Publication: Karpal tünel sendromunda düşük enerjili lazer ve kesikli ultrason tedavi etkinliklerinin karşılaştırılması: plasebo kontrollü bir çalışma
Abstract
Amaç: Karpal tünel sendromunda (KTS) düşük enerjili lazer (DEL) ve kesikli ultrason (US) tedavilerinin etkinliklerini değerlendirmek ve karşılaştırmaktır. Gereç ve Yöntem: KTS tanısı alan toplam 60 hasta rastgele yöntemle dört gruba ayrıldı: Grup 1e kesikli US, Grup 2ye plasebo US, Grup 3e DEL, Grup 4e ise plasebo lazer tedavisi üç hafta boyunca haftada beş gün uygulandı. Hastalar tedavi öncesi ve tedavi sonrası 3, 6 ve 12. aylarda klinik ve elektrofizyolojik olarak değerlendirildi. Klinik değerlendirmede ağrı, uyuşukluk, el kavrama gücü ve Boston anketi ile semptom şiddet ve fonksiyonel kapasite değerlendirildi. Bulgular: Çalışma 52 hasta ve toplam 101 el ile tamamlandı. Hastaların genel özellikleri ve bazal elektrofizyolojik değişkenleri dört grupta da benzerdi. Ağrı, duyu kaybı, semptom şiddet skoru ve fonksiyonel kapasite skorlarında hem US hem de DEL gruplarında tedavi öncesine göre anlamlı düzelmeler saptandı (p<0,05). Her iki plasebo grubunda da anlamlı tedavi etkinliği saptanmadı (p>0,05). Elektronörofizyolojik değişkenlerde, dört grupta da tedavi öncesine göre anlamlı değişimler saptanmadı (p>0,05). Klinik parametreler bakımından kesikli US tedavisinin DEL tedavisinden üstün olduğu tespit edildi (p<0,05). Sonuç: KTSde US ve DEL tedavisinin subjektif klinik semptomlar üzerine etkili, ancak elektrofizyolojik parametreler üzerine etkili olmadığı, kesikli US tedavisinin klinik parametreler göz önüne alındığında DEL tedavisinden daha üstün olduğu gösterilmiştir. Türk Fiz T p Rehab Derg 2013;59:201-8.
Objective: To evaluate the effect of low-level laser treatment (LLLT) and pulsed ultrasound (US) treatment in carpal tunnel syndrome (CTS) and to compare the effects of both treatment modalities. Materials and Methods: 60 patients diagnosed with CTS were randomly divided into four groups as US group (group 1), placebo US group (group 2), LLLT group (group 3) and plasebo LLLT group (group 4). Both treatments were applied five days a week for three weeks. Clinical and electrophysiological assessments were performed before and 3, 6 and 12 months after treatment. Pain, hypoesthesia and handgrip strength were evaluated. The Boston Questionnaire was used to assess the severity of symptoms and functional status. Results: 52 patients with 101 hands completed the study. Demographic and electrophysiological parameters were similar in the four groups. Both pulsed US treatment and LLLT were found to provide significant improvements in clinical parameters such as pain, sensory loss, symptom severity score and functional capacity score (p<0.05). No significant beneficial effect was observed in both placebo groups (p<0.05). Evaluations of the electrophysiological parameters showed no significant difference between the groups (p>0.05). In terms of clinical efficacy, pulsed US was found to be superior to LLLT (p<0.05). Conclusion: The two treatment modalities showed significant improvements in subjective clinical symptoms while no significant changes were observed in any electrophysiological parameters. Turk J Phys Med Rehab 2013;59:201-8.
Objective: To evaluate the effect of low-level laser treatment (LLLT) and pulsed ultrasound (US) treatment in carpal tunnel syndrome (CTS) and to compare the effects of both treatment modalities. Materials and Methods: 60 patients diagnosed with CTS were randomly divided into four groups as US group (group 1), placebo US group (group 2), LLLT group (group 3) and plasebo LLLT group (group 4). Both treatments were applied five days a week for three weeks. Clinical and electrophysiological assessments were performed before and 3, 6 and 12 months after treatment. Pain, hypoesthesia and handgrip strength were evaluated. The Boston Questionnaire was used to assess the severity of symptoms and functional status. Results: 52 patients with 101 hands completed the study. Demographic and electrophysiological parameters were similar in the four groups. Both pulsed US treatment and LLLT were found to provide significant improvements in clinical parameters such as pain, sensory loss, symptom severity score and functional capacity score (p<0.05). No significant beneficial effect was observed in both placebo groups (p<0.05). Evaluations of the electrophysiological parameters showed no significant difference between the groups (p>0.05). In terms of clinical efficacy, pulsed US was found to be superior to LLLT (p<0.05). Conclusion: The two treatment modalities showed significant improvements in subjective clinical symptoms while no significant changes were observed in any electrophysiological parameters. Turk J Phys Med Rehab 2013;59:201-8.