Investigation of the Efficiency of Radial Extracorporeal Shock Wave Therapy at Different Pulses in Carpal Tunnel Syndrome

Ahi Evran University Education and Research Hospital

Status: Completed

Conditions: Carpal Tunnel Syndrome

Treatments: Device: extracorporeal shockwave therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT06321276

AEU-FTR-ID-01

Details and patient eligibility

About

Different parameters have been used in studies investigating the efficacy of extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome. Although extracorporeal shock wave therapy has been shown to have a positive effect on carpal tunnel syndrome, there is no consensus on which pulse rate is more effective. Therefore, in this study, the efficacy of extracorporeal shock wave therapy applied at different pulse rates in the treatment of carpal tunnel syndrome will be examined.

Full description

The study included 72 patients with CTS aged 18-65 years who applied to Kırşehir Ahi Evran University Training and Research Hospital Physical Therapy and Rehabilitation Center.

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. In CTS, the median nerve is compressed within the carpal canal, about 1 to 2 cm beyond the distal wrist crease. It is more common in women and is typically more severe in the dominant hand but is often bilateral. Repetitive hand and wrist movements, such as using a keyboard or vibrating tools, have been associated with CTS. Medical conditions associated with CTS include diabetes, hypothyroidism and RA, as well as obesity and pregnancy. Rarely, CTS may be caused by a mass lesion in the wrist, such as a ganglion cyst or neurofibroma, or may be associated with acute trauma to the wrist. The vast majority of CTS cases are idiopathic.

CTS treatment is divided into conservative and surgical treatment. Conservative treatment methods are recommended in mild and moderate CTS patients, while surgical treatment is recommended in severe cases.

Extracorporeal Shock Wave Therapy is one of the physical therapy applications used in the treatment of Carpal Tunnel. The effectiveness of ESWT in the treatment of CTS will be examined

Enrollment: 98 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female patients aged 18-65 years with carpal tunnel syndrome diagnosed clinically and by EMG
• Patients who can correctly understand what is stated in the patient information form and who can cooperate
• Patients who consent to participate in the study according to the informed consent form will be included in the study.

Exclusion criteria

• Cervical radiculopathy
• Polyneuropathy
• Brachial plexopathy
• Use of systemic corticosteroids or local corticosteroid injections
• History of fracture and trauma in the forearm and wrist on the treated side
• Inflammatory rheumatic disease
• Pregnant and lactating patients
• Systemic diseases such as renal failure, peptic ulcer, DM, hypothyroidism, coagulation disorder
• Patients undergoing carpal tunnel syndrome surgery
• People with pacemakers
• Thoracic outlet syndrome
• Tenar atrophy, severe carpal tunnel syndrome

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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98 participants in 3 patient groups

two thousand pulse ESWT Group

Active Comparator group

Description:

ESWT will be applied to the patient's wrist and conventional treatment consisting of hand-wrist rest splint and nerve gliding exercises will be applied. The point of the ESWT site was located by ultrasonography interfaced with a 5-12 MHz linear array transducer, and the median nerve was visualized at the line of the proximal carpal tunnel (scaphoid pisiform level). (0,06 mj/mm2, 2000 impulses, 4 bar) (Modus ESWT Radial Shockwave Therapy)

Treatment:

Device: extracorporeal shockwave therapy

one thousand pulse ESWT Group

Active Comparator group

Description:

ESWT will be applied to the patient's wrist and conventional treatment consisting of hand-wrist rest splint and nerve gliding exercises will be applied. The point of the ESWT site was located by ultrasonography interfaced with a 5-12 MHz linear array transducer, and the median nerve was visualized at the line of the proximal carpal tunnel (scaphoid pisiform level). (0,06 mj/mm2, 1000 impulses, 4 bar) (Modus ESWT Radial Shockwave Therapy)

Treatment:

Device: extracorporeal shockwave therapy

Conventional Control Group

No Intervention group

Description:

The patient will receive conventional treatment consisting of hand-wrist rest splint and nerve gliding exercises as directed by the physiotherapist