Effectiveness of Carpal Tunnel Syndrome Rehabilitation after Endoscopic Versus Open Surgical Release

Chmielewska, Daria; Skęczek-Urbaniak, Aneta; Kubacki, J; Błaszczak, Edward; Kwaśna, Krystyna

doi:10.5604/15093492.1084354

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…The 2-point discrimination test was carried out in accordance with the guidelines of the American Society of Hand Surgery. A distance ≤ 6 mm was adopted as a normal result of the discrimination test [22]. The therapeutic program applied in the subjects included 10 whirlpool massage sessions of the hand, sonotherapy and median nerve glide exercises, which the subjects repeated as homework.…”

Section: Ijomeh 2019;32(2)mentioning

confidence: 99%

Factors determining the effectiveness of conservative treatment in patients with carpal tunnel syndrome

Zwolińska

Kwołek

2019

Int J Occup Med Environ Health

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Objectives: The study aims to assess selected factors contributing to the long-term effects of the conservative treatment of carpal tunnel syndrome (CTS). Material and Methods: Forty-nine individuals diagnosed with CTS were enrolled in the study. The symptoms resulted from occupational hand overuse in 37 patients. The assessment involved 78 hands before the therapy (study 1) and 1 year after the end of the therapy (study 2). The clinical symptoms assessed included: pain, numbness, tingling, morning stiffness, vegetative disorders and difficulties in activities of daily living (ADL). The range of motion (ROM) in the hand joints and the pressure generated during the cylindrical grip were measured. Phalen's tests, an electrodiagnostic test and a 2-point discrimination study were performed. Results: A significant reduction of symptoms and improvement in tested parameters were found in study 2. The largest ROM in the hand, the lowest level of pain and the largest reduction in the frequency of daytime tingling were found in the oldest patients in study 2. In subjects with better initial electrodiagnostic test results, a significant reduction in daytime numbness and daytime tingling was obtained. In individuals previously subjected to conservative therapy, a significant improvement in the ROM of the hand and a better quality of sensation were noted in study 2. A higher level of pain, a lower reduction in the frequency of daytime tingling, and a smaller improvement in ADL capacity were noted in individuals who overused their hands at work after the therapy. Conclusions: The effects of conservative CTS treatment after 1 year, expressed as the reduction of subjective symptoms, were independent of the patient's age. A worse initial electrodiagnostic test result is a predictor of less favorable therapy results. Hand overuse during occupational activity may negatively affect the effects of conservative treatment in individuals with CTS. A change in the nature of occupational activity positively influenced the long-term maintenance of the effects of conservative treatment.

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Section: Ijomeh 2019;32(2)mentioning

confidence: 99%

Factors determining the effectiveness of conservative treatment in patients with carpal tunnel syndrome

Zwolińska

Kwołek

2019

Int J Occup Med Environ Health

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“…7 Since this report, multiple studies have investigated the benefit of several postoperative therapy modalities, including splinting, electrical stimulation, cold treatment, contrast baths, extremity elevation, topical application of herbal remedies, and a comprehensive rehabilitation regimen. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Some of these investigations suggest that postoperative rehabilitation is beneficial, while most of the studies conducted suggest that there is no benefit and that the additional cost is unjustifiable. In 2013, Peters et al performed a comprehensive review of the studies that have investigated the benefit of postoperative 812155H ANXXX10.1177/1558944718812155HANDGil et al research-article2018 1 The Warren Alpert Medical School of Brown University, Providence, RI, USA rehabilitation after carpal tunnel release.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Evaluation of the Effect of Supervised Hand Therapy After Carpal Tunnel Surgery

Gil

Weiss

Kleiner

et al. 2018

Hand (New York, N,Y.)

