Abstract
Aim: The most frequent type of peripheral entrapment neuropathy is carpal tunnel syndrome (CTS), which is caused by compression of the median nerve at the wrist level. Ultrasound (US) and low-intensity laser therapy (LILT) are among the most commonly used physical therapy methods in the treatment of CTS. The aim of this study is to examine the efficacy of US and LILT in the treatment of CTS and their superiority to each other.
Material and Method: Patients who were admitted to the physical therapy program with the diagnosis of CTS in our clinic were retrospectively examined. A total of eleven patients (18 wrists) diagnosed with mild and moderate CTS were included in our study with the G-Power program with a 5 % margin of error and 80 % power. Patients were divided into US and LILT groups using a simple randomization method. The patients were evaluated in terms of clinical and electrophysiological parameters before and after treatment.
Results: A total of 18 wrists were included in our study, of which eight patients were diagnosed with mild CTS and the rest (n=10) with moderate CTS. The mean age of the patients was 49.66±10.68 years. When the post-treatment clinical (Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), hand and pinch grip strength, measurement of wrist joint range of motion) and electrophysiological parameters were evaluated between the US and LILT groups, no significant difference was found in terms of their superiority over each other (p>0.05). When the LILT group was compared before and after treatment, a statistically significant difference was found in the degree of wrist extension, handgrip strength and BCTQ parameters. (p<0.05).
Conclusion: When US and LILT were compared in patients with mild and moderate carpal tunnel syndrome, no significant difference was found between the groups in terms of clinical and electrophysiological parameters. However, a statistically significant difference was found in the LILT group in terms of some clinical parameters before and after treatment.
Supporting Institution
Amasya Üniversitesi
Project Number
FMB-BAP 20-0448
Thanks
The study, project number FMB-BAP 19-0412, was funded by Amasya University, Scientific Research Projects Coordination Unit, Turkey.
References
- Phalen GS. The carpal-tunnel syndrome: seventeen years'experience in diagnosis and treatment of six hundred fifty-four hands. JBJS 1966; 48: 211-28.
- Kaymak B, Özçakar L. Karpal tünel sendromu. Hacettepe Tıp Derg 2007; 38: 141-6.
- Serarslan Y, Melek İM, Duman T. Karpal tünel sendromu. Pamukkale Tıp Derg 2008: 45-9.
- Kamolz L-P, Beck H, Haslik W, et al. Carpal tunnel syndrome: a question of hand and wrist configurations? J Hand Surg 2004; 29: 321-4.
- Muller M, Tsui D, Schnurr R, Biddulph-Deisroth L, Hard J, MacDermid JC. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review. J Hand Ther 2004; 17: 210-28.
- Evcili G, Gül HL, Karadaş Ö, Börü ÜT. Carpal tunnel syndrome: In which ratio does electroneuromyography confirm the diagnosis? J Clin Analytic Med 2012; 3: 412-4.
- Piazzini DB, Aprile I, Ferrara PE, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil 2007; 21: 299-314.
- O'Connor D, Marshall S, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev 2003; 2003: CD003219.
- Rayegani SM, Moradi-Joo M, Raeissadat SA, Bahrami MH, Seyed-Nezhad M, Heidari S. Effectiveness of low-level laser therapy compared to ultrasound in patients with carpal tunnel syndrome: A systematic review and meta-analysis. J Lasers Med Sci 2019; 10: S82.
- Ebenbichler GR, Resch KL, Nicolakis P, et al. Ultrasound treatment for treating the carpal tunnel syndrome: randomised “sham” controlled trial. Bmj 1998; 316: 731-5.
- Stevens JC. AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve 1997; 20: 1477-86.
- Bagga B, Sinha A, Khandelwal N, Modi M, Ahuja CK, Sharma R. Comparison of magnetic resonance imaging and ultrasonography in diagnosing and grading carpal tunnel syndrome: a prospective study. Curr Probl Diagn Radiol 2020; 49: 102-15.
- Padua L, LoMonaco M, Gregori B, Valente E, Padua R, Tonali P. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurologica Scandinavica 1997; 96: 211-7.
- Hirani S. A study to further develop and refine carpal tunnel syndrome (CTS) nerve conduction grading tool. BMC Musculoskeletal Disorders 2019; 20: 1-7.
- Levine DW, Simmons BP, Koris MJ, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993; 75: 1585-92.
- Sezgin M, İncel NA, Sevim S, Çamdeviren H, As İ, Erdoğan C. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and validity of the Turkish version of the Boston Questionnaire. Disabil Rehabil 2006; 28: 1281-6.
- Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg 1984; 9: 222-6.
- Walker J, Sue D, Miles-Elkousy N, Ford G, Trevelyan H. Active mobility of the extremities in older subjects. Physical Ther 1984; 64: 919-23.
