Physical Medicine and Rehabilitation, Gaziantep University School of Medicine, Gaziantep, Turkey,
Rheumatol Int. 2014 Dec;34(12):1639-45. doi: 10.1007/s00296-014-3005-3. Epub 2014 Apr 12.
We assessed the effectiveness of interferential current (IFC) and transcutaneous electrical nerve stimulation (TENS) therapies in the management of carpal tunnel syndrome (CTS) compared with splint therapy, a standard treatment modality for CTS. This was a prospective, single-blinded, single-center, randomized, three-group parallel intervention study of 3 weeks duration. Efficacy was examined in the third week after the end of treatments. Subjects were assigned randomly to one of three groups: group I patients received splint therapy, group II patients received TENS applied on the palmar surface of the hand and the carpal tunnel, and group III patients underwent IFC therapy applied on the palmar surface of the hand and the volar surface of the forearm. TENS and ICF treatments were applied five times weekly for a total of 15 sessions. Group 1 patients were stabilized with volar wrist splints for 3 weeks. The efficacy of the therapies was assessed before initiation of therapy and at 3 weeks after completion of therapy using a visual analog scale (VAS), a symptom severity scale, the functional capacity scale of the BCTQ, and measurement of median nerve motor distal latency (mMDL) and median sensory nerve conduction velocity (mSNCV). Groups were compared pairwise using the Mann-Whitney U test to identify the source of differences between groups. The Wilcoxon test was used to analyze changes in variables over time within a group. In the VAS, BCTQ, MDL, and mSNCV, no significant difference was observed between the groups (p > 0.05). In the VAS, BCTQ, and mSNCV, statistically significant improvements were detected in all groups (p < 0.05). There was no statistically significant difference between TENS and splint therapy with respect to improvement in clinical scores, whereas IFC therapy provided a significantly greater improvement in VAS, mMDL, and mSNCV values than splint therapy (VAS: 4.80 ± 1.18 and 6.37 ± 1.18; p = 0.001, mMDL: 3.89 ± 0.88 and 4.06 ± 0.61; p = 0.001, mSNCV: 41.80 ± 1.76 and 40.75 ± 1.48; p = 0.010). IFC therapy provided a significantly greater improvement in VAS, symptom severity, functional capacity, and mMDL and mSNCV values than TENS therapy (VAS: 4.80 ± 1.18 and 6.68 ± 1.42; p < 0.001, symptom severity: 2.70 ± 1.03 and 3.37 ± 1.21; p = 0.015, functional capacity: 1.90 ± 1.21 and 2.50 ± 0.78; p = 0.039, mMDL: 3.89 ± 0.88 and 4.06 ± 0.88; p = 0.003, and mSNCV: 41.80 ± 1.76 and 41.38 ± 1.78; p = 0.021). IFC may be considered a new and safe therapeutic option for the treatment of CTS.
我们评估了干扰电流（IFC）和经皮电刺激神经疗法（TENS）在治疗腕管综合征（CTS）方面的有效性，并与夹板疗法（CTS的标准治疗方式）进行了比较。这是一项为期3周的前瞻性、单盲、单中心、随机、三组平行干预研究。在治疗结束后的第三周检查疗效。受试者被随机分为三组：第一组患者接受夹板疗法，第二组患者接受在手掌表面和腕管施加的TENS治疗，第三组患者接受在手掌表面和前臂掌侧表面施加的IFC治疗。TENS和IFC治疗每周进行5次，共15次。第一组患者使用掌侧腕部夹板固定3周。在治疗开始前和治疗完成后3周，使用视觉模拟量表（VAS）、症状严重程度量表、BCTQ功能能力量表以及正中神经运动远端潜伏期（mMDL）和正中感觉神经传导速度（mSNCV）测量来评估治疗效果。使用Mann-Whitney U检验对各组进行两两比较，以确定组间差异的来源。使用Wilcoxon检验分析组内变量随时间的变化。在VAS、BCTQ、MDL和mSNCV方面，各组之间未观察到显著差异（p>0.05）。在VAS、BCTQ和mSNCV方面，所有组均检测到有统计学意义的改善（p<0.05）。在临床评分改善方面，TENS和夹板疗法之间没有统计学意义上的差异，而IFC疗法在VAS、mMDL和mSNCV值方面比夹板疗法有显著更大的改善（VAS：4.80±1.18和6.37±1.18；p=0.001，mMDL：3.89±0.88和4.06±0.61；p=0.001，mSNCV：41.80±1.76和40.75±1.48；p=0.010）。IFC疗法在VAS、症状严重程度、功能能力以及mMDL和mSNCV值方面比TENS疗法有显著更大的改善（VAS：4.80±1.18和6.68±1.42；p<0.001，症状严重程度：2.70±1.03和3.37±1.21；p=0.015，功能能力：1.90±1.21和2.50±0.78；p=0.039，mMDL：3.89±0.88和4.06±0.88；p=0.003，mSNCV：41.80±1.76和41.38±1.78；p=0.021）。IFC可被视为治疗CTS的一种新的安全治疗选择。
