Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA, USA.
Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Stanford, CA, USA.
J Hand Ther. 2020 Jul-Sep;33(3):272-280. doi: 10.1016/j.jht.2019.12.002. Epub 2020 May 1.
Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome worldwide. There are limited studies on the effectiveness of carpal ligament stretching on symptomatic and electrophysiologic outcomes.
The purpose of this study was to evaluate the effect of self-myofascial stretching of the carpal ligament on symptom outcomes and nerve conduction findings in persons with CTS.
This is a prospective, double-blinded, randomized, placebo-controlled trial.
Eighty-three participants diagnosed with median mononeuropathy across the wrist by nerve conduction study were randomized 1:1 to sham treatment or self-carpal ligament stretching. Participants were instructed to perform the self-treatment four times a day for six weeks. Seventeen participants in the sham treatment group and 19 participants in the carpal ligament stretching group completed the study. Pre- and post-treatment outcome measures included subjective complaints, strength, nerve conduction findings, and functional scores.
Groups were balanced on age, sex, hand dominance, symptom duration, length of treatment, presence of nocturnal symptoms, and compliance with treatment. Even though the ANOVA analyses were inconclusive about group differences, explorative post hoc analyses revealed significant improvements in numbness (P = .011, Cohen's d = .53), tingling (P = .007, Cohen's d = .60), pinch strength (P = .007, Cohen's d = -.58), and symptom severity scale (P = .007, Cohen's d = .69) for the treatment group only.
The myofascial stretching of the carpal ligament showed statistically significant symptom improvement in persons with CTS. Larger comparative studies that include other modalities such as splinting should be performed to confirm the effectiveness of this treatment option.
腕管综合征（CTS）是全球最常见的神经卡压综合征。关于腕横韧带拉伸对症状和电生理结果的有效性的研究有限。
本研究旨在评估自我腕横韧带筋膜拉伸对 CTS 患者症状结果和神经传导发现的影响。
这是一项前瞻性、双盲、随机、安慰剂对照试验。
83 名经神经传导研究诊断为腕部正中神经单一神经病的参与者被随机分为 1:1 接受假治疗或自我腕横韧带拉伸治疗。参与者被指示每天进行 4 次自我治疗，持续 6 周。在假治疗组中有 17 名参与者和自我腕横韧带拉伸组中有 19 名参与者完成了研究。治疗前后的结果测量包括主观抱怨、力量、神经传导发现和功能评分。
两组在年龄、性别、手优势、症状持续时间、治疗长度、夜间症状存在和治疗依从性方面平衡。尽管方差分析对组间差异没有定论，但探索性事后分析显示，麻木（P=0.011，Cohen's d=0.53）、刺痛（P=0.007，Cohen's d=0.60）、捏力（P=0.007，Cohen's d=0.58）和症状严重程度量表（P=0.007，Cohen's d=0.69）的改善在治疗组中具有统计学意义。
腕横韧带的筋膜拉伸在 CTS 患者中显示出统计学上的症状改善。应该进行更大的比较研究，包括其他治疗方法，如夹板，以确认这种治疗选择的有效性。
