Table 2 - uploaded by Karl Ludwig Resch
Content may be subject to copyright.
Source publication
To assess the efficacy of ultrasound treatment for mild to moderate idiopathic carpal tunnel syndrome.
Randomised, double blind, "sham" controlled trial with assessments at baseline, after 2 weeks' and 7 weeks' treatment, and at a follow up assessment 6 months later (8 months after baseline evaluation).
Outpatient clinic of a university department...
Citations
... The rationale of using US therapy in carpal tunnel syndrome is based on results of some studies which showed its beneficial effects such as an anti-inflammatory effect, stimulation of nerve regeneration via enhanced blood flow, and membrane permeability, as well as improvement of conduction properties in the nerve. Activation of these mechanisms by US treatment might (in assumption) facilitate recovery from nerve compression [27,28]. Results of study by Ebenbichler et al., (1998) showed that pulsed ultrasound at frequency of 1MHz, and energy of 1,0 W/cm 2 applied to the palmar side of the wrist over 15 min for ten consecutive days, followed by twice weekly treatments for five additional weeks resulted in cessation of pain and nocturnal paresthesiae, improved sensation in the fingers innervated by the median nerve, increased grip and pinch strength and improved electrophysiological parameters. ...
... Activation of these mechanisms by US treatment might (in assumption) facilitate recovery from nerve compression [27,28]. Results of study by Ebenbichler et al., (1998) showed that pulsed ultrasound at frequency of 1MHz, and energy of 1,0 W/cm 2 applied to the palmar side of the wrist over 15 min for ten consecutive days, followed by twice weekly treatments for five additional weeks resulted in cessation of pain and nocturnal paresthesiae, improved sensation in the fingers innervated by the median nerve, increased grip and pinch strength and improved electrophysiological parameters. Treatment effects were observed up to 6 months [27]. ...
... Results of study by Ebenbichler et al., (1998) showed that pulsed ultrasound at frequency of 1MHz, and energy of 1,0 W/cm 2 applied to the palmar side of the wrist over 15 min for ten consecutive days, followed by twice weekly treatments for five additional weeks resulted in cessation of pain and nocturnal paresthesiae, improved sensation in the fingers innervated by the median nerve, increased grip and pinch strength and improved electrophysiological parameters. Treatment effects were observed up to 6 months [27]. However, with these measures. ...
Introduction. Carpal tunnel syndrome (CTS) can be treated with several methods, including surgical and non-surgical techniques. Non-surgical methods include wrist splinting, systemic pharmacotherapy, intracarpal injections of steroids hydrodissection, acupuncture, nerve and tendon mobilization, osteopathy, taping, topical application of ointments, laser, ultrasound and shock-wave therapies. These treatments are generally less effective than surgery, and provide only short-lived effect, but it may be quite sufficient for a certain category of patients, particularly those suffering from mild symptoms. Over the last years, these techniques have attracted increasing popularity, because they offer non-invasive option for surgical treatment what can be attractive for some patients. However, although these methods were shown in the literature, their actual effectiveness has not been scientifically verified. The objective of this study was a review of the effectiveness of non-operative methods of treatment of CTS. Methods. A review of the published literature from PubMed and Medline databases on the effectiveness of CTS non-operative treatments of was done. Results. The review indicates that each of the presented methods is effective in reduction of symptoms and improvement of hand function in CTS patients, but their effect is only short-lived. None of these treatments provides a permanent cure, like does surgical treatment. Conclusion. In spite of numerous non-operative treatments of CTS, surgery is the only method that provides permanent recovery.
... As a result, the biophysical properties of thermal US after the acute period would be favorable to ligament damage. Good outcomes for US therapy have been reported in patients with epicondylitis [29], carpal tunnel syndrome [30], calcific tendinitis of the shoulder [31], and chronic varicose ulcers [32]. ...
Introduction
Despite the fact that ultrasound (US) therapy is not advised for acute ankle sprains, its therapeutic effects may be beneficial for other stages of ankle sprains, such as a subacute ankle sprain. There is, however, a lack of evidence regarding the effects of US on pain relief and functional improvement in subacute ankle sprains. Therefore, this study aimed to determine the immediate effects of US on pain and plantar pressure in individuals with unilateral subacute ankle sprains.
Methods
Fifty-four participants with unilateral subacute ankle sprains (aged 16–55 years) were recruited and randomly allocated into a treatment group ( n = 27) and a control group ( n = 27). The treatment and control groups received a single intervention session of US and an ineffectual US, respectively. Pain intensity during weight-bearing and static and dynamic plantar pressures were assessed before and after receiving the intervention.
