Ceylan İsmail, Kürtüncüoğlu Büşra, Tuncay Figen, Canli Mehmet, Alkan Halil, Tayfur Abdulhamit
Kırşehir Ahi Evran University, School of Physical Therapy and Rehabilitation - Kırşehir, Turkey.
Kırşehir Ahi Evran University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation - Kırşehir, Turkey.
Rev Assoc Med Bras (1992). 2025 May 2;71(3):e20241815. doi: 10.1590/1806-9282.20241815. eCollection 2025.
The aim of this study was to compare the efficacy of radial extracorporeal shock wave therapy administered at low vs. high pressures in patients with carpal tunnel syndrome.
Patients with carpal tunnel syndrome were randomized into two groups: low-dose group and high-dose group. Each patient underwent a total of four sessions of radial extracorporeal shock wave therapy, administered once a week. The radial extracorporeal shock wave therapy was delivered at 4.0 bars for the high-dose group and 1.5 bars for the low-dose group. Both groups received conventional physical therapy program consisting of transcutaneous electrical nerve stimulation, paraffin wax, orthoses, and tendon gliding exercises, three times per week over a 4-week duration. Outcome measures included pain levels, hand grip strength, pinch strength, the Boston Carpal Tunnel Syndrome Questionnaire, and nerve conduction studies.
Both groups exhibited improvements across all measures, except for the nerve conduction studies parameters. In the intragroup analysis, statistically significant differences were observed with small-to-moderate effect sizes for median motor distal latency, median sensory nerve conduction velocity, median sensory distal latency, and the Boston functional status subscale, all favoring the high-dose group (p<0.05). In the low-dose group, a statistically significant difference with a moderate effect size was noted solely for hand grip strength (p<0.05).
High-dose radial extracorporeal shock wave therapy was significantly better than low-dose radial extracorporeal shock wave therapy with small-to-moderate effect sizes in the recovery of the function and nerve conduction studies parameters of patients with carpal tunnel syndrome.
The study was registered on the Clinical Trials Registry (registration number: NCT05681663).
本研究旨在比较低压力与高压力下的桡侧体外冲击波疗法对腕管综合征患者的疗效。
将腕管综合征患者随机分为两组：低剂量组和高剂量组。每位患者总共接受4次桡侧体外冲击波治疗，每周1次。高剂量组的桡侧体外冲击波治疗压力为4.0巴，低剂量组为1.5巴。两组均接受常规物理治疗方案，包括经皮神经电刺激、石蜡疗法、矫形器和肌腱滑动练习，为期4周，每周3次。观察指标包括疼痛程度、握力、捏力、波士顿腕管综合征问卷以及神经传导研究。
除神经传导研究参数外，两组在所有指标上均有改善。组内分析显示, 在正中运动远端潜伏期、正中感觉神经传导速度、正中感觉远端潜伏期和波士顿功能状态子量表方面，观察到具有小到中等效应量的统计学显著差异，均有利于高剂量组（p<0.05）。在低剂量组中，仅握力有统计学显著差异，效应量中等（p<0.05）。
在腕管综合征患者的功能恢复和神经传导研究参数方面，高剂量桡侧体外冲击波疗法明显优于低剂量桡侧体外冲击波疗法，效应量小到中等。
本研究已在临床试验注册中心注册（注册号：NCT05681663）。
