• 제목/요약/키워드: carpal tunnel

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수근관 증후군의 Needle TENS, 초음파, 테이핑이 통증감소와 악력에 미치는 효과 (Effects of Pain Release and Power Grip after Apply Needle TENS, Ultrasound, Taping to Carpal Tunnel Syndrom Patients)

  • 한종만;공원태
    • 대한물리의학회지
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    • 제1권1호
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    • pp.49-57
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    • 2006
  • Purpose : The Purpose of this study was to pain release and power grip in wrist affect of needle TENS(utilized of TENS in electrotherapy with oriental needle) and ultrasound therapy and taping with carpal tunnel syndrome patients. Methods : To study divided of each groups. each groups were apply to ultrasound therapy for 5 mintus, Taping was attached from wrist joint to elbow joint medial epicondly after maximum extension. needle TENS application was following of median nerve in wrist. Result : 1. The pain was released on needle TENS, ultrasound and taping groups of all(p<.05). 2. Power grip was enhanced in needle TENS and taping groups(p<.05) but ultrasound was no difference compared with before therapy. 3. Compared with needle TENS and taping therapy about pain release was needle TENS groups better than ultrasound groups(p<.05) Conclusion : Needle TENS, taping therapy are more effectable than ultrasound therapy for grip power and pain release. Needle TENS therapy is more effectable than taping therapy for pain release. Therefor, neddle TENS therapy is most effectable for pain release with carpal tunnel syndrome patients.

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손목터널증후군 환자에서 당뇨병이 수술 후 전기생리학적 결과에 미치는 영향 (The Effect of Diabetes Mellitus on Postoperative Electrodiagnostic Outcomes of Carpal Tunnel Syndrome)

  • 곽중민;정영하;강석;윤준식
    • 대한근전도전기진단의학회지
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    • 제20권2호
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    • pp.91-97
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    • 2018
  • Objective: The aim of this study was to compare the electrodiagnostic outcomes of carpal tunnel release in patients with and without diabetes with carpal tunnel syndrome (CTS), and to evaluate the effect of diabetes mellitus (DM) on electrodiagnostic outcomes. Method: We conducted a retrospective analysis of 67 patients with electro-diagnostic evidence of CTS. Patients were classified into two groups according to the presence of DM. Both groups were evaluated using nerve conduction studies preoperatively and 3 weeks and 3 months postoperatively. Results: There were no statistical differences in any of the electrodiagnostic parameters between groups 3 weeks postoperatively. However, there were statistical differences in the amplitude and the latency of compound muscle action potential, and sensory nerve conduction velocity 3 months postoperatively. Conclusion: Patients with DM did not show a significantly different outcome 3 weeks after surgery but showed a worse electrodiagnostic outcome 3 months after surgery than those without DM.

Neuromodulation of the median nerve in carpal tunnel syndrome, a single-blind, randomized controlled study

  • Gevher Rabia Genc Perdecioglu;Mehlika Panpalli Ates;Damla Yuruk;Omer Taylan Akkaya
    • The Korean Journal of Pain
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    • 제37권1호
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    • pp.34-40
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    • 2024
  • Background: This study aimed to evaluate the efficacy of pulsed radiofrequency applied using transcutaneous electrodes in carpal tunnel syndrome (CTS). Methods: After randomization, the patients received two cycles of noninvasive pulsed radiofrequency (NiPRF), once weekly, or splinting (the control group) for three months. Clinical evaluations were recorded at baseline and weeks 4 and 8. The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to determine the functional status and symptom severity. Results: Sixty-two patients were followed up for three months. There was no difference between the groups in the BCTQ scores before and after treatment. The NiPRF group found a significant difference between the BCTQ measurements at all time intervals (paired sample t-test; P < 0.001). In the splint group, there was a significant difference only between the basal-1st month and basal-3rd month (paired samples t-test; P < 0.001). The main effect of the time variable was statistically significant (ANOVA; P < 0.001), but the group variable was not. There was no correlation between the BCTQ results measured at any time and the electroneuromyelogragphy findings in either group. Conclusions: NiPRF effectively improves symptoms and functionality in patients with CTS for up to 3 months. Thus, NiPRF can be considered an easy, safe, and useful alternative treatment modality for CTS.

