Talebi Ghadam Ali, Saadat Payam, Javadian Yahya, Taghipour Mohammad
Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Caspian J Intern Med. 2020;11(2):163-170. doi: 10.22088/cjim.11.2.163.
Manual therapy techniques are part of physiotherapy treatment of carpal tunnel syndrome (CTS) which are classified into two groups including nerve mobilization and mechanical interface mobilization. The aim of the study was to find which manual therapy method-technique directed to mechanical interface and nerve mobilization-has superior beneficial effects on clinical and electrophysiological findings in conservative management of patients with CTS.
Thirty patients with CTS participated into two groups namely: mechanical interface and nerve mobilization in this randomized clinical trial. The intervention was performed three times weekly for 4 weeks. Mechanical interface mobilization was directed to structures around the median nerve at the forearm and wrist. Techniques of median nerve gliding and tension were used in the nerve mobilization group. The outcome measures included visual analogue scale (VAS), symptom severity scale (SSS), hand functional status scale (FSS) and motor and sensory distal latencies of median nerve. Paired t-test and ANCOVA were used for statistical analysis.
At the end of the 4 week of the treatment, the mean of VAS, SSS and FSS significantly improved in both groups (p<0.05), but the difference was not significant between the two groups (P>0.05). Although the mean of motor and sensory distal latencies of median nerve at the end of the treatment period only improved in the nerve mobilization group (p<0.05), the difference was not significant between the two groups (P>0.05).
Mechanical interface mobilization and nerve mobilization techniques are not superior to each other in reducing pain and improving hand symptoms and functional status.
手法治疗技术是腕管综合征（CTS）物理治疗的一部分，可分为两组，包括神经松动术和机械界面松动术。本研究的目的是找出哪种针对机械界面和神经松动的手法治疗方法在CTS患者的保守治疗中对临床和电生理结果具有更显著的有益效果。
30例CTS患者参与了这项随机临床试验，分为两组，即机械界面组和神经松动组。干预每周进行3次，共4周。机械界面松动术针对前臂和腕部正中神经周围的结构。神经松动组采用正中神经滑动和张力技术。结果测量包括视觉模拟量表（VAS）、症状严重程度量表（SSS）、手部功能状态量表（FSS）以及正中神经运动和感觉远端潜伏期。采用配对t检验和协方差分析进行统计分析。
治疗4周结束时，两组的VAS、SSS和FSS平均值均显著改善（p<0.05），但两组之间的差异不显著（P>0.05）。虽然治疗期结束时正中神经运动和感觉远端潜伏期的平均值仅在神经松动组有所改善（p<0.05），但两组之间的差异不显著（P>0.05）。
在减轻疼痛、改善手部症状和功能状态方面，机械界面松动术和神经松动术并不优于彼此。
