Yıl: 2011 Cilt: 14 Sayı: 1 Sayfa Aralığı: 1 - 8 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial

Öz:
Karpal Tünel Sendromu (KTS) tedavisinde öncelikle konservatif tedavi yaklaşımlarına odaklanılır. Pulse manyetik alan tedavisi (PMAT) KTS için konservatif yöntemlerden biridir. Bu randomize, plasebo kontrollü, çift kör çalışmada idiopatik karpal tünel sendromlu hastalarda pulse manyetik alan tedavisinin klinik ve elektrofizyolojik parametrelere etkinliği araştırıldı. Yöntem Alınma kriterlerini taşıyan 38 hastanın (57 elin) 36’sı (53 el) çalışmayı tamamladı. Fizyoterapist tarafından 1:1 randomize edilen hastaların 18 ‘i (27 el) pulse manyetik alan 20’si de (30 el) plasebo manyetik alan tedavisi gördü Her hasta tedavi öncesinde, sonrasında ve tedaviden 1 ay sonra klinik ve elektrofizyolojik son noktalarla değerlendirildi. Klinik son noktalar VAS, semptom skoru ve ağrı nedeniyle uyanma skorundan oluşurken elektrofizyolojik son noktalar median duyusal distal latans, duyusal amplitüd, duyusal sinir ileti hızı, motor distal latans, motor amplitüd ve motor sinir ileti hızını içeriyordu. İstatistik analizlerde, SPSS 10.1 bilgisayar programı kullanılarak student t-test, chi-square test, Mann-Whitney U Wilcoxon test uygulandı. Bu testlerin sonucu olarak, her iki tedavinin, tedavi sonrası ve tedaviden 1 ay sonra klinik ve elektrofizyolojik son noktalara etkin olduğu, ancak pulse manyetik alan tedavisinin klinik ve elektrofizyolojik olarak plaseboya üstün olmadığı görüldü. Bu çalışmanın takip süresi ve çalışılan el sayısı göz önüne alındığında daha sağlıklı sonuçlar elde etmek için fazla sayıda ve uzun dönem takipleri olan hastalarla çalışmanın gerekli olduğu ortaya çıkmaktadır.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp Rehabilitasyon

İdiyopatik karpal tünel sendromlu hastalarda pulse manyetik alan tedavisinin etkinliği: Randomize, çift kör, kontrollü çalışma

Öz:
Conservative treatment approachs are primarly focused on the therapy of carpal tunnel syndrome (CTS). Pulse magnetic field therapy (PMFT) is one of the conservative method for CTS. In this randomized, double-blind, 'sham' controlled trial, PMFT's effectiveness to clinical and electrophysiological parameters on the patients with idiopathic CTS was studied. Among 38 patients (57hands) who had the inclusion criteria, 36 of them(53hands) completed the study. Enrolled patients were randomized 1:1 methodology into two groups by physiotherapist, apllied to 18 of the patients (27hands) with PMFT and sham with 20 of them (30 hands) were treated. Each patient was evaluated with clinical and electrophysological parameters before and after the treatment and one month later after treatment. Clinical parameters were the awakening scores due to pain, evaluation of the pain with visual analogue scala (VAS) and symptom severity score. Electrophysological parameters were median sensory distal latency, amplitude and the velocity of sensory nerve conduction, motor distal latency, amplitude and velocity of motor nerve conduction. In statistical analysis, student t-test,chi square test, Mann-Whitney U and Wilcoxon test were carried out by using SPSS 10.1 computer program. As a result of these tests, it was observed that both two treatments have influences on clinical and electrophysological variables at the end of the therapy and one month later after the therapy, however PMFT is not superior to sham according to clinical and electrophysiological findings. In these terms, PMFT seems ineffective in idiopathic CTS; besides we consider it is essential to follow up in a long.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp Rehabilitasyon
Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık
  • 1. Dawson DM. Entrapment Neuropathies of the upper extremities. N Engl J Med 1993;329:2013-8.
  • 2. Werner RA, Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol 2002;113:1373-81.
  • 3. Iob I, Battaggia C, Rossetto L, Ermani M. The Carpal Tunnel Syndrome, anatomo clinical correlations. Neurochirurgie 2000;46:355-7.
  • 4. Yocum DE. The many faces of carpal tunnel syndrome. Arch Intern Med 1998;158:1496.
  • 5. Herbert R, Gerr F, Dropkin J. Clinical evaluation and management of work-related carpal tunnel syndrome. Am J Ind Med 2000;37:62-74.