Position Change of the Neurovascular Structures around the Carpal Tunnel with Dynamic Wrist Motion

  • Kwon, Jae-Yoel;Kim, Ji-Young;Hong, Jae-Taek;Sung, Jae-Hoon;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.377-380
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    • 2011
  • Objective : The purpose of this study was to determine the anatomic relationships between neurovascular structures and the transverse carpal ligament so as to avoid complications during endoscopic carpal tunnel surgery. Methods : Twenty-eight patients (age range, 35-69 years) with carpal tunnel syndrome were entered into the study. We examined through wrist magnetic resonance imaging in three different positions (neutral, radial flexion, and ulnar flexion) and determined several anatomic landmark (distance from the hamate hook to the median nerve, ulnar nerve, and ulnar vessel) based on the lateral margin of the hook of the hamate. The median nerve and ulnar neurovascular structure were studied with the wrist in the neutral, ulnar, and radial flexion positions. Results : The ulnar neurovascular structures usually passed just over or ulnar to the hook of the hamate. However, in 12 hands, a looped ulnar artery coursed 0.6-3.3 mm radial to the hook of the hamate and continued to the superficial palmar arch. The looped ulnar artery migrates on the ulnar side of Guyon's canal (-5.2-1.8 mm radial to the hook of the hamate) with the wrist in radial flexion. During ulnar flexion of the wrist, the ulnar artery shifts more radially beyond the hook of the hamate (-2.5-5.7 mm). Conclusion : It is appropriate to transect the ligament greater than 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the transverse carpal ligament in the ulnar flexed wrist position to protect the ulnar neurovascular structure.

Miniscalpel Needle Therapy with Integrative Korean Medical Treatment for Carpal Tunnel or Tarsal Tunnel Syndrome: Case Series of Three Patients

  • Kim, Jae Ik;Kim, Hye Su;Park, Gi Nam;Jeon, Ju Hyon;Kim, Jung Ho;Kim, Young Il
    • Journal of Acupuncture Research
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    • 제34권3호
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    • pp.139-152
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    • 2017
  • Objectives : This study reports the clinical effects of miniscalpel needle therapy in patients with carpal tunnel or tarsal tunnel syndrome. Methods : Three patients with carpal tunnel syndrome (CTS) or tarsal tunnel syndrome (TTS) (first case, patient with CTS and TTS; second case, patient with CTS; and third case, patient with TTS) were treated with miniscalpel needle (MSN) therapy and integrative Korean medical treatment. The Numeric Rating Scale (NRS), Neuropathic Pain Scale (NPS), Boston scale score, and AOFAS (American Orthopaedic Foot and Ankle Society) ankle-hindfoot score were measured. Results : In general, outcome measures after treatment showed improvement in all cases. In the first case (CTS and TTS), scores on the NRS, NPS, and Boston scale decreased, and AOFAS ankle-hind foot scores increased. In addition, Tinel's sign showed improvement. In the second case (CTS), scores on the NRS, NPS, and Boston scale, and Tinel's sign, were decreased. In the third case (TTS), scores on the NRS and NPS, and Tinel's sign, showed improvement, and AOFAS ankle-hind foot scores were increased. Conclusion : These results suggest that MSN therapy has a meaningful clinical effect in CTS and TTS.

