Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial
Yıl: 2012 Cilt: 27 Sayı: 1 Sayfa Aralığı: 38 - 46 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial
Öz: Amaç: Bu çalışmada, hafif karpal tünel sendromu (KTS) tedavisinde bazı konservatif yöntemlerle birlikte uygulanan deksametazon iyontoforezi veya ultrason veya plasebo iyontoforezin (deksametazonsuz) etkinliği karşılaştırıldı.Hastalar ve yöntemler: Elektromiyografi ile doğrulanmış hafif KTS tanılı 58 hasta çalışmaya dahil edildi. Hastalar rastgele üç gruba ayrıldı: (i) deksametazon iyontoforezi ile tedavi edilen iyontoforez grubu (n=20); (ii) ultrason ile tedavi edilen grup (n=20) ve (iii) plasebo iyontoforezi uygulananlar (n=18). Bu tedavilerden biri, tüm hastalara üç aylık tendon ve sinir kaydırma egzersizleri, gece splinti ve aktivite modifikasyonları gibi fizyoterapi prosedürleri ile beraber 15 seans uygulandı. Tedavinin başında, tedavi sonunda ve tedavi bitiminden sonra takip sırasında 3. ayda el bileği eklem hareket açıklığı ve kas testleri, Görsel Analog Skalası (VAS), el sıkma testi, pinçmetre ölçümleri, monofilaman ile duyu testleri, iki nokta diskriminasyon testi, Phalen, ters Phalen, Tinel ve karpal kompresyon testleri, Sağlık Değerlendirme Anketi (HAQ), Boston Sorgulama Anketi (BQ) ve elektrofizyolojik ölçümler değerlendirildi. İstatistiksel analiz SPSS (versiyon 10.0, Windows) yazılımı kullanılarak yapıldı.Bulgular: Çalışma sonunda tüm grupların klinik değerlendirmelerinde istatistiksel olarak anlamlı iyileşmeler görüldü (p<=0.05). Ultrason ve plasebo grubu ile karşılaştırıldığında, iyontoforez grubunda daha başarılı sonuçlar alındı; KTS'li hastaların üç ay sonraki takiplerinde pinçmetre, monofilaman, iki nokta diskriminasyon testleri ve BQ skorlarında istatistiksel anlamlı iyileşme gözlemlendi (p<=0.05). İyontoforez ve ultrason grubunda yapılan elektrofizyolojik ölçümlerde de, istatistiksel olarak anlamlı iyileşmeler kaydedildi (p<=0.05).Sonuç: Bu çalışmanın sonuçları, hafif KTS'li hastaların deksametazon iyontoforezi, tendon kaydırma egzersizleri, splint ve aktivite modifikasyonu ile beraber tedavisinin güvenilir ve etkili olduğunu önermektedir. Ancak, bulgularımızı destekleyen daha geniş ölçekli başka çalışmalara da ihtiyaç vardır.
Anahtar Kelime: Konular:
Karpal Tünel Sendromunun Tedavisinde Bazı Kombine Konservatif Yöntemlerin Etkinliği: Randomize, Kontrollü, Klinik ve Elektrofizyolojik Bir Çalışma
Öz: Objectives: In this study, we aimed to compare the efficacy of some conservative methods in combination with dexamethasone iontophoresis, ultrasound therapy or placebo iontophoresis (without dexamethasone) in the treatment of mild carpal tunnel syndrome (CTS). Patients and methods: Fifty-eight patients diagnosed with mild CTS confirmed by electromyography were included in the study. The subjects were divided randomly into three groups: (i) iontophoresis group-treated with dexamethasone iontophoresis (n=20); (ii) ultrasound group-treated with ultrasound (n=20), and (iii) placebo group-treated with placebo iontophoresis (n=18). All patients received one of these treatments in 15 sessions for three months in combination with physiotherapeutic procedures, such as tendon/nerve gliding exercises, night splinting and activity modifications. Wrist range of motion, muscle test, the Visual Analog Scale (VAS), handgrip test, pinch meter measurement, sensory testing with monofilaments, two-point discrimination test, Phalen's, reverse Phalen's, Tinnel's and carpal compression test, the Health Assessment Questionnaire (HAQ), the Boston Questionnaire (BQ) and electrophysiological assessment were performed at baseline, at the end of therapies and at threemonths during follow-up. Statistical analysis was performed using SPSS software (version 10.0 for Windows). Results: Statistically significant improvements in the clinical status of all groups were observed at the end of the study (p<=0.05). Compared to ultrasound group and placebo group, more successful outcomes were seen in the iontophoresis group, resulting in statistically significant improvements in the pinch meter measurements, monofilament and two-point discrimination tests, and in BQ scores at three months during follow-up (p<=0.05). A statistically significant improvement was also recorded in the electrophysiological measurements in the iontophoresis group and ultrasound group (p<=0.05). Conclusion: Our study results suggest that dexamethasone iontophoresis administration combined with tendon gliding exercises, splint and activity modification is reliable and effective in the treatment of patients with mild CTS. However, further large-scale studies are required to confirm these findings
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | DUYMAZ T, SİNDEL D, kesiktas n, Muslumanoglu L (2012). Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. , 38 - 46. |
| Chicago | DUYMAZ Tomris,SİNDEL Dilşad,kesiktas nur,Muslumanoglu Lutfiye Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. (2012): 38 - 46. |
| MLA | DUYMAZ Tomris,SİNDEL Dilşad,kesiktas nur,Muslumanoglu Lutfiye Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. , 2012, ss.38 - 46. |
| AMA | DUYMAZ T,SİNDEL D,kesiktas n,Muslumanoglu L Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. . 2012; 38 - 46. |
| Vancouver | DUYMAZ T,SİNDEL D,kesiktas n,Muslumanoglu L Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. . 2012; 38 - 46. |
| IEEE | DUYMAZ T,SİNDEL D,kesiktas n,Muslumanoglu L "Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial." , ss.38 - 46, 2012. |
| ISNAD | DUYMAZ, Tomris vd. "Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial". (2012), 38-46. |
| APA | DUYMAZ T, SİNDEL D, kesiktas n, Muslumanoglu L (2012). Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. Turkish Journal of Rheumatology(.)Archives of Rheumatology, 27(1), 38 - 46. |
| Chicago | DUYMAZ Tomris,SİNDEL Dilşad,kesiktas nur,Muslumanoglu Lutfiye Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. Turkish Journal of Rheumatology(.)Archives of Rheumatology 27, no.1 (2012): 38 - 46. |
| MLA | DUYMAZ Tomris,SİNDEL Dilşad,kesiktas nur,Muslumanoglu Lutfiye Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. Turkish Journal of Rheumatology(.)Archives of Rheumatology, vol.27, no.1, 2012, ss.38 - 46. |
| AMA | DUYMAZ T,SİNDEL D,kesiktas n,Muslumanoglu L Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2012; 27(1): 38 - 46. |
| Vancouver | DUYMAZ T,SİNDEL D,kesiktas n,Muslumanoglu L Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2012; 27(1): 38 - 46. |
| IEEE | DUYMAZ T,SİNDEL D,kesiktas n,Muslumanoglu L "Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial." Turkish Journal of Rheumatology(.)Archives of Rheumatology, 27, ss.38 - 46, 2012. |
| ISNAD | DUYMAZ, Tomris vd. "Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial". Turkish Journal of Rheumatology(.)Archives of Rheumatology 27/1 (2012), 38-46. |
