ORIJINAL ARAŞTIRMA
Karpal Tünel Sendromu Tanısı Almış Kadınlarda El Bilek Eklem Hareket Açıklığının ve El Kavrama Gücünün Değerlendirilmesi: Kontrollü Çalışma
Evaluation of Wrist Range of Motion and Hand Grip Strength in Women with the Diagnosis of Carpal Tunnel Syndrome: A Controlled Study
Received Date : 08 Aug 2019
Accepted Date : 23 Jan 2020
Available Online : 05 Feb 2020
Nurdan PAKERa, Mehmet ALPb, Ayşe Nur BARDAKa, Derya BUĞDAYCIa, Feride SABIRLIa, Sedef ERSOYa
aİstanbul Physical Medicine and Rehabilitation Training and Research Hospital, İstanbul, TURKEY
bPrivate Memorial Şişli Hospital, Clinic of Orthopedics and Traumatology, İstanbul, TURKEY
Doi: 10.31609/jpmrs.2019-70503 - Makale Dili: EN
J PMR Sci. 2020;23(2):57-61
ÖZET
Amaç: Karpal tünel sendromu (KTS) toplumda en sık görülen
tuzak nöropatidir. Erken tanı konulduğu zaman farmakolojik ve farmakolojik
olmayan yöntemlerle kolayca tedavi edilebilir. Bu
çalışmanın amacı karpal tünel sendrom tanısı almış kadınlarda el bileği
hareket açıklığı ve kavrama kuvvetini değerlendirmek ve kontrol grubu
ile karşılaştırmak idi. Gereç ve Yöntemler: Kesitsel çalışmamıza elektrofizyolojik
olarak hafif- orta şiddette bilateral karpal tünel sendromu
tanısı almış 28 kadın dahil edildi. Kontrol grubu yaş ve cinsiyet eşitliği
sağlanmış sağ el dominant olan sağlıklı 41 gönüllüden oluşuyordu. El
bileği eklem hareket açıklığı (EHA) gonyometre ile ölçüldü.
Uygulayıcılar arası ve test uygulamaları arası güvenilirlik çalışmaları
için, çalışmanın başında 10 sağlıklı gönüllüde bilek EHA ölçümleri
yapıldı. Sınıf içi korelasyon katsayısı (SKK) hesaplandı. El kavrama
kuvveti, hidrolik el dinamometresi ile ölçüldü. Bulgular: KTS ve kontrol
grubunda el bileği ekstansiyon derecesi sırasıyla 62,66°±15,56°ve
77°±9,9° idi. El bileği fleksiyon derecesi KTS’e 57,66°±11,89°, kontrol
grubunda 67,38°±4,7° idi. Hasta ve kontrol grubundaki ortalama
kavrama kuvveti sırasıyla 15,32±7,27 kg ve 40,40±7,80 kg idi
(p<0,001). SKK değerleri uygulamalar arası güvenilirliği için 0.61-0.98
arasındaydı, SKK değerleri 0.76-0.97 arasındaydı. KTS grubundaki el
bileği fleksiyonu, ekstansiyonu ve radial, ulnar deviasyon derecesi ve
el kavrama kuvveti kontrol grubundan anlamlı derecede düşük olarak
değerlendirildi (p<0.00). Sonuç: KTS’li hastalar, sağlıklı kontrol grubu
ile karşılaştırıldığında el bilek hareketlerinde ve el kavrama kuvvetinde
azalma görülebilir. El bileği EHA ve el kavrama kuvvetini
değerlendirmek, KTS değerlendirmesinde kullanılabilecek ölçülebilir
parametrelerdir.
Anahtar Kelimeler: Karpal tünel sendromu; el bileği; eklem hareket açıklığı; el kavrama kuvveti
ABSTRACT
Objective: Carpal tunnel syndrome (CTS) is the most
common entrapment neuropathy in the community. When diagnosed
early, it can be easily treated by pharmacological and non-pharmacological
methods. The aim of this study was to evaluate wrist range of
motion (ROM) and grip strength in women diagnosed with carpal tunnel
syndrome and to compare the results with those of the controls. Material
and Methods: Twenty-eight women with bilateral CTS were
included in this cross-sectional study. The control group consisted of 41
healthy age and gender matched volunteers who had right hand dominancy.
Wrist range of motions (ROM) were measured by goniometer.
For the intrarater and interrater reliability studies, wrist ROM measurements
were performed in 10 healthy volunteers at the beginning of the
study. Intraclass correlation coefficient (ICC) values were calculated.
Grip strength was measured by hydraulic hand dynamometer. Results:
Wrist extension values in the CTS and control groups were
62.66±15.56° and 77±9.9°, respectively. Wrist flexion values were
57.66±11.89° in the CTS and 67.38±4.7° in the control groups. The
mean grip strength values in the patient and control groups were
15.32±7.27 kg and 40.40±7.80 kg, respectively (p<0.001). The ICC values
were between 0.61-0.98 for the intrarater reliability, ICC values
were between 0.76-0.97. Wrist flexion, extension, radial, ulnar deviation
and hand grip strength were significantly lower in the CTS group
than the control group (p<0.00). Conclusion: Wrist ROM and hand
grip strength of patients with CTS resulted in decreased wrist movements
and hand grip strength when they were compared with the healthy
control group. Evaluating wrist ROM and hand grip strength are
measurable parameters that can be used in CTS assessment.
Keywords: Carpal tunnel syndrome; wrist; range of motion measurement; hand grip strength
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