ASSESSMENT OF THE LONG TERM EFFECTIVENESS OF DIFFERENT PHYSIOTHERAPY PROGRAMS OF REHABILITATION FOR PATIENTS WITH CARPAL TUNNEL SYNDROME

Background: Carpal tunnel syndrome (CTS) is the most common compression neuropathy of the upper extremity, which leads to aggravated venous blood flow, oedema, microcirculation disturbances, and consequently - a broad spectrum of clinical manifestations. Laser biostimulation and pulsed electromagnetic field (PEMF) therapy are the most commonly recommended physiotherapeutic methods of CTS treatment. Objectives: The aim of this study was to compare the effects of two different physiotherapy programs in the rehabilitation of patients with CTS. Methods: Single-blind prospective clinical trial included 38 patients with diagnosed idiopathic CTS, confirmed by electroneurographic (ENG) examination. Clinical assessment, including pain severity rating on the VAS scale, the presence of paresthesia and functional tests, was conducted in the following stages: before treatment (phase 0), after the first series consisted of 10 sessions (phase I), after the two-week break between series (phase II), after the second series of 10 sessions (phase III), and six months after the end of treatment (phase IV). The both series of sessions were performed daily with one weekend-break. All patients were randomly assigned to 2 groups: group A (18 patients) was treated with laser biostimulation (LB) while group B (20 patients) had PEMF and LB therapy. LB therapy was performed using LAI-71 laser adapted to pulsation mode in the 904 range, median frequency 150mW. Total energy per treatment was 50 J, frequency 10 000 Hz and duration of one session 5 minutes and 33 seconds. For the PEMF therapy, Magnetronic MF-10 (frequencies of 10 – 40 Hz, induction 1,0-5,0 mT), was used. Patients of group B received in one session 15 minutes of the PEMF therapy and after 15 minutes break the LB therapy (according to the mode of group A). Results: In the both patients groups, after the first series of treatment, a significant reduction in pain and paresthesia were observed (p<0.05). After the second series of the therapy further reduction in night pain, paresthesia, as well as the incidence of Phalen's symptoms were noticed in group A and group B (p<0.05). Six months after treatment completion, an increase in symptoms was observed. However, in both groups the differences were not significant in comparison to the values after the second series of treatment. Although significant differences between groups were not found, the therapy in group B was more effective in comparison with group A. Conclusion: Our findings confirm that both treatment programs should be applied at least in two series, while the greatest efficacy was observed immediately after the second series. The therapeutic effect persists for up to six months after treatment. Moreover, in comparison with LB therapy, the combination of LB and PEMF treatment is more effective. Disclosure of Interest: None declaredCitation: Annals of the Rheumatic Diseases, volume 69, supplement 3, year 2010, page 619Session: Back pain, mechanical musculoskeletal problems, local soft tissue disorders (Poster Presentations )