Kablan Nilüfer, Mete Emel, Karatekin Bilinç Doğruöz, Tombul Temel
University of İstanbul Medeniyet, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, İstanbul, Turkey.
University of İstanbul Medeniyet, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, İstanbul, Turkey.
J Hand Ther. 2025 Jan-Mar;38(1):80-90. doi: 10.1016/j.jht.2024.10.002. Epub 2025 Jan 6.
Intraneural edema is an important factor in the pathophysiology of carpal tunnel syndrome (CTS). Manual Lymphatic Drainage (MLD) is a manual treatment widely used to treat edema in a variety of conditions.
This study aimed to evaluate the effect of MLD on intraneural edema of the median nerve in CTS patients, as well as its impact on symptom severity and hand function.
Randomized controlled study.
Twenty-seven patients (aged 48.9 ± 9.9) with mild-to-moderate bilateral CTS were recruited for the study. One hand of each subject was allocated to the experimental group and the other hand in the control group randomly. The experimental group underwent MLD, myofascial release (MFR) therapy and conventional physiotherapy (CP). The control group received sham MLD, MFR and CP. Interventions were performed 2 days a week for 6 weeks. The distal motor latency (DML), motor nerve (MNCV), and sensory nerve (SNCV) conduction velocity of the median nerve were evaluated using electrodiagnostic techniques. As secondary evaluations, grip strength, pressure pain threshold, pain intensity, symptom severity, and hand functions were assessed. The cross-sectional area (CSA) of the median nerve was measured by ultrasound. All assessments were performed at baseline and 6 weeks after intervention.
According to the analysis of a two-way repeated measures of ANOVA, the experimental group showed greater improvement in CSA (p < 0.001; η2 = 0.510), DML (p < 0.001; η2 = 0.549), sensory (p < 0.001; η2 = 0.408), and motor conduction velocity (p < 0.001; η2 = 0.419) of the median nerve than the control group. There was no significant difference between the groups in the secondary evaluation results (p > 0.05).
MLD may contribute to symptom relief in CTS by reducing intraneural edema in the median nerve.
神经内水肿是腕管综合征（CTS）病理生理学中的一个重要因素。手法淋巴引流（MLD）是一种广泛用于治疗各种病症水肿的手法治疗方法。
本研究旨在评估MLD对CTS患者正中神经神经内水肿的影响，及其对症状严重程度和手部功能的影响。
随机对照研究。
招募了27例（年龄48.9±9.9）轻度至中度双侧CTS患者参与本研究。将每个受试者的一只手随机分配到实验组，另一只手分配到对照组。实验组接受MLD、肌筋膜松解（MFR）治疗和常规物理治疗（CP）。对照组接受假MLD、MFR和CP。每周进行2天干预，持续6周。使用电诊断技术评估正中神经的远端运动潜伏期（DML）、运动神经（MNCV）和感觉神经（SNCV）传导速度。作为次要评估，评估握力、压力痛阈、疼痛强度、症状严重程度和手部功能。通过超声测量正中神经的横截面积（CSA）。所有评估均在基线和干预后6周进行。
根据双向重复测量方差分析，实验组正中神经的CSA（p<0.001；η2=0.510）、DML（p<0.001；η2=0.549）、感觉（p<0.001；η2=0.408）和运动传导速度（p<0.001；η2=0.419）的改善程度均大于对照组。次要评估结果在两组之间无显著差异（p>0.05）。
MLD可能通过减轻正中神经的神经内水肿来缓解CTS的症状。
