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超声引导经皮电刺激治疗肘管综合征患者:一例 1 年随访的病例报告。

Ultrasound-guided percutaneous electrical stimulation for a patient with cubital tunnel syndrome: a case report with a one-year follow-up.

机构信息

Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.

Cátedra de Investigación y Docencia En Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Madrid, Spain.

出版信息

Physiother Theory Pract. 2022 Oct;38(10):1564-1569. doi: 10.1080/09593985.2020.1843211. Epub 2020 Nov 6.

DOI:10.1080/09593985.2020.1843211
PMID:33155496
Abstract

OBJECTIVE

Patients with ulnar neuropathy usually experience sensory disturbances, weakness, and decreased function; however, optimal treatment approaches for this condition are not conclusive.

CASE DESCRIPTION

A 48-year-old male with cubital tunnel syndrome was previously managed with a multimodal approach including splinting, neural mobilizations, and exercises with no change in symptoms. Approximately 1 year after the initial onset, he received three sessions of ultrasound-guided percutaneous electrical stimulation (PENS) and self-neural glides as a home program.

OUTCOMES

After PENS intervention, the patient experienced a dramatic improvement in function and symptoms as measured by the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH) and self-reported version of the Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale as outcomes. These improvements were maintained after 1, 3, 6, and 12 months. The patient also experienced self-perceived improvement in his condition as measured by the Global Rating of Change (GROC) at each follow-up.

CONCLUSION

A patient with ulnar nerve entrapment at the elbow did not respond to a multimodal conservative care for the previous year. Once the patient was treated with ultrasound-guided PENS targeting the ulnar nerve, full functional recovery and resolution of symptoms were documented. Future clinical studies should examine the effects of PENS in managing neural entrapment syndromes on a statistically powered sample of patients.

摘要

目的

尺神经病变的患者通常会出现感觉障碍、无力和功能减退,但针对这种情况的最佳治疗方法尚无定论。

病例描述

一名 48 岁男性患有肘管综合征,此前接受了包括夹板固定、神经松动和锻炼在内的多模式治疗,但症状没有改善。在最初发病约 1 年后,他接受了 3 次超声引导下经皮电刺激(PENS)和自我神经滑行治疗,并将其作为家庭治疗方案。

结果

PENS 干预后,患者的上肢功能和症状得到了显著改善,这可以通过残疾程度量表(DASH)和自我报告的利兹神经病变症状和体征评估量表(S-LANSS)疼痛量表进行评估。这些改善在 1、3、6 和 12 个月后仍得以维持。患者还通过每次随访时的整体变化评级(GROC)自我评估到病情的改善。

结论

一名患有肘部尺神经受压的患者在过去一年中对多模式保守治疗没有反应。一旦患者接受超声引导下针对尺神经的 PENS 治疗,就会记录到完全的功能恢复和症状的缓解。未来的临床研究应在具有统计学效力的患者样本中,检验 PENS 治疗神经卡压综合征的效果。

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