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聚焦式冲击波疗法治疗中重度腕管综合征患者的疗效:初步研究。

Efficacy of focused shockwave therapy in patients with moderate-to-severe carpal tunnel syndrome: a preliminary study.

机构信息

Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.

Department of Rehabilitation Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Rehabil Med. 2024 Feb 8;56:jrm13411. doi: 10.2340/jrm.v56.13411.

Abstract

OBJECTIVE

To evaluate the efficacy of focused extracorporeal shockwave therapy for symptoms and function in patients with moderate-to-severe carpal tunnel syndrome.

DESIGN

A single-blind randomized controlled trial.

SUBJECTS

Twenty-four outpatients with moderate-to-severe carpal tunnel syndrome.

METHODS

Patients were randomly allocated into 2 groups: a focused extracorporeal shockwave therapy group and a control group. The focused extracorporeal shockwave therapy group received conservative treatment in addition to focused extracorporeal shockwave therapy with an energy flux density ranging from 0.01 to 0.15 mJ/mm2, a frequency of 4-5 Hz, and 1500 pulses per session once a week for a total of 3 sessions. The control group received only conservative treatment, which comprised gliding exercises for carpal tunnel syndrome, a night wrist splint, and lifestyle modification. The Thai version of the Boston Carpal Tunnel Questionnaire (T-BCTQ), a nerve conduction study, and ultrasonography of the median nerve cross-sectional area were performed before treatment and at 3 and 6 weeks after baseline.

RESULTS

The T-BCTQ symptom and function scores had significantly decreased in both groups, favouring focused extracorporeal shockwave therapy at all time-points. In addition, distal sensory and motor latency were significantly different between the groups at 3 weeks from baseline.

CONCLUSION

Focused extracorporeal shockwave therapy plus conservative treatment effectively provided short-term improvement in symptoms, hand function, and nerve conduction in patients with moderate-to-severe carpal tunnel syndrome compared with conservative treatment alone.

摘要

目的

评估聚焦式体外冲击波疗法对中重度腕管综合征患者症状和功能的疗效。

设计

单盲随机对照试验。

受试者

24 名中重度腕管综合征门诊患者。

方法

患者随机分为 2 组:聚焦式体外冲击波治疗组和对照组。聚焦式体外冲击波治疗组在接受常规治疗的基础上,增加聚焦式体外冲击波治疗,能量通量密度为 0.01 至 0.15 mJ/mm²,频率为 4-5 Hz,每次 1500 脉冲,每周 1 次,共 3 次。对照组仅接受常规治疗,包括腕管综合征滑液运动、夜间腕部夹板和生活方式改变。治疗前、基线后 3 周和 6 周时,采用泰国版波士顿腕管问卷(T-BCTQ)、神经传导研究和正中神经横截面积超声检查。

结果

两组 T-BCTQ 症状和功能评分均显著降低,聚焦式体外冲击波治疗在所有时间点均更具优势。此外,与基线相比,两组在 3 周时的远端感觉和运动潜伏期差异显著。

结论

与单纯保守治疗相比,聚焦式体外冲击波治疗联合常规治疗可有效改善中重度腕管综合征患者的症状、手部功能和神经传导,短期效果显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c7/10865893/b1a98041cb5c/JRM-56-13411-g001.jpg

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