Effectiveness of Ultrasound Plus Nerve Gliding Exercise with and without Low-level Laser Therapy in Patients with Moderate Carpal Tunnel Syndrome
-
Amirhossein Ghasemi
,
Gholam Reza Olyaei
,
Hossein Bagheri
,
Mohammad Reza Hadian Rasanani
,
Shohre Jalaei
,
Khadijeh Otadi
Abstract
Introduction: Although carpal tunnel syndrome (CTS) is an incident entrapment neuropathy disorder, there has been inadequate evidence about the effect evaluation of adding low-level laser therapy to ultrasound (US) plus median nerve glide exercises in these patients. Hence, this research investigated the trace of US plus median nerve glide exercises with and without low-level laser therapy (LLLT).
Materials and Methods: Thirty-six patients with moderate CTS in two groups of intervention were assessed. One group received 10 sessions of adding LLLT to median nerve glide exercises plus US and the other group received median nerve glide exercises plus US without LLLT. Outcome measures were hand grip strength (HGS), visual analogue scale (VAS), Boston questionnaire (BQ), and cross-sectional area (CSA) of the median nerve.
Results: Baseline analysis revealed similarities between the two groups in all parameters. Statistical analysis indicated significant improvement of HGS, VAS, BQ, and CSA of the median nerve in two groups of intervention.
Conclusion: In patients with CTS, US and median nerve glide exercises with and without LLLT significantly improved without the superiority of adding LLLT to mentioned treatment.
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Rayegani SM, Bahrami MH, Eliaspour D, Raeissadat SA, Samakoosh MS, Sedihgipour L, et al. The effects of low intensity laser on clinical and electrophysiological parameters of carpal tunnel syndrome. Journal of Lasers in Medical Sciences. 2013; 4(4):182-9. [PMID] [PMCID]
Raeissadat A, Reza SZ. Study of long term effects of laser therapy versus local corticosteroid injection in patients with carpal tunnel syndrome. Lasers in Medical Science. 2010; 1(1):24-30. [Link]
Page MJ, O’Connor D, Pitt V, Massy-Westropp N. Exercise and mobilisation interventions for carpal tunnel syndrome. Cochrane library: Cochrane reviews. 2012; (6):CD009899. [DOI:10.1002/14651858.CD009899]
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Chen PC, Wang LY, Pong YP, Hsin YJ, Liaw MY, Chiang CW. Effectiveness of ultrasound-guided vs direct approach corticosteroid injections for carpal tunnel syndrome: A double-blind randomized controlled trial. Journal of Rehabilitation Medicine. 2018; 50(2):200-8. [DOI:10.2340/16501977-2308] [PMID]
Kim JC, Jung SH, Lee SU, Lee SY. Effect of extracorporeal Shockwave therapy on carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine. 2019; 98(33):e16870. [DOI:10.1097/MD.0000000000016870] [PMID] [PMCID]
Bartkowiak Z, Eliks M, Zgorzalewicz-Stachowiak M, Romanowski L. The effects of nerve and tendon gliding exercises combined with low-level laser or ultrasound therapy in carpal tunnel syndrome. Indian Journal of Orthopaedics. 2019; 53:347-52. [DOI:10.4103/ortho.IJOrtho_45_17] [PMID] [PMCID]
Rayegani SM, Moradi-Joo M, Raeissadat SA, Bahrami MH, Seyed-Nezhad M, Heidari S. Effectiveness of low-level laser therapy compared to ultrasound in patients with carpal tunnel syndrome: A systematic review and meta-analysis. J Lasers in Medical Science. 2019; 10(Suppl 1):S82-9. [DOI:10.15171/jlms.2019.S15] [PMID] [PMCID]
Fowler JR, Hirsch D, Kruse K. The reliability of ultrasound measurements of the median nerve at the carpal tunnel inlet. The Journal of Hand Surgery. 2015; 40(10):1992-5. [DOI:10.1016/j.jhsa.2015.07.010] [PMID]
Haghighat S, Zabihi Z, Khosrawi S. Effects of low-level laser therapy with wrist splinting on outcome of patients with carpal tunnel syndrome; a randomized, double-blind, placebo-controlled trial. International Journal of Medical Investigation. 2018; 7(4):5-14. [Link]
Barbosa RI, da Silva Rodrigues EK, Tamanini G, Marcolino AM, Elui VM, de Jesus Guirro RR, et al. Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: Design of a randomized single-blinded controlled trial. BMC Musculoskeletal Disorders. 2012; 13:1-5. [DOI:10.1186/1471-2474-13-248] [PMID] [PMCID]
Butler DS. Mobilization of the nervous system. Amsterdam: Elsevier; 1991. [Link]