Results
In both groups, pain intensity was statistically reduced ( p < 0.05) and clinically relevant. Although the maximum plantar pressure in the hindfoot during static conditions was statistically higher in the control group ( p = 0.024), the values were still lower than MDC95.
Conclusions
A single treatment of US could clinically reduce pain, but it had no effect on altering plantar pressure in individuals with unilateral subacute ankle sprains.
... These include diuretics, pyridoxine, non-steroidal antiinflammatory drugs, yoga, steroid injections, US therapy, and acupuncture. 5 These techniques can decrease inflammation and provide some relief but do not always cause complete resolution of pain. Herein, we describe a patient with new-onset CTS whose treatment in the emergency department (ED) with combined local anesthetic and corticosteroid injection provided complete relief of symptoms. ...
Introduction
Carpal tunnel syndrome is an entrapment neuropathy that affects 3% of adults in the United States. The current techniques used for diagnosis have limited specificity/sensitivity, and the techniques used for treatment have limited efficacy.
Case Report
A 34-year-old female presented to the emergency department with two months of worsening painful paresthesias in her right thenar eminence. Ultrasound was performed showing a median nerve area of 20.4 square millimeters within the carpal tunnel. Median nerve block was performed within the carpal tunnel causing complete resolution of her pain.
Conclusion
Emergency physicians skilled in point-of-care ultrasound and needle-guided procedures can diagnose and treat carpel tunnel syndrome.
... The findings demonstrated that after the second and seventh weeks, as well as after six months, the patient's symptoms had significantly improved [38]. Some studies showed that there was minimal evidence of US treatment in the long term relief of CTS, despite the frequent results of the transitory benefits of ultrasound therapy [39,40]. A previous study only suggested that cases with mild to moderate idiopathic CTS would benefit from short to mediumterm ultrasound therapy [38]. ...
Background. Carpal tunnel syndrome (CTS) is a major health issue that can impede postpartum women's activities and skills in both their personal and professional lives. Purpose. To compare the effectiveness of low-level laser therapy (LLLT) and pulsed ultrasound (US) in relieving postpartum CTS. Methods. Forty-eight women with mild to moderate CTS were divided into three groups. In addition to wrist exercises, Group (A) (n = 16) received LLLT, Group (B) (n = 16) received pulsed US, and Group (C) (n = 16) performed wrist exercises alone. For all groups, the treatment sessions were applied to the affected hand, 3 sessions weekly for four weeks. All postpartum women were evaluated pre- and post-treatment via a visual analogue scale (VAS) for pain intensity, the Boston Questionnaire of CTS (BCTS) for diagnosing CTS symptoms, electromyography for measuring motor conduction velocity (MCV), sensory conduction velocity (SCV), motor distal latency (MDL), and sensory peak latency (SPL), and a hand grip dynamometer for assessing hand grip strength. Results. All measured variables were significantly improved in the three groups post-treatment compared to pre-treatment. Between-groups comparison showed a highly significant decrease in the VAS, BCTS, and SPL and a significant increase of SCV and hand grip strength between groups A and C in favor of group A and between groups B and C in favor of group B, while the significant change in MDL and MCV was found between groups A and C only in favor of group A (p < 0.05), with no significant change in all outcome measures between groups A and B (P > 0.05). Conclusion. Either LLLT or pulsed US are useful modalities that can be used as an effective conservative therapy for alleviating postpartum CTS.
... Some evidence states that peripheral nerves do in some manner respond to therapy with ultrasound, the results of early trials were not entirely conclusive, especially when it comes to the use of ultrasound in individuals. 11 High-intensity radiation would prevent neuron regeneration, whereas low-intensity therapeutic ultrasound delivered in minute doses would promote it, according to experimental research. This demonstrates that, as was shown in rats, ultrasonic exposure within a relatively narrow intensity range has a dose-related effect that is inversely proportionate. ...
