Polat Yasemin Durum, Aydın Elif, Ince Fikriye Sinem, Bilgen Mehmet
Department of Radiology, Aydın Adnan Menderes University, Faculty of Medicine , Aydın , Turkey.
Department of Physical Therapy and Rehabilitation, Aydın Adnan Menderes University, Faculty of Medicine , Aydın , Turkey.
J Ultrason. 2020;20(81):e90-e94. doi: 10.15557/JoU.2020.0014. Epub 2020 Jun 15.
To evaluate the sonoelastic response of the median nerve in patients with carpal tunnel syndrome following conservative rehabilitation with splint plus exercise regimens. A total of thirty-five patients diagnosed with mild carpal tunnel syndrome and treated with splint plus exercise therapy; hand resting splint all day for 3 weeks and then only at nights along with nerve gliding exercises in 10 repetitions 3 times a day. The median nerve was evaluated clinically prior to the treatment and at week 6 of therapy using physical examination, electrodiagnostic neurophysiology tests and radiological imaging; Boston Scores, electromyogram, ultrasonography and sonoelastography. Following the 6-week treatment protocol on 35 subjects with mild carpal tunnel syndrome, sonoelastography showed significantly softer median nerve, while the traditional parameters based on Boston Scores and cross-sectional area based on ultrasonography remained nearly unresponsive. Such early indication of biomechanical changes in the nerve may be of clinical importance if it can offer a prognostic value of the applied treatment, while tissue softening suggests the alleviation of nerve compression. Sonoelasticity of the median nerve can serve as a reliable marker for assessing therapeutic changes in median nerve stiffness and potentially the outcome early on in mild carpal tunnel syndrome. To evaluate the sonoelastic response of the median nerve in patients with carpal tunnel syndrome following conservative rehabilitation with splint plus exercise regimens. A total of thirty-five patients diagnosed with mild carpal tunnel syndrome and treated with splint plus exercise therapy; hand resting splint all day for 3 weeks and then only at nights along with nerve gliding exercises in 10 repetitions 3 times a day. The median nerve was evaluated clinically prior to the treatment and at week 6 of therapy using physical examination, electrodiagnostic neurophysiology tests and radiological imaging; Boston Scores, electromyogram, ultrasonography and sonoelastography. Following the 6-week treatment protocol on 35 subjects with mild carpal tunnel syndrome, sonoelastography showed significantly softer median nerve, while the traditional parameters based on Boston Scores and cross-sectional area based on ultrasonography remained nearly unresponsive. Such early indication of biomechanical changes in the nerve may be of clinical importance if it can offer a prognostic value of the applied treatment, while tissue softening suggests the alleviation of nerve compression. Sonoelasticity of the median nerve can serve as a reliable marker for assessing therapeutic changes in median nerve stiffness and potentially the outcome early on in mild carpal tunnel syndrome.
评估腕管综合征患者在采用夹板加运动疗法进行保守康复治疗后正中神经的超声弹性响应。共有35例被诊断为轻度腕管综合征的患者接受了夹板加运动疗法治疗；全天佩戴手部休息夹板3周，之后仅在夜间佩戴，同时每天进行3次、每次10组的神经滑动练习。在治疗前以及治疗第6周时，通过体格检查、电诊断神经生理学测试和放射学成像（波士顿评分、肌电图、超声检查和超声弹性成像）对正中神经进行临床评估。对35例轻度腕管综合征患者进行为期6周的治疗方案后，超声弹性成像显示正中神经明显变软，而基于波士顿评分的传统参数以及基于超声检查的横截面积几乎没有变化。如果这种神经生物力学变化的早期迹象能够为所应用的治疗提供预后价值，那么它可能具有临床重要性，而组织软化表明神经压迫得到缓解。正中神经的超声弹性可作为评估轻度腕管综合征早期正中神经硬度治疗变化及潜在治疗结果的可靠标志物。评估腕管综合征患者在采用夹板加运动疗法进行保守康复治疗后正中神经的超声弹性响应。共有35例被诊断为轻度腕管综合征的患者接受了夹板加运动疗法治疗；全天佩戴手部休息夹板3周，之后仅在夜间佩戴，同时每天进行3次、每次10组的神经滑动练习。在治疗前以及治疗第6周时，通过体格检查、电诊断神经生理学测试和放射学成像（波士顿评分、肌电图、超声检查和超声弹性成像）对正中神经进行临床评估。对35例轻度腕管综合征患者进行为期6周的治疗方案后，超声弹性成像显示正中神经明显变软，而基于波士顿评分的传统参数以及基于超声检查的横截面积几乎没有变化。如果这种神经生物力学变化的早期迹象能够为所应用的治疗提供预后价值，那么它可能具有临床重要性，而组织软化表明神经压迫得到缓解。正中神经的超声弹性可作为评估轻度腕管综合征早期正中神经硬度治疗变化及潜在治疗结果的可靠标志物。