Boonstra AM, Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. International Journal of Rehabilitation Research. 2008; 31(2):165-9. [DOI:10.1097/MRR.0b013e3282fc0f93]
Baker NA, Moehling KK, Desai AR, Gustafson NP. Effect of carpal tunnel syndrome on grip and pinch strength compared with sex-and age-matched normative data. Arthritis Care & Research. 2013; 65(12):2041-5. [DOI:10.1002/acr.22089] [PMID] [PubMed]
Leite JC, Jerosch-Herold C, Song F. A systematic review of the psychometric properties of the Boston carpal tunnel questionnaire. BMC Musculoskeletal Disorders. 2006; 7(1):1-9. [DOI:10.1186/1471-2474-7-78] [PMID] [PMCID]
Cohen J. Statistical power analysis for the behavioral sciences. New York: Routledge; 2013. [PERSIA]
Tai TW, Wu CY, Su FC, Chern TC, Jou IM. Ultrasonography for diagnosing carpal tunnel syndrome: A meta-analysis of diagnostic test accuracy. Ultrasound in Medicine & Biology. 2012; 38(7):1121-8. [DOI:10.1016/j.ultrasmedbio.2012.02.026] [PMID]
Li ZJ, Wang Y, Zhang HF, Ma XL, Tian P, Huang Y. Effectiveness of low-level laser on carpal tunnel syndrome: A meta-analysis of previously reported randomized trials. Medicine. 2016; 95(31):e4424. [DOI:10.1097/MD.0000000000004424] [PMID] [PMCID]
Lim YH, Chee DY, Girdler S, Lee HC. Median nerve mobilization techniques in the treatment of carpal tunnel syndrome: A systematic review. Journal of Hand Therapy. 2017; 30(4):397-406. [DOI:10.1016/j.jht.2017.06.019] [PMID]
Vikranth GR, Kumar VK, Mathias L. Comparative effect of carpal bone mobilization versus neural mobilization in improving pain, functional status and symptoms severity in patients with carpal tunnel syndrome. International Journal of Physiotherapy. 2015; 2(3):524-30. [DOI:10.15621/ijphy/2015/v2i3/67025]
Cheung WK, Wu IX, Sit RW, Ho RS, Wong CH, Wong SY, et al. Low-level laser therapy for carpal tunnel syndrome: Systematic review and network meta-analysis. Physiotherapy. 2020; 106:24-35. [DOI:10.1016/j.physio.2019.06.005] [PMID]
Goodyear-Smith F, Arroll B. What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management. The Annals of Family Medicine. 2004; 2(3):267-73. [DOI:10.1370/afm.21] [PMID] [PMCID]
Jenkins DB. Hollinshead's functional anatomy of the limbs and back-e-book. Amesterdam: Elsevier Health Sciences; 2008. [Link]
Shi Q, MacDermid JC. Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? A systematic review. Journal of Orthopaedic Surgery and Research. 2011; 6:1-9. [DOI:10.1186/1749-799X-6-17] [PMID] [PMCID]
Yildirim P, Dilek B, Şahin E, Gülbahar S, Kizil R. Ultrasonographic and clinical evaluation of additional contribution of kinesiotaping totendon and nerve gliding exercises in the treatment of carpal tunnel syndrome. Turkish Journal of Medical Sciences. 2018; 48(5):925-32. [DOI:10.3906/sag-1709-72] [PMID]
Fusakul Y, Aranyavalai T, Saensri P, Thiengwittayaporn S. Low-level laser therapy with a wrist splint to treat carpal tunnel syndrome: A double-blinded randomized controlled trial. Lasers in Medical Science. 2014; 29:1279-87. [DOI:10.1007/s10103-014-1527-2] [PMID]
Rayegani SM, Bahrami MH, Eliaspour D, Raeissadat SA, Samakoosh MS, Sedihgipour L, et al. The effects of low intensity laser on clinical and electrophysiological parameters of carpal tunnel syndrome. Journal of Lasers in Medical Sciences. 2013; 4(4):182-9. [PMID] [PMCID]
Raeissadat A, Reza SZ. Study of long term effects of laser therapy versus local corticosteroid injection in patients with carpal tunnel syndrome. Lasers in Medical Science. 2010; 1(1):24-30. [Link]
Page MJ, O’Connor D, Pitt V, Massy-Westropp N. Exercise and mobilisation interventions for carpal tunnel syndrome. Cochrane library: Cochrane reviews. 2012; (6):CD009899. [DOI:10.1002/14651858.CD009899]
Page MJ, O'Connor D, Pitt V, Massy-Westropp N. Therapeutic ultrasound for carpal tunnel syndrome. Cochrane Database of Systematic Reviews. 2013(3):CD009601 [DOI:10.1002/14651858.CD009601.pub2] [PMCID]
Chen PC, Wang LY, Pong YP, Hsin YJ, Liaw MY, Chiang CW. Effectiveness of ultrasound-guided vs direct approach corticosteroid injections for carpal tunnel syndrome: A double-blind randomized controlled trial. Journal of Rehabilitation Medicine. 2018; 50(2):200-8. [DOI:10.2340/16501977-2308] [PMID]