- Cambridge-Keeling. ROM measurement of the hand. Rehabilitation of the Hand and Upper Extremity 5th ed Missouri.169-82.
- Bakhtiary AH, Rashidy-Pour A. Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother 2004; 50: 147-51.
- Dincer U, Cakar E, Kiralp MZ, Kilac H, Dursun H. The effectiveness of conservative treatments of carpal tunnel syndrome: splinting, ultrasound, and low-level laser therapies. Photomed Laser Surg 2009; 27: 119-25.
- Tıkız C, Duruöz T, Zeliha Ü, Cerrahoğlu L, Yalçinsoy E. Karpal tünel sendromunda düşük enerjili lazer ve kesikli ultrason tedavi etkinliklerinin karşılaştırılması: plasebo kontrollü bir çalışma. Turk J Phys Med Rehabil Sci 2013; 16.
- Ekim A, Çolak E. Karpal tünel sendromunda ultrason tedavisi: plasebo kontrollü bir çalışma. Turk J Phys Med Rehabil 2008; 54.
- Carlson H, Colbert A, Frydl J, Arnall E, Elliot M, Carlson N. Current options for nonsurgical management of carpal tunnel syndrome. Int J Clin Rheumatol 2010; 5: 129.
- Afşar Sİ, Sarıfakıoğlu B, Yalbuzdağ ŞA. Karpal Tünel sendromu tedavisinde fizik tedavi modalitelerinin yeri: derleme. Turk J Osteoporosis 2014; 20.
- Klaiman MD, Shrader JA, Danoff JV, Hicks JE, Pesce WJ, Ferland J. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc 1998; 30: 1349-55.
- Oztas O, Turan B, Bora I, Karakaya MK. Ultrasound therapy effect in carpal tunnel syndrome. Arch Phys Med Rehabil 1998; 79: 1540-4.
- Piravej K, Boonhong J. Effect of ultrasound thermotherapy in mild to moderate carpal tunnel syndrome. J Med Assoc Thailand=Chotmaihet Thangphaet 2004; 87: S100-6.
- Jothi KP, Bland JD. Ultrasound therapy adds no benefit to splinting in carpal tunnel syndrome. Muscle Nerve 2019; 60: 538-43.
- Soriano F, Ríos R. Gallium arsenide laser treatment of chronic low back pain: a prospective, randomized and double blind study. Laser Ther 1998; 10: 175-80.
- Kemmotsu O, Sato K, Furumido H, et al. Efficacy of low reactive-level laser therapy for pain attenuation of postherpetic neuralgia. Laser Ther 1991; 3: 71-5.
- Naeser MA, Hahn K-AK, Lieberman BE, Branco KF. Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: a controlled study. Arch Phys Med Rehabil 2002; 83: 978-88.
- Shooshtari S, Badiee V, Taghizadeh S, Nematollahi A, Amanollahi A, Grami M. The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome. Electromyogr Clin Neurophysiol 2008; 48: 229.
- Irvine J, Chong SL, Amirjani N, Chan KM. Double‐blind randomized controlled trial of low‐level laser therapy in carpal tunnel syndrome. Muscle Nerve 2004; 30: 182-7.
Abstract
Project Number
FMB-BAP 20-0448
References
- Phalen GS. The carpal-tunnel syndrome: seventeen years'experience in diagnosis and treatment of six hundred fifty-four hands. JBJS 1966; 48: 211-28.
- Kaymak B, Özçakar L. Karpal tünel sendromu. Hacettepe Tıp Derg 2007; 38: 141-6.
- Serarslan Y, Melek İM, Duman T. Karpal tünel sendromu. Pamukkale Tıp Derg 2008: 45-9.
- Kamolz L-P, Beck H, Haslik W, et al. Carpal tunnel syndrome: a question of hand and wrist configurations? J Hand Surg 2004; 29: 321-4.
- Muller M, Tsui D, Schnurr R, Biddulph-Deisroth L, Hard J, MacDermid JC. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review. J Hand Ther 2004; 17: 210-28.
- Evcili G, Gül HL, Karadaş Ö, Börü ÜT. Carpal tunnel syndrome: In which ratio does electroneuromyography confirm the diagnosis? J Clin Analytic Med 2012; 3: 412-4.
- Piazzini DB, Aprile I, Ferrara PE, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil 2007; 21: 299-314.
- O'Connor D, Marshall S, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev 2003; 2003: CD003219.
- Rayegani SM, Moradi-Joo M, Raeissadat SA, Bahrami MH, Seyed-Nezhad M, Heidari S. Effectiveness of low-level laser therapy compared to ultrasound in patients with carpal tunnel syndrome: A systematic review and meta-analysis. J Lasers Med Sci 2019; 10: S82.
