Ayşe SARIFAKIOĞLU, Aliye YILDIRIM GÜZELANT

Karpal Tünel Sendromunda Fizik Tedavi Modalitelerinin Etkinliği; Klinik Deneyimlerimiz

Amaç: Karpal tünel sendromu (KTS), median sinirin karpal tünelde tuzaklanmasıyla gelişen, vücutta en sık görülen tuzak nöropatidir. Yaygın kullanılmasına rağmen, fizik tedavi ajanlarının KTS tedavisindeki yeri hala açık değildir. Bu çalışma ile KTS tanılı hastalarda, fizik tedavi modalitelerinden ultrason (US) tedavisinin etkinliğini değerlendiren klinik deneyimlerimiz paylaşılmıştır. Materyal-Metod: Kliniğimiz fizik tedavi ünitesinde tedavi almış KTS tanılı hastalar retrospektif olarak incelenmiştir. Hastaların demografik verileri, klinik ve muayene bulguları kaydedilmiştir. Hastaların tedavi öncesi ve tedavi sonrası klinik durumları; vizuel analog skalası, Boston karpal tünel sendromu anketi, Beck depresyon ve anksiyete ölçekleri ile değerlendirilmiştir. Bulgular: Çalışmaya 24 hasta (20 kadın, 4 erkek), 43 el alınmıştır. Hastaların yaş ortalaması 51.95±10.10 idi. Hastalarda en sık görülen semptomlar; uyuşma (41 el, %95.34), ağrı (36 el, %83.72), flick işareti (27 el, %62.79) idi. Hastaların muayene bulgularından; 36 elde Tinel pozitifliği (%83.72), 33 elde Phalen testi pozitifliği (%76.74), 4 elde tenar atrofi bulgusu (%0.09) saptandı. Değerlendirmeye alınan 22 elde hafif, 18 elde orta, 3 elde ise ileri evre KTS saptandı. Değerlendirilen tüm klinik ölçeklerde istatistiksel anlamlı iyileşme saptanmıştır. Sonuç: Sonuç olarak, KTS tedavisinde US kolay uygulanabilen, invazif olmayan, etkin bir tedavi yöntemidir. Etki derecesi ve etki süresinin daha net olarak belirlenebilmesi için, daha geniş serilerle yapılacak, kontrollü klinik çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Karpal tünel sendromu, fizik tedavi, ultrason, Boston karpal tünel sendromu anketi

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Aim Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, developed by entrapment of the median nerve in the carpal tunnel. Despite widespread use, the effectiveness of physical therapy agents in the treatment of CTS is still not clear. In this study, our clinical experience of evaluating the efficacy of ultrasound (US) therapy in patients with CTS has been shared. Materials and Methods A diagnosis of CTS patients who received treatment in our physical therapy unit were analyzed retrospectively. Demographic data, clinical and physical examination findings were recorded. Before and after treatment, patients’ clinical scales, as visual analog scale, the Boston carpal tunnel syndrome questionnaire, Beck depression and anxiety scales were evaluated. Results 24 patients (20 women and 4 men), 43 hands included in the study. The mean age of patients was 51.95 ± 10.10 years. The most common symptoms in patients were; numbness (41 hands, 95.34%), pain (36 hands, 83.72%), flick mark (27 hands, 62.79%), respectively. In the examination findings; 36 Tinel sign (83.72%), 33 positive Phalen test (76.74%), 4 evidence of thenar atrophy (0.09%) were detected. 22 hand were obtained as mild stage of CTS, 18 hand were obtained as moderate stage of CTS, 3 hand were obtained as advanced stage of CTS. In all clinical measurements significant improvement were determined. Conclusion As a result, US is easy to apply, non-invasive, effective method of treatment of CTS. In order to determine the activity and duration of action more clearly, more clinical trials with larger series are needed

Keywords:

Carpal tunnel syndrome, physical therapy, ultrasound, Boston carpal tunnel syndrome questionnaire,

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