Hesami Omid, Haghighatzadeh Mahsa, Lima Behnam Safarpour, Emadi Naghmeh, Salehi Shahin
Department of Neurology, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.
Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Exerc Rehabil. 2018 Dec 27;14(6):1067-1073. doi: 10.12965/jer.1836420.210. eCollection 2018 Dec.
Carpal tunnel syndrome (CTS) is one of the reasons for labor abandonment due to inability and pain. The aim of this study was to evaluate the effectiveness of gabapentin and exercise training in the treatment of CTS and compare their effects. This single-blind clinical trial was conducted on patients referred to the Imam Hossein hospital's electrodiagnostic (EDX) unit. The patients randomly assigned into four groups: using nocturnal splint as an approved treatment in the control group; taking 300-mg gabapentin per night and using nocturnal splint; nerve and tendon gliding exercises and using nocturnal splint; and taking 300-mg gabapentin per night, performing same exercise as group 3 and using nocturnal splint. At baseline, four indicators were assessed in all patients, including the Boston carpal tunnel questionnaire, visual analogue scale (VAS), pinch and grip strength of the affected hand. One month after the beginning of intervention, participants were reassessed and compared for each of the four indicators. Using nocturnal splint along with exercise and gabapentin significantly improved VAS, pinch and grip strength in moderate CTS compared to control group that only used nocturnal splint. However in mild CTS, grip strength was not significantly higher compared to control group (=0.048). Results of this study showed that use of splint alone in mild CTS is an appropriate and sufficient treatment; however, in moderate CTS, receiving gabapentin along with exercise and splinting showed better treatment results compared to splinting alone.
腕管综合征（CTS）是导致因功能障碍和疼痛而放弃工作的原因之一。本研究的目的是评估加巴喷丁和运动训练对CTS的治疗效果，并比较它们的作用。这项单盲临床试验是在转诊至伊玛目侯赛因医院电诊断（EDX）科的患者中进行的。患者被随机分为四组：对照组采用夜间夹板这一已获认可的治疗方法；每晚服用300毫克加巴喷丁并使用夜间夹板；进行神经和肌腱滑动练习并使用夜间夹板；每晚服用300毫克加巴喷丁，进行与第3组相同的练习并使用夜间夹板。在基线时，对所有患者评估了四项指标，包括波士顿腕管问卷、视觉模拟量表（VAS）、患手的捏力和握力。干预开始一个月后，对参与者的这四项指标分别进行重新评估和比较。与仅使用夜间夹板的对照组相比，在中度CTS患者中，夜间夹板联合运动和加巴喷丁可显著改善VAS、捏力和握力。然而，在轻度CTS患者中，与对照组相比握力并无显著提高（P=0.048）。本研究结果表明，轻度CTS单独使用夹板是一种合适且充分的治疗方法；然而，在中度CTS患者中，与单独使用夹板相比，加巴喷丁联合运动和夹板治疗效果更好。