- Ebenbichler GR, Resch KL, Nicolakis P, et al. Ultrasound treatment for treating the carpal tunnel syndrome: randomised “sham” controlled trial. Bmj 1998; 316: 731-5.
- Stevens JC. AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve 1997; 20: 1477-86.
- Bagga B, Sinha A, Khandelwal N, Modi M, Ahuja CK, Sharma R. Comparison of magnetic resonance imaging and ultrasonography in diagnosing and grading carpal tunnel syndrome: a prospective study. Curr Probl Diagn Radiol 2020; 49: 102-15.
- Padua L, LoMonaco M, Gregori B, Valente E, Padua R, Tonali P. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurologica Scandinavica 1997; 96: 211-7.
- Hirani S. A study to further develop and refine carpal tunnel syndrome (CTS) nerve conduction grading tool. BMC Musculoskeletal Disorders 2019; 20: 1-7.
- Levine DW, Simmons BP, Koris MJ, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993; 75: 1585-92.
- Sezgin M, İncel NA, Sevim S, Çamdeviren H, As İ, Erdoğan C. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and validity of the Turkish version of the Boston Questionnaire. Disabil Rehabil 2006; 28: 1281-6.
- Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg 1984; 9: 222-6.
- Walker J, Sue D, Miles-Elkousy N, Ford G, Trevelyan H. Active mobility of the extremities in older subjects. Physical Ther 1984; 64: 919-23.
- Cambridge-Keeling. ROM measurement of the hand. Rehabilitation of the Hand and Upper Extremity 5th ed Missouri.169-82.
- Bakhtiary AH, Rashidy-Pour A. Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother 2004; 50: 147-51.
- Dincer U, Cakar E, Kiralp MZ, Kilac H, Dursun H. The effectiveness of conservative treatments of carpal tunnel syndrome: splinting, ultrasound, and low-level laser therapies. Photomed Laser Surg 2009; 27: 119-25.
- Tıkız C, Duruöz T, Zeliha Ü, Cerrahoğlu L, Yalçinsoy E. Karpal tünel sendromunda düşük enerjili lazer ve kesikli ultrason tedavi etkinliklerinin karşılaştırılması: plasebo kontrollü bir çalışma. Turk J Phys Med Rehabil Sci 2013; 16.
- Ekim A, Çolak E. Karpal tünel sendromunda ultrason tedavisi: plasebo kontrollü bir çalışma. Turk J Phys Med Rehabil 2008; 54.
- Carlson H, Colbert A, Frydl J, Arnall E, Elliot M, Carlson N. Current options for nonsurgical management of carpal tunnel syndrome. Int J Clin Rheumatol 2010; 5: 129.
- Afşar Sİ, Sarıfakıoğlu B, Yalbuzdağ ŞA. Karpal Tünel sendromu tedavisinde fizik tedavi modalitelerinin yeri: derleme. Turk J Osteoporosis 2014; 20.
- Klaiman MD, Shrader JA, Danoff JV, Hicks JE, Pesce WJ, Ferland J. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc 1998; 30: 1349-55.
- Oztas O, Turan B, Bora I, Karakaya MK. Ultrasound therapy effect in carpal tunnel syndrome. Arch Phys Med Rehabil 1998; 79: 1540-4.
- Piravej K, Boonhong J. Effect of ultrasound thermotherapy in mild to moderate carpal tunnel syndrome. J Med Assoc Thailand=Chotmaihet Thangphaet 2004; 87: S100-6.
- Jothi KP, Bland JD. Ultrasound therapy adds no benefit to splinting in carpal tunnel syndrome. Muscle Nerve 2019; 60: 538-43.
- Soriano F, Ríos R. Gallium arsenide laser treatment of chronic low back pain: a prospective, randomized and double blind study. Laser Ther 1998; 10: 175-80.
- Kemmotsu O, Sato K, Furumido H, et al. Efficacy of low reactive-level laser therapy for pain attenuation of postherpetic neuralgia. Laser Ther 1991; 3: 71-5.
- Naeser MA, Hahn K-AK, Lieberman BE, Branco KF. Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: a controlled study. Arch Phys Med Rehabil 2002; 83: 978-88.
- Shooshtari S, Badiee V, Taghizadeh S, Nematollahi A, Amanollahi A, Grami M. The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome. Electromyogr Clin Neurophysiol 2008; 48: 229.
- Irvine J, Chong SL, Amirjani N, Chan KM. Double‐blind randomized controlled trial of low‐level laser therapy in carpal tunnel syndrome. Muscle Nerve 2004; 30: 182-7.
Details
| Primary Language | English |
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| Subjects | Health Care Administration |
| Journal Section | Original Article |
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| Project Number | FMB-BAP 20-0448 |
| Publication Date | March 15, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 2 |
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