Document Type : Original Articles

Authors

• Hamid Azade ¹
• Alireza Jamshidi fard ²
• Fatemeh Ansari ³
• Soghra Jokar ⁴

¹ PhD, Assistant Professor, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

² PhD, Assistant Professor, Department of physiology, School of Medical Sciences, Arak University of Medical Sciences, Arak, Iran.

³ BSc, Physical Therapist, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

⁴ MSc, Physical Therapist, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Introduction: Carpal tunnel syndrome is one of the most common entrapment neuropathy for which different treatment options, both surgical and non-surgical, are available. With respect to physical therapy management, several treatment approaches including splinting, neuromobilization, laser, ultrasound and ultraton has been offered for this syndrome. Materials and Methods: This clinical trial study was performed to compare the effects that ultrasound and ultraton might have on carpal tunnel syndrome. Participants were 59 patients (totally 68 wrists) with mild to moderate carpal tunnel syndrome. The patients were randomly assigned into one of two groups: A (ultraton) and B (ultrasound).Patients in ultraton groupreceived10 sessions of treatment with ultraton (3 minutes per session, with 4Cm2 area of flat electrode and full contact of electrode on volar surface of wrist). In group B, patients underwent 10 sessions of treatment with ultrasound (5 minutes per session, 1MHz frequency, 1/0 W/Cm2 intensity, with pulse mode, duty cycle: 1:2and 5Cm2 applicator areas). Quality of treatment was evaluated by VAS measurementat the following time points:1) pre-treatment, 2) by the 3rd , 5th , 7th  and 9ththerapy sessions, 3) by the 10ththerapy session, and 4)Follow-upfour weeks after treatment. Electroneurography measurement was carried out at two time points: 1) pre-treatment and 2) Follow-up four weeks after treatment. Results: Distal Sensory Latency and Distal Motor Latency were decreased in both groups four weeks after completion of treatment. This reduction, however, wasn't statistically significant (P<O.84).On final assessment, at the end of the 10thtreatmentsession, an increase in sensory &motor amplitudes observed, but again it was not significant (P<O.61).At initial sessions and four weeks following the completion of treatment, Analgue pain scales ofultraton group were more satisfactory than ultraton group (P<0/05). Conclusion: This clinical trial showed that the ultraton treatment method was as effective as ultrasound method; although effects of the former appeared more rapidly than those of the latter. However, a combination of these two treatment approaches can be utilized. Key words: Carpal tunnel syndrome, Ultraton, Ultrasound, Pain, Electromyography