Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments
Objective To evaluate the efficacy of combined association instrument myofascial mobilization (IASTM) and stretching in patients with idiopathic bilateral carpal tunnel syndrome (CTS) operated on one hand and to analyze the response of the operated (OH) and non‐operated (NH) hand according to the se...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13705 |
| _version_ | 1797813842416238592 |
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| author | Sergio Murilo Georgeto Rodrigo Antônio Carvalho Andraus Eros deOliveira Júnior Rubens A daSilva Suzy Ngomo Karen Barros Parron Fernandes |
| author_facet | Sergio Murilo Georgeto Rodrigo Antônio Carvalho Andraus Eros deOliveira Júnior Rubens A daSilva Suzy Ngomo Karen Barros Parron Fernandes |
| author_sort | Sergio Murilo Georgeto |
| collection | DOAJ |
| description | Objective To evaluate the efficacy of combined association instrument myofascial mobilization (IASTM) and stretching in patients with idiopathic bilateral carpal tunnel syndrome (CTS) operated on one hand and to analyze the response of the operated (OH) and non‐operated (NH) hand according to the sequence of therapies. Research on these parameters has not yet been found in the literature. Methods Randomized controlled crossover study with 43 participants using the objective and subjective outcome variables. Patients were randomly assigned to two groups: starting with stretching followed by IASTM and starting with IASTM followed by stretching. Then patients underwent surgery on the hand with more severe involvement and physical therapy rehabilitation was started 30 days after for a period of 4 weeks. After the 1‐week interval the participants who started with stretching were referred to IASTM and vice versa, following the same previous patterns. The outpatient reassessments took place at 3 to 6 months. Crossover ANOVA and effect sizes were used as analysis methods. Results Time was the most significant outcome for all variables both during therapies and at 6‐month follow‐up. Regarding response to the combined therapies between OH and NH, there were differences for both OH and NH, with the greatest impact on NH for the palmar grip and VAS variables. The treatment sequences were significant for pain on the NH and mental SF‐12, suggesting that starting with IASTM followed by stretching had a superior outcome for these outcomes. Conclusion The combination of IASTM with stretching, used in the postoperative period of bilateral idiopathic CTS, proved to be supplementary, with significant results and large effect sizes for most of the outcomes assessed, both during the time of application of the therapies and in the 6‐month follow‐up for both hands, and may constitute a viable therapeutic alternative for this population. |
| first_indexed | 2024-03-13T07:58:41Z |
| format | Article |
| id | doaj.art-fc54eb0dde24466a8e0be6728384d97d |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-03-13T07:58:41Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-fc54eb0dde24466a8e0be6728384d97d2023-06-02T03:04:34ZengWileyOrthopaedic Surgery1757-78531757-78612023-06-011561654166310.1111/os.13705Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic TreatmentsSergio Murilo Georgeto0Rodrigo Antônio Carvalho Andraus1Eros deOliveira Júnior2Rubens A daSilva3Suzy Ngomo4Karen Barros Parron Fernandes5Department of Neurosurgery, Irmandade da Santa Casa de Londrina (ISCAL); Doctoral Program in Rehabilitation Sciences UEL/UNOPAR, Universidade Pitágoras UNOPAR Londrina PR BrazilDoctoral Program in Rehabilitation Sciences UEL/UNOPAR Universidade Pitágoras UNOPAR Londrina PR BrazilInstituto Avançado de Ensino Pesquisa e Tecnologia de Londrina (IAEPETEL) Londrina PR BrazilDépartement des Sciences de la Santé Centre Intersectoriel en Santé Durable, Laboratoire de Recherche BioNR, Université du Québec à Chicoutimi (UQAC); Centre Intégré de Santé et Services Sociaux du Saguenay‐Lac‐Saint‐Jean (CIUSSS SLSJ), Services Spécialisés de Gériatrie – Hôpital de La Baie Saguenay Québec CanadaDépartement des Sciences de la Santé Centre Intersectoriel en Santé Durable, Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC) Saguenay Québec CanadaSchool of Medicine, Pontifical Catholic University of Parana (PUCPR), Londrina, PR, Brazil; Département des Sciences de la Santé, Centre Intersectoriel en Santé Durable, Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada; Instituto de Ensino, Pesquisa e Inovação da Irmandade da Santa Casa de Londrina (IEPI‐ISCAL) Londrina PR BrazilObjective To evaluate the efficacy of combined association instrument myofascial mobilization (IASTM) and stretching in patients with idiopathic bilateral carpal tunnel syndrome (CTS) operated on one hand and to analyze the response of the operated (OH) and non‐operated (NH) hand according to the sequence of therapies. Research on these parameters has not yet been found in the literature. Methods Randomized controlled crossover study with 43 participants using the objective and subjective outcome variables. Patients were randomly assigned to two groups: starting with stretching followed by IASTM and starting with IASTM followed by stretching. Then patients underwent surgery on the hand with more severe involvement and physical therapy rehabilitation was started 30 days after for a period of 4 weeks. After the 1‐week interval the participants who started with stretching were referred to IASTM and vice versa, following the same previous patterns. The outpatient reassessments took place at 3 to 6 months. Crossover ANOVA and effect sizes were used as analysis methods. Results Time was the most significant outcome for all variables both during therapies and at 6‐month follow‐up. Regarding response to the combined therapies between OH and NH, there were differences for both OH and NH, with the greatest impact on NH for the palmar grip and VAS variables. The treatment sequences were significant for pain on the NH and mental SF‐12, suggesting that starting with IASTM followed by stretching had a superior outcome for these outcomes. Conclusion The combination of IASTM with stretching, used in the postoperative period of bilateral idiopathic CTS, proved to be supplementary, with significant results and large effect sizes for most of the outcomes assessed, both during the time of application of the therapies and in the 6‐month follow‐up for both hands, and may constitute a viable therapeutic alternative for this population.https://doi.org/10.1111/os.13705Carpal tunnel syndromeCrossover studyMuscle stretching exercisesMyofascial mobilizationPhysical therapySurgical decompression |
| spellingShingle | Sergio Murilo Georgeto Rodrigo Antônio Carvalho Andraus Eros deOliveira Júnior Rubens A daSilva Suzy Ngomo Karen Barros Parron Fernandes Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments Orthopaedic Surgery Carpal tunnel syndrome Crossover study Muscle stretching exercises Myofascial mobilization Physical therapy Surgical decompression |
| title | Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments |
| title_full | Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments |
| title_fullStr | Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments |
| title_full_unstemmed | Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments |
| title_short | Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments |
| title_sort | bilateral idiopathic carpal tunnel syndrome clinical functional characterization and efficacy of two combined postoperative physiotherapeutic treatments |
| topic | Carpal tunnel syndrome Crossover study Muscle stretching exercises Myofascial mobilization Physical therapy Surgical decompression |
| url | https://doi.org/10.1111/os.13705 |
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