상지역동학 치료가 수근관 증후군 환자의 통증, 악력, 신경전도속도에 미치는 효과 (The Effects of Upper Limb Neuro Dynamic Treatment on the Pain, Grip Strength and Nerve Conduction Velocity of Patients with Carpal Tunnel Syndrome)

  • 유성훈;박성두;김태원;송현승;김진영
    • 대한정형도수물리치료학회지
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    • 제18권1호
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    • pp.49-56
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    • 2012
  • Background: When applying the upper limb neurodynamic treatment ULNT1 and upper limb neurodynamic treatment ULNT2, The object of this study evaluates the pain and grip strength, nerve conduction velocity and tries to present the treatment that is effective in the carpal tunnel syndrome through the comparison of effect between tests. Methods: The ULNT1 (n=10) and ULNT2 (n=10) was applied to the carpal tunnel syndrome in patient of 20 subject for 10 time 5 set during 4 weeks. Both groups received conventional physical therapy (hot pack with 30 minutes and ICT with 15 minutes and ultra sound with 15 minutes). Results: The ULNT1 showed the difference which the result of this study significantly in the median nerve motor latency, median nerve motor amplitude, median nerve sensory latency, median nerve sensory amplitude, grip strength and pain. ULNT2 showed the difference significantly in median nerve motor latency, median nerve motor amplitude, median nerve sensory latency, median nerve sensory amplitude and pain. Conclusions: If it implements by applying the traditional physiotherapy and ULNT1 and ULNT2 to the carpal tunnel syndrome subjects according to the subject state and function, the remedial value can be more enhanced.

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수근관증후군에서 국소 스테로이드 주사 후 임상적, 전기생리학적 변화 (Clinical and Electrophysiological Changes after Local Steroid Injection in the Carpal Tunnel Syndrome)

  • 김지훈;이기욱;윤보라;김용덕;정언석;나상준
    • Annals of Clinical Neurophysiology
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    • 제15권1호
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    • pp.7-12
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    • 2013
  • Background: Local steroid injection is used to treat carpal tunnel syndrome (CTS). The aim of this study was to evaluate the clinical and electrophysiological effects of local steroid injection in patients with CTS over a 3-months period. Methods: Twenty-one patients (35 hands) with clinical and electrophysiological evidence of CTS were treated by injection of triamcinolone 40 mg to the carpal tunnel. Visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), rates of paresthesia, night awakening, and electrophysiological studies were used as outcomes. Clinical and electrophysiological assessments were performed before, 1 and 3 months after treatment. Results: Prior to treatment, 86% of patients complained of night awakening. At 1 and 3 months after injection, only 17% and 29% of the patients, respectively, had night awakening (p<0.001). All patients complained of paresthesia before the treatment. This symptom disappeared in 60% and 31% of the patients after 1 and 3 months, respectively (p<0.001). Compared to baseline, both BCTQ and VAS show significant improvement during the 3 months of the study (p<0.005). Although significant improvements in clinical parameters were shown, electrophysiological parameters were not significantly improved at 1 and 3 months. Conclusions: Local corticosteroid injection for the treatment of CTS provides significant improvement in symptoms for 3 months. On the other hand, no significant improvement was observed in electrophysiological parameters.

Predictive Value of Sensory Nerve Conduction in Carpal Tunnel Syndrome

  • Park, Sa-Kyuk;Lee, Jung-Ho;Lee, Hyuk-Gee;Ryu, Kee-Young;Kang, Dong-Gee;Kim, Sang-Chul
    • Journal of Korean Neurosurgical Society
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    • 제40권6호
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    • pp.401-405
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    • 2006
  • Objective : Electrodiagnostic test has shown diagnostic sensitivity and specificity in carpal tunnel syndrome[CTS]. This study was to evaluate the correlation between clinical outcome of endoscopic carpal tunnel ligament release[ECTR] and the predictive value of sensory nerve conduction. Methods : From January 1998 to December 2004, 87 patients [44 right hand, 37 left hand, 6 bilateral hands] with CTS who underwent ECTR were followed up in our hospital for an average of 24 months. We retrospectively analyzed the results with previous medical records. All patients underwent electrodiagnostic test and ECTR. The patients were divided into three groups according to the electrodiagnostic test results. Group [A] was normal sensory nerve response, Group [B] was slowing sensory response and Group [C] was no sensory response. Improvement of the symptom after ECTR was assessed using a visual analogue scale[VAS] score. Results : Differences between the three groups on the correlation of severity of sensory potential and duration of preoperative symptoms were significant. The mean value of improved VAS scores for the three groups were $6.0{\pm}0.96$ in the Group A, $6.11{\pm}0.48$ in the Group B and $6.14{\pm}0.53$ in the Group C. There was no statistically significant difference between the severity of sensory nerve response and improvement in VAS score after ECTR. Complications included a wound infection, a case of skin necrosis, and two patients with persistent symptoms without any improvement. Conclusion : Although electrodiagnostic test has been known to be useful, sensory nerve response is considered not to be a good prognostic value for carpal tunnel syndrome after ECTR.

