Effectiveness of Physiotherapy Interventions on Symptom Severity and Hand Function in Patients with Idiopathic CTS

Hazliza Razali¹, Naresh Bhaskar RAJ², Wan-Arfah N³, Zakaria Yusoff⁴, Vinodhkumar Ramalingam⁵

Author:

¹PhD student, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300 Kuala Nerus, Terengganu, Malaysia.

Co-Authors:

³Senior Lecturer,Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300 Kuala Nerus, Terengganu, Malaysia.

⁴Orthopedic Surgeon, Department of Orthopaedic, Hospital Raja Perempuan Zainab, 15100 Kota Bharu, Kelantan, Malaysia.

⁵Senior Lecturer, Faculty of health and life sciences, INTI International University, Nilai, Malaysia

Corresponding Author:

²Dr.Naresh Bhaskar Raj, Senior Lecturer, Faculty of Health Science, Universiti Sultan Zainal Abidin (UniSZA), 21300 Terengganu, Malaysia. E-mail address: bnaresh@unisza.edu.my

ABSTRACT

Background of the study: Extracorporeal shock wave therapy (ESWT) has been reported as valuable and beneficial treatment for musculoskeletal disorder. Over the last few years, ESWT became more widely employed in clinical practice, with certain clinical studies confirming significant efficacy. Clinically, ESWT has been utilised to treat a variety of musculoskeletal and peripheral neuropathy disorders, including CTS. ESWT’s low energy was proven effective in mild to moderate CTS. The aim of the study is to analyse the effect of three physiotherapy intervention on symptom and hand functions in patients with carpal tunnel syndrome. Methodology: This study consisted of 52 male and female who had pain in their hands, either bilaterally or unilaterally. They were allotted into of three groups, Group A; received Ultrasound therapy (UST) combined with nerve and tendon gliding exercise,Group B; received Shock wave therapy (ESWT) combined with nerve and tendon gliding exercise and Group C; received only nerve and tendon gliding exercise, two times per week for four weeks. The outcome measure used was Boston Carpal Tunnel Questionnaire (BCTQ) to evaluate the symptom severity and functional status scale among the participants. The evaluation was performed at baseline, 2 weeks, 4 weeks and follow-up. Results: Repeated measure ANOVA shows significant improvement (p<0.005) in all comparison based on time. The overall improvement in Group B from baseline to follow-up was a reduction of 48.43% in the symptoms and 55.2% increase in the functions and was significant (p<0.005). Conclusion: This study concludes that the ESWT is an effective modality for idiopathic mild to moderate CTS. The beneficial effect of this non-invasive modality is safe and valuable to be used as one of physiotherapy modality in Malaysia.  Keywords: Carpal Tunnel Syndrome; Shock Wave Therapy; Ultrasound Therapy; Nerve and Tendon Gliding Exercise; Hand function; Idiopathic.