Background: A variety of etiological factors that lead to peripheral nerve injury include crushing, traction, longfractures in bones, cutting injuries, entrapment neuropathies, infection, inflammation, and tumours of varyingdegrees. LIPUS has a variety of biological effects on tissues, including speeding up the regeneration of soft tissues,and lowering inflammatory reactions. In LLLT, low-level laser light with a wavelength of 808 nm is employed totrigger a biological reaction.Purpose: The objective of this study was to evaluate the functional recovery of low-level laser therapy (LLLT) andlow-intensity pulsed ultrasound (LIPUS) treating the sciatic nerve in rats.Methods: Using simple random sampling method and the inclusion and exclusion criteria, 18 rats in total werechosen. A mechanical crush will be performed for 30 seconds using haemostatic forceps. The study’s rats weredivided into 3 groups at random: Group A received ultrasound for 21 days; Group B received laser for 21 days;and Group C received no treatment. The toe spread assay was used to assess functional recovery 3 weeks aftersurgery. Result: All three groups are statistically significant (p<0.005) when analysed using one-way ANOVAduring intervention period (7th, 24th, 21st day) but LLLT & UST has shown better improvement in their functionalindex than the control group.Conclusion: According to the study’s findings, LLLT significantly outperforms LIPUS in improving the functionalrecovery of an experimentally induced rat model.
... Phonophoresis involves using ultrasound to enhance the absorption of various anti-inflammatory drugs through the skin. [7] In our study, phonophoresis treatment was applied at a 1 W/cm² dose, with 1 MHz frequency, in a 1:4 intermittent mode, [17][18][19] using 2.5% ketoprofen gel, consistent with other studies in the literature. Cagnie et al. [20] reported that 2.5% ketoprofen is better absorbed with 1 MHz, 1.5 W/cm², 5 minutes intermittent mode ultrasound compared to continuous mode and demonstrated ketoprofen's efficacy in reducing pain and inflammation. ...
Objectives:
Carpal Tunnel Syndrome (CTS) is the most common peripheral nerve compression syndrome. This study aims to evaluate the additive contribution of phonophoresis and low-level laser therapy (LLLT) to tendon and nerve gliding exercises electrophysiologically, ultrasonographically, and clinically in the treatment of moderate CTS.
Methods:
The sample consisted of 45 patients with moderate CTS, randomized into three groups. Group 1 received phonophoresis and exercise, Group 2 received LLLT and exercise, and Group 3 received exercise alone. Participants were evaluated electrophysiologically, clinically, and ultrasonographically before treatment and at the 6th and 12th weeks after the treatment.
Results:
An improvement was observed in clinical parameters (Boston Functional Status Scale, Boston Symptom Severity Scale, visual analog scale at rest, and visual analog scale during activity) for all groups at the 6th and 12th weeks after the treatment (p<0.05). An improvement was also noted in the ultrasonographic parameter (cross-sectional area) for all groups at the 12th week after the treatment (p=0.017).
Conclusion:
Phonophoresis and LLLT do not provide additional effects to exercise therapy. Exercise therapy alone may positively contribute to ultrasonographic and clinical outcomes in the treatment of moderate CTS.
... Surgical management are prescribed after failure of conservative treatment or patients with severe symptoms. 3,4 OCTR is a well-established surgical management of CTS. 5 OCTR has some complications including scar formation, scar tenderness, pillar pain, slow recovery, and higher incidence of persistent pain and weakness. OCTR remains the preferred surgical procedure for CTS in most orthopedic practices. ...
Key Clinical Message
Contractubex phonophoresis can be used in clinical setting to manage postsurgical scar after carpal tunnel release. Contractubex phonophoresis can improve pliability, height, and tenderness of the scar.
Abstract
Scar is one of the most common complications after open release of carpal tunnel. Scars are mentally and physically disturbing, and they can result into itching and pain. Scar after release of carpal tunnel can lead to compression of median nerve and failure of surgery. Various treatments are suggested for scar management. topical drugs are one of these treatments. Phonophoresis of topical drugs can enhance delivery of topical drugs. In present case, author report the effect of phonophoresis of Contractubex on postsurgical scar after carpal tunnel release. Result indicated that phonophoresis of Contractubex can be effective in scar management.
... [18,[20][21][22] However, the type, intensity, and frequency of US treatment and the methodological differences of the studies demonstrating the effectiveness of US reveal that the effectiveness of this treatment should be supported by placebo-controlled studies. [9,[18][19][20][21][22] In a study by Ebenbichler et al., [23] 45 patients with mild-to-moderate bilateral CTS were divided into two groups. The first group was given 1:4 pulsed US with an intensity of 1.0 W/cm 2 , while the second group received placebo US. ...
Objectives:
This study aimed to evaluate the efficiency of therapeutic pulsed ultrasound (US) applied underwater in mild-to-moderate carpal tunnel syndrome (CTS).
