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腕管综合征保守治疗后的长期患者观察:两项随机对照试验的总结

Long-term patient observation after conservative treatment of carpal tunnel syndrome: a summary of two randomised controlled trials.

作者信息

Wolny Tomasz, Linek Pawel

机构信息

Institute of Physiotherapy and Health Sciences, Musculoskeletal Elastography and Ultrasonography Laboratory, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.

出版信息

PeerJ. 2019 Nov 8;7:e8012. doi: 10.7717/peerj.8012. eCollection 2019.

Abstract

BACKGROUND

Physiotherapy of carpal tunnel syndrome (CTS) involves manual therapy based on neurodynamic techniques. Until now, two randomized controlled trials have shown that immediately after therapy, CTS patients who received neurodynamic techniques had significant improvement in nerve conduction, pain, symptom severity (SSS), functional state (FSS), muscle strength (MS) and two-point discrimination (2PD). However, long-term effects seem to be more important, as they are the only ones that can significantly improve the patient's health and influence economic and social costs. Thus, the objective of this study was to evaluate the long-term (six months) effects of neurodynamic techniques in the conservative treatment of CTS patients.

METHODS

Carpal tunnel syndrome patients (107) from two previously published randomised clinical trials were observed for six months after the treatment based on neurodynamic techniques.

RESULTS

The sensory conduction velocity, motor conduction velocity, and motor latency were not subject to statistically significant changes within six months after therapy ( > 0.05). In both groups, there was further pain reduction ( < 0.05). In Group B, the symptom severity improved significantly ( < 0.05), while the functional status in both groups remained unchanged ( > 0.05). In both groups, there was muscle strength improvement ( < 0.05). Two-point discrimination remained unchanged six months after the therapy.

CONCLUSION

The use of manual therapy based on neurodynamic techniques maintains the beneficial effects 6 months after therapy in CTS patients.

摘要

背景

腕管综合征(CTS)的物理治疗包括基于神经动力学技术的手法治疗。到目前为止,两项随机对照试验表明,治疗后立即观察发现,接受神经动力学技术治疗的CTS患者在神经传导、疼痛、症状严重程度(SSS)、功能状态(FSS)、肌肉力量(MS)和两点辨别觉(2PD)方面有显著改善。然而,长期效果似乎更为重要,因为只有长期效果才能显著改善患者健康并影响经济和社会成本。因此,本研究的目的是评估神经动力学技术在CTS患者保守治疗中的长期(六个月)效果。

方法

对来自两项先前发表的随机临床试验的107例腕管综合征患者在基于神经动力学技术的治疗后进行了六个月的观察。

结果

治疗后六个月内,感觉传导速度、运动传导速度和运动潜伏期无统计学显著变化(P>0.05)。两组患者的疼痛均进一步减轻(P<0.05)。B组患者的症状严重程度显著改善(P<0.05),而两组患者的功能状态均保持不变(P>0.05)。两组患者的肌肉力量均有所改善(P<0.05)。治疗后六个月两点辨别觉保持不变。

结论

在CTS患者中,基于神经动力学技术的手法治疗在治疗后6个月仍能维持有益效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9105/6844241/842de1b11cbe/peerj-07-8012-g001.jpg

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