Type of Ultrasound Wave and Median Nerve Conductivity in Carpal Tunnel Syndrome

Abstract

Introduction: Carpal tunnel syndrome (CTS) is common compression neuropathy of the upper limb. Median nerve compression in the carpal tunnel causes nerve conduction disorders, paraesthesia and hand dysfunction. Sonotherapy is used to improve median nerve conductivity in CTS patients. The effectiveness of sonotherapy may depend on the type of ultrasonic wave and treatment energy. The aim of the study was to assess changes in the conductivity of the median nerve in CTS patients depending on the type of ultrasonic wave. Material and methods: 44 patients with CTS were included in the study. Conductivity of the median nerve was assessed using: electroneurography, a traditional electrodiagnostic test and the two-point discrimination test. The therapy protocol included: sonotherapy of the carpal tunnel, whirlpool massage, neuromobilization of the median nerve. Group 1 (37 hands) was treated using a pulsed wave with a 1/5 duty cycle, while Group 2 (29 hands) with a continuous wave. The energy of the applied treatment was 1,080 J. Results: Statistically significant improvement of electroneurographic parameters in sensory fibres and an increase in the amplitude of potentials in motor fibres were observed after pulse wave sonication. Increased rheobase and accommodation factor were also noted. After continuous wave sonication, statistically significant improvement regarding electroneurographic parameters was observed in motor fibres. The differences between the study groups were not statistically significant. Conclusion: The effect of sonotherapy in patients with CTS is not affected by the nature of the ultrasonic wave, but only by the amount of energy transferred to the tissues during the procedure.

Keywords

• carpal tunnel syndrome
• electrophysiologic study
• median nerve
• ultrasonic therapy