  • 6. Carter R, Aspy CB, Mold J. The effectiveness of magnet therapy for treatment of wrist pain attributed to carpal tunnel syndrome. J Fam Pract 2002;51:38-40.
  • 7. Livingston JD. Magnetic therapy: plausible attraction? Skeptical inquirer 1998. http://www.acemagnetics.com/ eduarticles-magsportsbracelets-plausibleatt.html. http://www. acemagnetics.com/eduarticles-magsportsbracelets-plausibleatt.html
  • 8. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter for carpal tunnel syndrome. Neurology 1993;43:2406-9.
  • 9. American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: Summary statement. Muscle Nerve 22: Supplement 8: S141-S143, 1999.
  • 10. Jackson DA, Clifford JC. Electrodiagnosis of mild carpal tunnel syndrome. Arch Phys Med Rehabil 1989;70:199-204.
  • 11. Carlsson AM. Assessment of chronic pain: aspects of the reliability and validity of the visual analogue scale. Pain 1983;16:87-101.
  • 12. Oztas O, Turan B, Bora I, Karakaya MK. Ultrasound therapy effect in carpal tunnel syndrome. Arch Phys Med Rehabil 1998;79:1540-4.
  • 13. Giannini F, Passero S, Cioni R, et al. Electrophysiologic evaluation of local steroid injection in carpal tunnel syndrome. Arch Phys Med Rehabil 1991;72:738-42.
  • 14. 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.
  • 15. Gerritsen AAM, de Vet HCW, Scholten RJPM, Bertelsmann FW, de Krom MCTFM, Bouter LM. Splinting vs surgery in the treatment of carpal tunnel syndrome. JAMA 2002;288:1245-51.
  • 16. Tudiver F, Johnson ED, Brown MO. Does surgery for carpal tunnel syndrome improve outcomes? J Fam Pract 2003;52:70-2.
  • 17. Michlovitz SL. Is There a Role for Ultrasound and Electrical Stimulation Following Injury to Tendon and Nerve? J Hand Ther 2005;18:292-6.
  • 18. Göko¤lu F, F›nd›ko¤lu G, Yorganc›o¤lu ZR, Okumufl M, Ceceli E, Kocao¤lu S. Evaluation of iontophoresis and local corticosteroid injection in the treatment of carpal tunnel syndrome. Am J Phys Med Rehabil 2005;84:92-6.
  • 19. Michlovitz S, Hun L, Erasala GN, Hengehold DA, Weingand KW. Continuous low-level heat wrap therapy is effective for treating wrist pain. Arch Phys Med Rehabil 2004;85:1409-16.
  • 20. Rubik B, Becker RO, Flower RG, Hazlewood CF, Liboff AR, Walleczek J. Applications in medicine-Alternative medicine: Expanding medical horizons. Washington DC: US government printing office, 1996;45-65.
  • 21. Markov MS, Colbert AP. Magnetic and electromagnetic field therapy. J Back Musculoskeletal Rehab 2001;15:17-29.
  • 22. Frey AH. Differential biologic effects of pulsed and continuous electromagnetic fields and mechanisms of effect. Ann N Y Acad Sci 1974;238:273-9.
  • 23. Lawrence R, Rosch PJ, Plowden J. Magnet therapy. The pain cure alternative, Rocklin, CA: Prima Publishing, 1998, 241.
  • 24. Diniz P, Shomura K, Soejima K, Ito G. Effects of pulsed electromagnetic field (PEMF) stimulation on bone-tissue-like formation are dependent on the maturation stages of the osteoblasts. Bioelectromagnetics 2002;23:398-405
  • 25. Fanelli C, Coppola S, Barone R, et al. Magnetic fields increase cell survival by inhibiting apoptosis via modulation of Ca2+ influx. FASEB J 1999;13:95-102.
  • 26. Thomsen JF, Mikkelsen S. Interview data versus questionnaire data in the diagnoses of carpal tunnel syndrome in epidemiologic studies. Occup Med (Lond) 2003;53:57-63.
  • 27. Levine JD, Gordon NC, Fields HL. The mechanism of placebo analgesia. Lancet 1978;23;654-7.
  • 28. Feuerstein M, Burrell LM, Miller VI, Lincoln A, Huang GD, Berger R. Clinical management of carpal tunnel syndrome: a 12-year review of outcomes. Am J Ind Med 1999;35:232-45.
