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Cukurova Med J. 2012; 37(1): 17-26


The Effects of Steroid Phonophoresis on Clinical Parameters and Nerve Conduction Velocities in Carpal Tunnel Syndrome

Filiz Doğan-Akçam, Sibel Başaran, Rengin Güzel, Füsun Güler Uysal.

Abstract
Objective: This study was aimed to investigate the effects of steroid phonophoresis on electroneurophysiological and clinical parameters and to compare these effects with ultrasound (US) and sham US in carpal tunnel syndrome (CTS).
Material-Method: 39 patients with CTS (69 hands) were included in the study. Patients were randomized to phonophoresis (n=13 patients, 21 hands), US (n=13 patients, 24 hands) and sham US (n=13 patients, 24 hands) groups. Steroid phonophoresis, using dexamethasone as conductive agent, was applied at 1.0 W/cm2 to the phonophoresis group. Ultrasound at 1.0 W/cm2 and imitative US at 0.0 W/cm2 were applied to the US and sham US groups respectively. All groups were asked to perform tendon and nerve gliding exercises. Distal motor latency (mMDL) and sensory nerve conduction velocity (mSNCV) of median nerve, visual analogue scale (VAS) and Boston Scale were assessed at the beginning, 2nd week and in the 12th week.
Results: All of the variables were significantly improved in the 12th week in steroid phonophoresis group, whereas VAS, symptom severity and functional capacity of Boston scale were improved in US and sham US groups. mSNCV was also improved in sham US group. The differences between 12th week-pre treatment values (delta) were used for group comparisons. Delta values of electroneurophysiological parameters of phonophoresis group were found to be significantly different, whereas no significant differences were found between the groups for the other variables.
Conclusion: Steroid phonophoresis has favorable effects on electroneurophysiological studies and these effects last longer. Favorable effects on clinical findings and patient based assessments were observed in all groups. The improvements seen in sham US group may suggest the effectiveness of tendon and nerve gliding exercises.

Key words: Carpal tunnel syndrome, ultrasound, steroid phonophoresis, Boston Scale, EMG



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