ORIJINAL ARAŞTIRMA
Karpal Tünel Sendromunda Ekstrakorporeal Şok Dalgası Tedavisi ve Kortikosteroid İyontoforezi Tedavisinin Etkinliğinin Karşılaştırılması: Prospektif Randomize Çalışma
Comparison of the Therapeutic Efficacy of Extracorporeal Shock Wave Therapy Versus Corticosteroid Iontophoresis in Carpal Tunnel Syndrome: A Prospective Randomized Study
Received Date : 30 Apr 2021
Accepted Date : 27 Sep 2021
Available Online : 01 Oct 2021
Kasım OSMANOĞLUa, Mustafa Turgut YILDIZGÖRENa, Hayal GÜLERa, Ayşe Dicle TURHANOĞLUa
aDepartment of Physical Medicine and Rehabilitation, Mustafa Kemal University Faculty of Medicine, Hatay, TURKEY
Doi: 10.31609/jpmrs.2021-84159 - Makale Dili: EN
J PMR Sci. 2022;25(1):63-72
ÖZET
Amaç: Karpal tünel sendromlu (KTS) hastalarda radyal ekstrakorporeal
şok dalgası tedavisi [radial extracorporeal shock wave therapy
(r-ESWT)] ve kortikosteroid iyontoforez [corticosteroid
iontophoresis (CI)] tedavisinin etkinliğini karşılaştırmak. Gereç ve
Yöntemler: Bu randomize prospektif çalışmaya, ortalama yaşları
42,2±8,7 yıl (22-59) olan 54 hastanın, KTS tanısı konulan 72 bileği
dâhil edildi. Hastalar rastgele 2 gruba ayrıldı. Grup 1 (n=37) r-ESWT
aldı ve Grup 2 (n=35) CI aldı. Hastalar vizüel analog skala (VAS), Boston
Semptom Şiddeti Ölçeği (BSŞÖ), Boston Fonksiyonel Durum Ölçeği
(BFDÖ), kavrama gücü ve elektrofizyolojik inceleme kullanılarak
başlangıçta ve tedavi sonrası 0, 1 ve 3. ayda değerlendirildi. Bulgular:
Başlangıç ile karşılaştırıldığında, tedaviden 0, 1 ve 3. ay sonra VAS,
BSŞÖ, BFDÖ, kavrama gücü değerleri her iki grupta da önemli ölçüde
iyileşti (tümü p<0,001). Ancak sinir ileti çalışması sonuçları sadece r-
ESWT grubunda anlamlı olarak iyileşti (tümü p<0,001). Gruplar arası
değişim seviyeleri karşılaştırıldığında, VAS’da azalma (tümü p<0,001),
BSŞÖ’de iyileşme (sırasıyla p=0,029, p=0,023 ve p=0,040), BFDÖ (sırasıyla
p<0,001, p=0,001 ve p<0,001), kavrama gücü (tümü p<0,001),
duyusal sinir iletim hızı (sırasıyla p=0,001, p<0,001 ve p<0,001) ve
distal motor latensi (p=0,001, p=0,001 ve p<0,001), tedaviden önce ve
tedaviden 0, 1 ve 3 ay sonra, r-ESWT grubunda CI grubuna göre anlamlı
derecede daha yüksekti. Sonuç: Bu çalışma, her iki yöntemin
KTS’de ağrıyı azaltmada ve fonksiyonu iyileştirmede yararlı olduğunu,
ancak r-ESWT’nin CI’dan daha etkili olduğunu ortaya koymuştur.
Anahtar Kelimeler: Karpal tünel sendromu; radyal ekstrakorporeal şok dalgası tedavisi; iyontoforez
ABSTRACT
Objective: To compare the effectiveness of radial extracorporeal
shock wave therapy (r-ESWT) and corticosteroid iontophoresis
(CI) in patients with carpal tunnel syndrome (CTS).
Material and Methods: This randomized prospective study included
a total of 72 wrists diagnosed with CTS of 54 patients with a mean age
of 42.2±8.7 years (range, 22-59 years). The patients were randomly
separated into two groups. Group 1 (n=37) received r-ESWT, and
Group 2 (n=35) received CI. Evaluations were made at baseline and at
0, 1 and 3 months after treatment using the visual analog scale (VAS),
Boston Symptom Severity Scale (BSSS), Boston Functional Capacity
Scale (BFCS), grip strength, and electrophysiological examination. Results:
Compared to baseline, the VAS, BSSS, BFCS, grip strength values
at the 0, 1 and 3 months after treatment improved significantly in
both groups (all p<0.001). However the nerve conduction study results
were significantly improved only in r-ESWT group (all p<0.001).
When the change levels were compared between the groups, the decrease
in VAS (all p<0.001), the improve in BSSS (p=0.029, p=0.023
and p=0.040, respectively), BFCS (p<0.001, p=0.001 and p<0.001, respectively),
grip strength (all p<0.001), sensory nerve conduction velocity
(p=0.001, p<0.001 and p<0.001, respectively) and distal motor
latency (p=0.001, p=0.001 and p<0.001, respectively) before and at 0,
1 and 3 months after treatment were significantly higher in the r-ESWT
group than the CI group. Conclusion: This study revealed that both
methods were useful in alleviating pain and improving function in CTS,
however r-ESWT seems to be more effective than CI.
Keywords: Carpal tunnel syndrome; radial extracorporeal shock wave therapy; iontophoresis
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