Kim JC, Jung SH, Lee SU, Lee SY. Effect of extracorporeal Shockwave therapy on carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine. 2019; 98(33):e16870. [DOI:10.1097/MD.0000000000016870] [PMID] [PMCID]
Bartkowiak Z, Eliks M, Zgorzalewicz-Stachowiak M, Romanowski L. The effects of nerve and tendon gliding exercises combined with low-level laser or ultrasound therapy in carpal tunnel syndrome. Indian Journal of Orthopaedics. 2019; 53:347-52. [DOI:10.4103/ortho.IJOrtho_45_17] [PMID] [PMCID]
Rayegani SM, Moradi-Joo M, Raeissadat SA, Bahrami MH, Seyed-Nezhad M, Heidari S. Effectiveness of low-level laser therapy compared to ultrasound in patients with carpal tunnel syndrome: A systematic review and meta-analysis. J Lasers in Medical Science. 2019; 10(Suppl 1):S82-9. [DOI:10.15171/jlms.2019.S15] [PMID] [PMCID]
Fowler JR, Hirsch D, Kruse K. The reliability of ultrasound measurements of the median nerve at the carpal tunnel inlet. The Journal of Hand Surgery. 2015; 40(10):1992-5. [DOI:10.1016/j.jhsa.2015.07.010] [PMID]
Haghighat S, Zabihi Z, Khosrawi S. Effects of low-level laser therapy with wrist splinting on outcome of patients with carpal tunnel syndrome; a randomized, double-blind, placebo-controlled trial. International Journal of Medical Investigation. 2018; 7(4):5-14. [Link]
Barbosa RI, da Silva Rodrigues EK, Tamanini G, Marcolino AM, Elui VM, de Jesus Guirro RR, et al. Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: Design of a randomized single-blinded controlled trial. BMC Musculoskeletal Disorders. 2012; 13:1-5. [DOI:10.1186/1471-2474-13-248] [PMID] [PMCID]
Butler DS. Mobilization of the nervous system. Amsterdam: Elsevier; 1991. [Link]
Boonstra AM, Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. International Journal of Rehabilitation Research. 2008; 31(2):165-9. [DOI:10.1097/MRR.0b013e3282fc0f93]
Baker NA, Moehling KK, Desai AR, Gustafson NP. Effect of carpal tunnel syndrome on grip and pinch strength compared with sex-and age-matched normative data. Arthritis Care & Research. 2013; 65(12):2041-5. [DOI:10.1002/acr.22089] [PMID] [PubMed]
Leite JC, Jerosch-Herold C, Song F. A systematic review of the psychometric properties of the Boston carpal tunnel questionnaire. BMC Musculoskeletal Disorders. 2006; 7(1):1-9. [DOI:10.1186/1471-2474-7-78] [PMID] [PMCID]
Cohen J. Statistical power analysis for the behavioral sciences. New York: Routledge; 2013. [PERSIA]
Tai TW, Wu CY, Su FC, Chern TC, Jou IM. Ultrasonography for diagnosing carpal tunnel syndrome: A meta-analysis of diagnostic test accuracy. Ultrasound in Medicine & Biology. 2012; 38(7):1121-8. [DOI:10.1016/j.ultrasmedbio.2012.02.026] [PMID]
Li ZJ, Wang Y, Zhang HF, Ma XL, Tian P, Huang Y. Effectiveness of low-level laser on carpal tunnel syndrome: A meta-analysis of previously reported randomized trials. Medicine. 2016; 95(31):e4424. [DOI:10.1097/MD.0000000000004424] [PMID] [PMCID]
Lim YH, Chee DY, Girdler S, Lee HC. Median nerve mobilization techniques in the treatment of carpal tunnel syndrome: A systematic review. Journal of Hand Therapy. 2017; 30(4):397-406. [DOI:10.1016/j.jht.2017.06.019] [PMID]
Vikranth GR, Kumar VK, Mathias L. Comparative effect of carpal bone mobilization versus neural mobilization in improving pain, functional status and symptoms severity in patients with carpal tunnel syndrome. International Journal of Physiotherapy. 2015; 2(3):524-30. [DOI:10.15621/ijphy/2015/v2i3/67025]
Cheung WK, Wu IX, Sit RW, Ho RS, Wong CH, Wong SY, et al. Low-level laser therapy for carpal tunnel syndrome: Systematic review and network meta-analysis. Physiotherapy. 2020; 106:24-35. [DOI:10.1016/j.physio.2019.06.005] [PMID]
| Files | ||
| Issue | Vol 17 No 2 (2023) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v17i2.12413 | |
| Keywords | ||
| Carpal tunnel Ultrasonic therapy Nerve mobilization Low-level laser therapy Cross-sectional study | ||
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How to Cite
1.
Ghasemi A, Olyaei GR, Bagheri H, Hadian Rasanani MR, Jalaei S, Otadi K. Effectiveness of Ultrasound Plus Nerve Gliding Exercise with and without Low-level Laser Therapy in Patients with Moderate Carpal Tunnel Syndrome. jmr. 2023;17(2):149-155.
