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治疗性水下超声疗法对轻至中度腕管综合征的疗效:一项随机假对照研究。

Efficiency of therapeutic underwater ultrasound therapy in mild-to-moderate carpal tunnel syndrome: A randomized sham-controlled study.

作者信息

Bagcaci Sinan, Yilmaz Ramazan, Sahin Nilay

机构信息

Department of Physical Medicine and Rehabilitation, Konya Medicana International Hospital, Konya, Türkiye.

Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Beyhekim Training and Research Hospital, Konya, Türkiye.

出版信息

Turk J Phys Med Rehabil. 2023 Jul 7;69(3):366-376. doi: 10.5606/tftrd.2023.12467. eCollection 2023 Sep.

Abstract

OBJECTIVES

This study aimed to evaluate the efficiency of therapeutic pulsed ultrasound (US) applied underwater in mild-to-moderate carpal tunnel syndrome (CTS).

PATIENTS AND METHODS

This randomized, placebo-controlled study included 75 patients (114 hands; 7 males, 68 females; mean age: 46.7±9.9 years; range, 24 to 64 years) diagnosed with CTS through clinical evaluation and electroneuromyography (ENMG) results between March 2012 and January 2013. Patients were randomized into three groups. Group 1 received underwater pulsed US, Group 2 received sham US, and Group 3 was the control group. All groups were given night splints. Patients were evaluated at baseline, at the end of treatment (two weeks), and 12 weeks after the treatment using clinical examination tests (Tinel, Phalen, and hand elevation test), hand grip strength, Visual Analog Scale (VAS) for pain, Pain Quality Assessment Scale (PQAS), and ENMG.

RESULTS

In all groups, a significant improvement was detected in the clinical assessment parameters, including the pain VAS, PQAS scores, physical examination outcomes, and hand grip strength. The decrease in VAS score and PQAS was found to be superior in the pulsed US group at both two weeks after the treatment and at the 12 week after the treatment compared to the sham US and control groups (p<0.001). Improvement in ENMG parameters, such as median motor latency, median sensorial velocity, and median sensory latency, was observed only in the underwater pulsed US group (p<0.001).

CONCLUSION

Therapeutic underwater pulsed US is an effective, safe, and easy-to-apply treatment option in the conservative treatment of mild-to-moderate CTS.

摘要

目的

本研究旨在评估水下应用治疗性脉冲超声(US)治疗轻至中度腕管综合征(CTS)的疗效。

患者与方法

本随机、安慰剂对照研究纳入了75例患者(114只手;男性7例,女性68例;平均年龄:46.7±9.9岁;范围24至64岁),这些患者在2012年3月至2013年1月期间通过临床评估和肌电图(ENMG)结果被诊断为CTS。患者被随机分为三组。第1组接受水下脉冲超声治疗,第2组接受假超声治疗,第3组为对照组。所有组均给予夜间夹板。在基线、治疗结束时(两周)以及治疗后12周,使用临床检查测试(Tinel征、Phalen试验和手部抬高试验)、握力、疼痛视觉模拟量表(VAS)、疼痛质量评估量表(PQAS)和ENMG对患者进行评估。

结果

在所有组中,临床评估参数均有显著改善,包括疼痛VAS、PQAS评分、体格检查结果和握力。与假超声组和对照组相比,在治疗后两周和治疗后12周时,脉冲超声组的VAS评分和PQAS的降低更为显著(p<0.001)。仅在水下脉冲超声组观察到ENMG参数的改善,如正中神经运动潜伏期、正中神经感觉速度和正中神经感觉潜伏期(p<0.001)。

结论

治疗性水下脉冲超声是轻至中度CTS保守治疗中一种有效、安全且易于应用的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28eb/10478536/fc1142d7365d/TJPMR-2023-69-3-366-376-F1.jpg

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