수근관 증후군에 대한 임상적 고찰 (Clinical study on the Patients with Carpal tunnel syndrome)

  • 김일두;오희홍;변재영;문형철;고강훈;박소영;장병선
    • Journal of Acupuncture Research
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    • 제19권6호
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    • pp.61-66
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    • 2002
  • Objective : Carpal tunnel syndrome has gained increasing attention and acceptance as a significant cause of peripheral neuropathy, since it was first reported in 1836. The purpose of this study is to inspect the effect of oriental medical treatment on Carpal tunnel syndrome patients who is not come under surgical decompession. Methods : 20 patients who visited Won-Kwang University Hospital during the period from January 1998 to May 2000 were analysed for clinical manifestations. Results : 1. Among 20 patients, 3 were male and 17 were female. 2. The syndrome occurred on the right side in 5 patients, on the left side in 0 patients, and on both 15 patients 3. The most of causes were overwork. 4. Numbness was the most common symptom followed by night pain, paresthesis, morning stiffness, puffiness and resting pain 5. Among 20 patients, 12 were Tinel's sign positive, 16 were Phalen's test positive Conclusions : When the symptom is mild and duration is short, conservative treatment is effetive, but when neurological deficit is prominent and conservative treatment is not effective, surgical decompession is indicated. We treated 19 among 20 cases of the patients which Carpal Tunnel syndrome. We achieved effective results.

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Endoscopic Release of Carpal Tunnel Syndrome; Temporal Correlation between Symptomatic and Electrophysiologicallmprovements in Postoperative Carpal Tunnel Syndrome

  • Park, Jin-Soo;Yoo, Chan-Jong;Chun, Young-Il;Kim, Woo-Kyung;Lee, Sang-Gu;Park, Cheol-Wan
    • Journal of Korean Neurosurgical Society
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    • 제37권1호
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    • pp.8-15
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    • 2005
  • Objective: We evaluate temporal correlations between postoperative symptomatic and electrophysiological improvements, and assessed the recovery time required for patients with carpal tunnel syndrome(CTS) before returning to routine activities. Methods: 30 CTS patients were treated via the endoscopic monoportal approach, from March 2001 to September 2003. We assessed the symptoms (hyperesthesia in the finger tips, or abnormal sensations and painful numbness or night pain) and electrophysiological changes in the preoperative state, 1 month and 6 months after surgery. We marked the times at which patients became able to return to activities of daily living and work, after undergoing endoscopic carpal tunnel release. Results: At the end of the follow-up period, high levels of achievement and good outcomes were observed, with respect to both the symptoms and electrophysiological studies. We discovered significant differences between the preoperative and postoperative periods, especially in terms of motor nerve onset latency from $4.50{\pm}1.43$ to $3.97{\pm}0.69$ and sensory nerve conduction velocity, the wrist-to-finger from $19.81{\pm}10.03$ to $28.18{\pm}11.01$ and wrist-to-palm from $23.34{\pm}13.40$ to $31.79{\pm}13.38$(P<0.05 for each comparison). The average time interval required before return to activities of daily living was 26.4 days, and time interval required before return to work was 48.08 days. Conclusion: Electrophysiological improvements are largely consistent with symptomatic relief, but there is some disparity between electrophysiological and symptomatic improvement.