Patients and methods:
This randomized, placebo-controlled study included 75 patients (114 hands; 7 males, 68 females; mean age: 46.7±9.9 years; range, 24 to 64 years) diagnosed with CTS through clinical evaluation and electroneuromyography (ENMG) results between March 2012 and January 2013. Patients were randomized into three groups. Group 1 received underwater pulsed US, Group 2 received sham US, and Group 3 was the control group. All groups were given night splints. Patients were evaluated at baseline, at the end of treatment (two weeks), and 12 weeks after the treatment using clinical examination tests (Tinel, Phalen, and hand elevation test), hand grip strength, Visual Analog Scale (VAS) for pain, Pain Quality Assessment Scale (PQAS), and ENMG.
Results:
In all groups, a significant improvement was detected in the clinical assessment parameters, including the pain VAS, PQAS scores, physical examination outcomes, and hand grip strength. The decrease in VAS score and PQAS was found to be superior in the pulsed US group at both two weeks after the treatment and at the 12th week after the treatment compared to the sham US and control groups (p<0.001). Improvement in ENMG parameters, such as median motor latency, median sensorial velocity, and median sensory latency, was observed only in the underwater pulsed US group (p<0.001).
Conclusion:
Therapeutic underwater pulsed US is an effective, safe, and easy-to-apply treatment option in the conservative treatment of mild-to-moderate CTS.
... Also, TECAR's action can be compared to other deep heat modalities. Ebenbichler et al. (25) studied the efficacy of therapeutic ultrasound in patients with mild to moderate CTS. They showed improved clinical symptoms, and NCS parameters were also observed at the 6-month followup. ...
Background: Carpal tunnel syndrome (CTS) is the most typical peripheral entrapment neuropathy. To date, various non-invasive methods have been used to manage CTS. This study investigates the effectiveness of Transfer Energy Capacitive and Resistive (TECAR), a new physical agent modality, on symptoms and neurophysiological parameters in patients with CTS. Methods: In this single-blind randomized clinical trial, 29 patients with mild or moderate CTS were randomly assigned to two groups. Group 1 received TECAR therapy with a frequency of 500 Hz and an intensity of 30 to 50%, 2 sessions/week, in addition to wrist splints and vitamin B supplements for 4 weeks. Group 2 also received a wrist splint and vitamin B for 4 weeks without TECAR therapy. The Visual Analog Scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ-SSS and FSS), as well as clinical and neurophysiological findings, were assessed before and 8 weeks after treatment. Within and between-group comparisons were made after the intervention period. Results: VAS and the Boston Carpal Tunnel Questionnaire (FSS and SSS) showed significant changes. Clinical CTS tests and electrophysiological parameters did not show significant differences before and after the study. From a clinical perspective (pain relief and functional improvement), the TECAR therapy group showed more definite changes. Conclusions: TECAR can be considered an effective non-invasive treatment for patients with mild to moderate CTS.
... Median sinirin el bileği seviyesindeki karpal tünelde, transvers karpal bağ ve fleksör tendonlar arasında sıkışması sonucu meydana gelir. [1][2][3][4][5] Erişkin popülasyonda % 2 oranında, kadınlarda ise erkeklerden % 15 daha fazla görülür. Amerikan nöroloji akademisine göre genel populasyonda görülme oranı % 10'a kadar ulaşmaktadır. ...
... 3,7,[17][18][19][20] Bu yöntemler arasında terapatik ultrason uygulamaları, kan akımında ve doku metabolizmasında artma, aksonal fonksiyonda değişme, konnektif dokunun elastikiyetinin artması, biyolojik membranların geçirgenliğinin artması etkilerinden dolayı en sık kullanılan elektroterapi modalitesidir. 2,7,19,21 Karpal tünel sendromunda, klinik ve elektrodiagnostik kanıt olan bireylerde aralıklı pnömatik dekompresif bilek traksiyonu da yarar göstermektir. 14,17 KTS'nin tedavisindeki amaç karpal tünel içerisinde median sinirin kompresyonunun azaltılmasıdır. ...
... Tedavinin hedefleri arasında ağrı ve parestezinin azaltılması kas gücünün arttırılması, el fonksiyonlarının geliştirilmesi ve devam ettirilmesi ile hastanın eğitimi sayılabilir. 2 Olguların demografik verileri, gruplara göre dağılımı ve gruplar arası farkları fiziksel özellikleri Tablo 1 de gösterildi. ...