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Background: The objective of this investigation is to examine the effect of postoperative therapy after routine carpal tunnel release. Our hypothesis was that supervised hand therapy does not improve outcomes after routine carpal tunnel release. Methods: Patients with carpal tunnel syndrome were randomly assigned to one of 3 groups based on the last digit of their medical record numbers to one of 3 groups: standard 6-week postoperative rehabilitation (standard therapy), expedited one-session postoperative rehabilitation group (expedited therapy), and no postoperative rehabilitation group (no therapy). The primary outcome measures were Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and return to work. The outcome questionnaire was completed preoperatively, at the 2-week follow-up visit, and monthly to 6 months after surgery. Results: All 3 treatment groups had similar mean QuickDASH scores preoperatively. At 1- to 6-month follow-up, all 3 groups had similar QuickDASH scores at each visit, and all showed a significant decline from baseline (preoperative) QuickDASH score. Overall, QuickDASH score decreased significantly from a preoperative visit mean of 42.7 to a final postoperative (visit 8) mean of 6.69. There was no significant difference in the mean QuickDASH score among all 3 groups at 6-month follow-up. There was no significance in the time of return to work among the 3 groups (standard therapy, 21.8 days; expedited therapy, 20.9 days; no therapy, 16.6 days). Conclusions: This investigation adds evidence that supervised hand therapy does not improve the outcomes of routine carpal tunnel surgery as measured by QuickDASH and return to work.

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“…The worldwide CTS incidence ranges from 0.1-11.7%, demonstrating numerous and varied diagnostic criteria, including electromyography parameters and ultrasonography [4][5][6][7]. CTS symptoms, including median nerve paresthesia, can dramatically decrease a patient's physical activity and quality of life, resulting in a significant medical and financial burden to the healthcare system [8]. Conservative treatments such as immobilization and physiotherapy are applied in mild and moderate CTS forms, and patients with contraindications to surgery [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Short and Long-Term Effects of Pulsed Wave and Continuous Wave Ultrasound for the Treatment of Carpal Tunnel Syndrome: A Randomized Clinical Trial

Zwolińska¹

2020

International Journal of Physiotherapy

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Background: Sonotherapy is used in carpal tunnel syndrome (CTS) treatment; continuous or pulsed ultrasound waves are commonly used. The aim was to assess the short and long-term effects of CTS treatment using continuous and pulsed ultrasound waves. Methods: This study was a randomized clinical trial. Forty-eight patients with mild and moderate CTS (20 unilateral and 28 bilateral) were subjected to complex physiotherapy. Complex physiotherapy included whirlpool massage, neuromobilization, and sonotherapy (continuous wave and pulsed wave ultrasound). The patients were randomly placed in two treatment groups and were subjected to sonotherapy with continuous or pulsed ultrasound waves. Seventy-six hands were assessed before, immediately after, and one year after treatment. Outcome measures included the Boston Carpal Tunnel Questionnaire (CTS SSS & FSS), computer-measured global handgrip force, provocative and functional tests, assessments of vegetative disorders, and sensation disorders. Results: Significant improvements in symptoms and parameters were observed after sonotherapy in both groups immediately after and one year after treatment. Long-term effects of CTS SSS & FSS for pulsed-wave amounted to p=0.0018, p=0.0001 while p=0.0003, p=0.0021 for continuous wave, respectively. Between the groups, a statistically significant difference was found in the change of muscle strength (p=0.0374) and Luthy's sign result (p=0.0262) between examination one and examination 3. Conclusions: Short and long-term effects of continuous and pulsed ultrasound wave in CTS treatment is comparable. Effects are influenced by energy density transmitted to tissues. Pulsed wave appears more effective in the long-term in improving the condition of hand muscles.

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Effectiveness of Carpal Tunnel Syndrome Rehabilitation after Endoscopic Versus Open Surgical Release

Cited by 4 publications

References 2 publications

Factors determining the effectiveness of conservative treatment in patients with carpal tunnel syndrome

Factors determining the effectiveness of conservative treatment in patients with carpal tunnel syndrome

A Prospective Evaluation of the Effect of Supervised Hand Therapy After Carpal Tunnel Surgery

Short and Long-Term Effects of Pulsed Wave and Continuous Wave Ultrasound for the Treatment of Carpal Tunnel Syndrome: A Randomized Clinical Trial

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