Tamaru Yoshiki, Yanagawa Akiyoshi, Matsugi Akiyoshi
Faculty of Rehabilitation, Shijonawate-Gakuen University, Hojo 5-11-10, Daitou, Osaka 574-0011, Japan.
Department of Rehabilitation, Tesseikai Neurosurgical Hospital, Nakano Honmachi 28-1, Shijonawate, Osaka 575-8511, Japan.
J Clin Med. 2021 Sep 13;10(18):4121. doi: 10.3390/jcm10184121.
This study aims to investigate the effects of nerve gliding exercise following carpal tunnel release surgery (NGE-CTRS) and the probing factors affecting the effect of NGE-CTRS on hand function. A total of 86 patients after CTRS participated. Grip strength (grip-s), pinch strength (pinch-s), Semmes-Weinstein monofilament test (SWMT), two-point discrimination (2PD), numbness, pain, and Phalen test (Phalen) were measured and compared between pre- and post-NGE-CTRS. The results showed that the combination of surgery and NGE significantly improved the postoperative grip-s, pinch-s, SWMT, 2PD, numbness, and Phalen; however, no improvement was observed in pain. Background factors that influenced the improved grip-s and pinch-s included gender and preoperative sensory nerve conduction velocity (SCV). Additionally, numbness and Phalen were not affected by age, gender, fault side, bilateral, trigger finger, dialysis, thenar eminence atrophy, motor nerve conduction velocity, SCV, the start of treatment, and occupational therapy intervention. In conclusion, the combination of surgical procedures and NGE showed a high improvement. SCV and time-to-start treatment of intervention for carpal tunnel syndrome may be useful in predicting the function after the intervention.
本研究旨在探讨腕管松解术后神经滑动训练(NGE-CTRS)的效果以及影响NGE-CTRS对手功能影响的相关因素。共有86例腕管松解术后患者参与。在NGE-CTRS前后测量并比较握力(grip-s)、捏力(pinch-s)、Semmes-Weinstein单丝试验(SWMT)、两点辨别觉(2PD)、麻木感、疼痛及Phalen试验(Phalen)。结果显示,手术联合NGE显著改善了术后的握力、捏力、SWMT、2PD、麻木感及Phalen试验结果;然而,疼痛方面未见改善。影响握力和捏力改善的背景因素包括性别和术前感觉神经传导速度(SCV)。此外,麻木感和Phalen试验结果不受年龄、性别、患侧、双侧、扳机指、透析、鱼际肌萎缩、运动神经传导速度、SCV、治疗开始时间及职业治疗干预的影响。总之,手术操作与NGE联合应用显示出较高的改善效果。腕管综合征干预治疗的SCV及开始治疗时间可能有助于预测干预后的功能。