Rehabilitation Faculty, School of Physical Therapy, Semnan University of Medical Sciences, Semnan, Iran.
Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Physiother Theory Pract. 2023 May;39(5):927-937. doi: 10.1080/09593985.2022.2033897. Epub 2022 Feb 3.
Pilot, randomized, single-blinded controlled clinical trial.
Trigger point (s) (TrPs) in thenar muscles could be a cause of narrowing of carpal tunnel in manual laborers with carpal tunnel syndrome (CTS). Effects of dry needling (DN) on the treatment of muscle tension have been reported, but no research has been done on the effect of DN on thenar tight muscles on reducing CTS symptoms. The aim of this study was to assess the effect of DN of thenar muscles TrPs in the treatment of mild-to-moderate carpal tunnel syndrome.
Thirty manual laborers with mild-to-moderate CTS and the presence of TrP(s) in thenar muscles were randomized to DN group (n = 15) and control group (waiting list) (n = 15). The DN group received 2 sessions of DN of thenar muscles TrP(s), with a 48-h interval. The control group received no treatment. Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores were the primary outcome, while secondary outcomes included electrophysiological domains, pinch and grip strength. Outcome measures were obtained at baseline, 48 hours, and 2 weeks after treatment (follow-up). Two-way analysis of variance (2 groups × 3 times) was used to compare within- and between-group differences. Bonferroni post hoc test was used to find any significant differences in the main effect for group, time, or interaction (group time).
A baseline assessment revealed no intergroup differences in all evaluated parameters ( > .05). Compared to the control group, the DN group had a statistically significant improvement in pinch and grip strength, median SDL, and BCTQ score after 2 weeks ( < .05). There were no between-group differences in the assessment of motor electrophysiologic and SNCV findings ( > .05).
Dry needling of thenar TrP(s) is effective in short-term improvement of function in manual laborers with mild-to-moderate CTS.
试点、随机、单盲对照临床试验。
手部大鱼际肌的触发点(TrPs)可能是导致手劳动者腕管综合征(CTS)患者腕管狭窄的原因。已有研究报道,干针疗法(DN)对肌肉紧张的治疗有效果,但尚无研究探讨 DN 对大鱼际紧张肌肉的影响,以及其对手劳动者中轻度至中度 CTS 症状的缓解作用。本研究旨在评估 DN 治疗手部大鱼际肌 TrPs 对手劳动者轻度至中度 CTS 的治疗效果。
将 30 名手部大鱼际肌有 TrPs 且患有轻度至中度 CTS 的手劳动者随机分为 DN 组(n=15)和对照组(等待名单)(n=15)。DN 组接受 2 次手部大鱼际肌 TrPs 的 DN 治疗,间隔 48 小时。对照组不接受任何治疗。波士顿腕管综合征问卷(BCTQ)评分是主要结局,次要结局包括电生理领域、捏力和握力。在基线、48 小时和治疗后 2 周(随访)时测量结果。采用双因素方差分析(2 组×3 次)比较组内和组间差异。Bonferroni 事后检验用于寻找主要组间、时间或交互作用(组间时间)的任何显著差异。
基线评估显示,所有评估参数在两组间均无差异(>0.05)。与对照组相比,DN 组在 2 周后捏力和握力、正中神经 SDL 和 BCTQ 评分均有统计学显著改善(<0.05)。在运动电生理和 SNCV 发现的评估中,两组间无差异(>0.05)。
DN 治疗手部大鱼际肌 TrPs 可在短期内改善轻度至中度 CTS 手劳动者的手部功能。