Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Physical therapy versus radial extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome: A randomized-controlled study(2022) Saglam, Gonca; Alisar, Dilek Cetinkaya; Ozen, Selin; 35949973Objectives: This study aims to compare the efficacy of physical therapy (PT) and radial extracorporeal shock wave therapy (rESWT) in the treatment of carpal tunnel syndrome (CTS). Patients and methods: Between May 2020 and July 2020, a total of 125 wrists of 95 patients (22 males, 73 females; mean age: 54.3 +/- 11.3 years; range, 19 to 69 years) with mild-to-moderate CTS were allocated into three groups. The control group (Group 1, n=42) was treated with splinting and an exercise program. Group 2 (n=42) was treated with a total of three sessions of rESWT, splinting and an exercise program. Group 3 (n=41) was treated with a total of 15 sessions of PT modalities, splinting, and an exercise program. Each patient was evaluated before, three weeks and 12 weeks after treatment using a Visual Analog Scale (VAS), the Boston Carpal Tunnel Questionnaire (BCTQ), the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale, and electrodiagnostic testing. Results: The reduction in VAS, BCTQ, LANSS, and improvement in sensory nerve conduction velocity were significantly greater at three and 12 weeks of follow-up in Groups 2 and 3, compared to Group 1 (p<0.001). A greater improvement was observed in all clinical parameters in Group 2, compared to Group 3 (p<0.001). Conclusion: This is the first study to compare the treatment outcomes of PT and rESWT in the treatment of CTS. The results of this study show that both PT and rESWT are effective in the treatment of CTS; however, rESWT yields superior treatment effects compared to conventional PT. The practicalities of administering rESWT and its efficacy in the treatment of CTS may make it the treatment of choice.Item Ultrasonographic And Electrophysiological Outcomes Of Carpal Tunnel Syndrome Treated With Low-Level Laser Therapy: A Double-Blind, Prospective, Randomized, Sham-Controlled Study(2022) Nalbant, Merve; Yemisci, Oya Umit; Ozen, Selin; Tezcan, Sehnaz; https://orcid.org/0000-0002-0501-5127; 35949869; AAJ-8820-2021Objectives: The aim of this study was to investigate the therapeutic effects of low-level laser therapy (LLLT) on clinical, ultrasonographic (US), and electrophysiological findings in carpal tunnel syndrome (CTS). Patients and methods: Between January 2015 and August 2015, 42 patients (7 males, 35 females; mean age: 50.4 +/- 8.7 years; range, 32 to 65 years) with mild-to-moderate CTS were randomly assigned to one of two groups: active LLLT (therapy group, n=22) 0.8 J/painful point and sham LLLT groups (n=20). Both groups wore neutral wrist orthoses. The patients were evaluated before and after 15 sessions of therapy (670 nm, 4 J/session over the carpal tunnel). Follow-up parameters included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (SSS), Functional Status Scale (FSS), nerve conduction studies and US evaluation of the median nerve cross-sectional area (CSA), vascularization (via power Doppler), flattening ratio (FR), and palmar bowing of the flexor retinaculum. Results: Nocturnal paresthesia improved in both groups; however, pain and patients with a positive Phalen's test reduced only in the therapy group (p=0.031). The FSS and SSS scores also improved only in the therapy group (p<0.001). Electrophysiologically, median sensory nerve conduction velocities showed a significant improvement only in the therapy group (p=0.002). The CSA, FR, and vascularization of the median nerve showed a significant improvement in the therapy group alone (p<0.001, p=0.048, and p=0.021, respectively). Conclusion: Improvements in the signs and symptoms of CTS and hand function, the improvements in sensory nerve conduction studies, and reduction in median nerve CSA, FR and vascularity in the LLLT group can be attributed to the anti-inflammatory and analgesic effects of LLLT. This study provides new US data demonstrating efficacy of LLLT along with a clinical and electrophysiological improvement. The LLLT seems to be an easily applied, non-invasive treatment option.Item Intraneural Vascular Resistive Index of the Median Nerve as a Predictor of Severity of Carpal Tunnel Syndrome(2020) Pekoz, Burcak Cakir; Pekoz, Mehmet Taylan; Analan, Pinar Doruk; 0000-0002-3528-3712; AAA-8043-2021Objective: There is a limited data about resistive index (RI) of median nerve (MN) in patients with carpal tunnel syndrome (CTS). In our study, we aimed to evaluate the relationship between CTS severity and MN-RI. Methods: A total of 115 CTS patient wrists, and 49 wrists of control subjects without CTS, were examined on ultrasonography (US) and color Doppler US (CDUS), pulsed Doppler ultrasonography (PDUS), and by electrophysiological evaluations. MN peak-systolic velocity (MN-PSV), MN end-diastolic velocity, MN-RI and MN pulsatility index (MN-PI) were measured by PDUS. Patients were divided into 3 groups according to electrophysiological examinations severity findings of CTS as mild (Group-I), moderate (Group-II), and severe (Group-III). Results: MN-PSV, MN-PI and MN-RI increased significantly from Group-I to Group-III and these parameters were significantly higher in Group-III than other two groups. MN-RI independently determines the patients to have severe CTS. Increased MN-RI (per-0.1) was found to increase the risk of having severe CTS by 3.45-times. In the ROC analysis, the area under the curve was 0.846 for MN-RI. When the MN-RI cut-off value was taken as 0.80, it determines patients to be severe CTS with 85.2% sensitivity and 78.2% specificity. Conclusion: The increase in MN-RI in CTS patients is independently associated with disease severity and may be used in the clinical follow-up of these patients.Item Parvovirus B19-induced acute bilateral carpal tunnel syndrome in twin girls(2015) Sakalli, Hale; Baskin, Esra; Dener, Sefik; 26422355We describe 2 cases of 6-year-old twin girls presenting with acute carpal tunnel syndrome (CTS) associated with human parvovirus B19 (HPV-B19) infection, as evidenced by serological data and detection of HPV-B19 DNA in blood with use of polymerase chain reaction (PCR). To our knowledge, this is the first time that HPV-B19 infection has been suggested as the causal agent of simultaneous acute bilateral CTS in twins, thus presenting the possibility that similar immunologic responses can be observed in twins during viral infections.Item The effect of smartphone usage on the median nerve(2018) Ilik, Faik; Buyukgol, Huseyin; Eren, Fatma A.; Ilik, Mustafa K.; Kayhan, Fatih; Kose, HaticePurpose: The aim of this study was to examine the effects of smartphone use on the median nerve. Materials and Methods: Participants were classified into three groups according to their smartphone use frequencies; high smartphone users (with Smartphone addiction scale (SAS) score of higher than 71), low smartphone users (SAS score less than 71) and classical type mobile phones users. The Visual analogue scale (VAS), quick-disabilities of arm, shoulder, hand (qDASH) and median nerve conductions of the participants were assessed. Groups were compared to each other as well as dominant and non-dominant hand nerve measurements of participants were also compared. Results: VAS and qDASH values were not significantly different between groups. It was observed that the rare use of smartphones affected the median nerve conductions in a lesser manner compared to the classical mobile phone use. However, using smart phone in an increasing rate influenced the median nerves adversely. Conclusion: Excessive use of smartphone can lead to carpal tunnel syndrome via affecting the median nerve. In recent decades, there has been a widespread use of smartphones even at the level of addiction. This should be noted while designing the smartphones and voice applications should be used more often. Furthermore, it can be beneficial to follow up the median nerve conductions of patients who are addicted to smartphones with the help of electrophysiological studies.