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Rheumatol Int ; 33(5): 1233-41, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23064542

RESUMEN

In carpal tunnel syndrome (CTS), manual therapy interventions (MTI) reduce tissue adhesion and increase wrist mobility. We evaluated the efficacy of a MTI in relieving CTS signs and symptoms. Twenty-two CTS patients (pts) (41 hands) were treated with a MTI, consisting in 6 treatments (2/week for 3 weeks) of soft tissues of wrist and hands and of carpal bones. Pts were assessed for hand sensitivity, paresthesia, hand strength, hand and forearm pain, night awakening; Phalen test, thenar eminence hypotrophy and Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Median nerve was studied by sensory nerve conduction velocity (SNCV) and distal motor latency (DML). CTS was scored as minimal, mild, medium, severe and extreme. We considered as control group the same pts assessed before treatment: at baseline (T0a) and after 12 weeks (T0b). Pts were evaluated at the end of treatment (T1) and after 24-week (T2) follow-up. At T0b, versus T0a, forearm pain and Phalen test positivity were increased and hand strength reduced (p < 0.05). BCTQ-SSS and BCTQ-FSS scores improved at T1 versus T0b (p < 0.05) with the amelioration maintained at T2. At T1, the number of pts with paresthesia, night awakening, hypoesthesia, Phalen test, hand strength reduction and hand sensitivity was reduced with the lacking of symptoms maintained at T2 (p < 0.05). No changes in SNCV, DML and CTS scoring were shown. MTI improved CTS signs and symptoms, with benefits maintained at follow-up. Thus, it may be valid as a conservative therapy.


Asunto(s)
Síndrome del Túnel Carpiano/terapia , Manipulaciones Musculoesqueléticas , Anciano , Análisis de Varianza , Fenómenos Biomecánicos , Síndrome del Túnel Carpiano/complicaciones , Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Carpiano/fisiopatología , Femenino , Fuerza de la Mano , Humanos , Italia , Masculino , Nervio Mediano/fisiopatología , Persona de Mediana Edad , Manipulaciones Musculoesqueléticas/efectos adversos , Conducción Nerviosa , Examen Neurológico , Dolor/etiología , Dolor/prevención & control , Dimensión del Dolor , Cooperación del Paciente , Satisfacción del Paciente , Proyectos Piloto , Valor Predictivo de las Pruebas , Rango del Movimiento Articular , Recuperación de la Función , Índice de Severidad de la Enfermedad , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/terapia , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Articulación de la Muñeca/fisiopatología
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