  • 29. Girlanda P, Quartarone A, Sinicropi S, et al. Electrophysiological studies in mild idiopathic carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol. 1998;109:44-9.
  • 30. Nodera H, Herrmann DN, Holloway RG, Logigian EL. A Bayesian argument against rigit cut-offs in electrodiagnosis of median neuropathy at the wrist. Neurology 2003;60:458-64.
  • 31. On AY, Cumal› A, Kirazl› Y, Celebo¤lu G. Karpal tünel sendromunda çok düflük frekansl› manyetik alan tedavisinin etkinli¤i. XVII. Ulusal fiziksel t›p ve rehabilitasyon kongresi 1999:432.
  • 32. Bailey WH and Nyenhuis JA. Thresholds for 60 Hz Magnetic Field Stimulation of Peripheral Nerves in Human Subjects. Bioelectromagnetics 2005;26:462-8.
  • 33. Weintraub MI, Cole SP. Pulsed magnetic field therapy in refractory neuropathic pain secondary to peripheral neuropathy: electrodiagnostic parameters—pilot study. Neurorehabil Neural Repair 2004;18:42-6.
  • 34. Raji AR, Bowden RE. Effects of high-peak pulsed electromagnetic fields on the degeneration and regeneration of the common peroneal nerve in rats. J Bone Joint Surg Br 1983;65:478-92.
  • 35. Weintraub MI, Cole SP. A Randomized Controlled Trial of the Effects of a Combination of Static and Dynamic Magnetic Fields on Carpal Tunnel Syndrome. Pain Med 2008;9:5:493-504.
  • 36. Olney RK. Carpal tunnel syndrome. Complex issues with a simple condition. Neurology 2001;56:1431-2.
  • 37. Padua L, Padua R, Aprile I, Pasqualetti P, Tonali P; Italian CTS Study Group. Carpal tunnel syndrome. Multiperspective follow-up of untreated carpal tunnel syndrome. Neurology 2001;56:1459-66.
APA ARIKAN F, YILDIZ ÖZER A, kesiktas n, Karan A, Muslumanoglu L (2011). The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. , 1 - 8.
Chicago ARIKAN Firdevs,YILDIZ ÖZER AYSEL,kesiktas nur,Karan Ayşe,Muslumanoglu Lutfiye The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. (2011): 1 - 8.
MLA ARIKAN Firdevs,YILDIZ ÖZER AYSEL,kesiktas nur,Karan Ayşe,Muslumanoglu Lutfiye The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. , 2011, ss.1 - 8.
AMA ARIKAN F,YILDIZ ÖZER A,kesiktas n,Karan A,Muslumanoglu L The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. . 2011; 1 - 8.
Vancouver ARIKAN F,YILDIZ ÖZER A,kesiktas n,Karan A,Muslumanoglu L The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. . 2011; 1 - 8.
IEEE ARIKAN F,YILDIZ ÖZER A,kesiktas n,Karan A,Muslumanoglu L "The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial." , ss.1 - 8, 2011.
ISNAD ARIKAN, Firdevs vd. "The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial". (2011), 1-8.
APA ARIKAN F, YILDIZ ÖZER A, kesiktas n, Karan A, Muslumanoglu L (2011). The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 14(1), 1 - 8.
Chicago ARIKAN Firdevs,YILDIZ ÖZER AYSEL,kesiktas nur,Karan Ayşe,Muslumanoglu Lutfiye The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi 14, no.1 (2011): 1 - 8.
MLA ARIKAN Firdevs,YILDIZ ÖZER AYSEL,kesiktas nur,Karan Ayşe,Muslumanoglu Lutfiye The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, vol.14, no.1, 2011, ss.1 - 8.
AMA ARIKAN F,YILDIZ ÖZER A,kesiktas n,Karan A,Muslumanoglu L The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi. 2011; 14(1): 1 - 8.
Vancouver ARIKAN F,YILDIZ ÖZER A,kesiktas n,Karan A,Muslumanoglu L The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi. 2011; 14(1): 1 - 8.
IEEE ARIKAN F,YILDIZ ÖZER A,kesiktas n,Karan A,Muslumanoglu L "The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial." Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 14, ss.1 - 8, 2011.
ISNAD ARIKAN, Firdevs vd. "The effectiveness of pulsed magnetic field theraphy i idiopathic Carpal Tunnel syndrome: A randomized, double blind, sham controlled trial". Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi 14/1 (2011), 1-8.