The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome.

S M J Shooshtari, V Badiee, S H Taghizadeh, A H Nematollahi, A H Amanollahi, M T Grami
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Abstract

Objectives: Carpal tunnel syndrome (CTS) is the most common neuropathy that can be diagnosed with confidence by the nerve conduction study (NCS). One of the recent treatments of CTS is the application of low power laser (LPL) therapy. The present study evaluates the effects of LPL irradiation through NCS and clinical signs and symptoms.

Methods: A total of 80 patients were included in this study. Diagnosis of CTS was based on both clinical examination and electromyographic (EMG) findings. Patients were randomly assigned into two groups. Test group (group A) underwent laser therapy (9-11 joules/cm2) over the carpal tunnel area. Control group (group B) received sham laser therapy. Pain, hand grip strength, median proximal sensory and motor latencies, transcarpal median sensory nerve conduction (SNCV) were recorded. After fifteen sessions of irradiation (five times per week), parameters were recorded again and clinical symptoms were measured in both groups. Pain was evaluated by Visual Analog Scale (VAS; day-night). Hand grip was measured by Jamar dynometer. Paired t-test and independent sample t-test were used for statistical analysis.

Results: There was a significant improvement in clinical symptoms and hand grip in group A (p < 0.001). Proximal median sensory latency, distal median motor latency and median sensory latencies were significantly decreased (p < 0.001). Transcarpal median SNCV increased significantly after laser irradiation (p < 0.001). There were no significant changes in group B except changes in clinical symptoms (p < 0.001).

Conclusions: Laser therapy as a new conservative treatment is effective in treating CTS paresthesia and numbness and improves the subjects' power of hand grip and electrophysiological parameters.

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低水平激光对腕管综合征临床预后及神经生理结果的影响。
目的:腕管综合征(Carpal tunnel syndrome, CTS)是最常见的神经病变,可通过神经传导研究(NCS)准确诊断。低功率激光(LPL)治疗是近年来治疗CTS的一种方法。本研究通过NCS和临床体征和症状来评价LPL照射的效果。方法:本研究共纳入80例患者。CTS的诊断是基于临床检查和肌电图(EMG)结果。患者被随机分为两组。实验组(A组)在腕管区域进行激光治疗(9-11焦耳/cm2)。对照组(B组)采用假激光治疗。记录疼痛、手部握力、正中近端感觉和运动潜伏期、经腕正中感觉神经传导(SNCV)。15次照射(每周5次)后,再次记录两组的各项参数,并测量两组的临床症状。采用视觉模拟量表(VAS)评估疼痛;昼夜)。握力测量采用贾马尔测速仪。采用配对t检验和独立样本t检验进行统计分析。结果:a组患者临床症状及握力均有显著改善(p < 0.001)。近端正中感觉潜伏期、远端正中运动潜伏期和正中感觉潜伏期显著降低(p < 0.001)。激光照射后,经scarapres中位SNCV显著升高(p < 0.001)。除临床症状改变外,B组无明显变化(p < 0.001)。结论:激光治疗作为一种新的保守治疗方法,可有效治疗CTS患者的感觉异常和麻木,改善了手握力和电生理参数。
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