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Extracorporeal shock wave therapy as a conservative treatment option for carpal tunnel syndrome: a double-blind, prospective, randomized, placebo-controlled study
Ulucakoy RK, Yurdakul FG, Bodur H
Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi [Turkish Journal of Physical Medicine and Rehabilitation] 2020;66(4):388-397
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: Yes; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: This study aims to evaluate the efficacy of extracorporeal shock wave therapy (ESWT) in carpal tunnel syndrome (CTS) compared to the wrist splint treatment. PATIENTS AND METHODS: Between April 2016 and March 2017, a total of 189 patients (22 males, 167 females, mean age 48.8 +/- 9.5 years, range 24 to 70 years) with mild-to-moderate CTS were included in this double-blind, prospective, randomized, placebo-controlled study. The patients were divided into four treatment groups using stratified randomization: splint group (group 1, N = 47), splint plus ESWT (group 2, N = 47), ESWT (group 3, N = 45), and splint plus placebo ESWT (group 4, N = 50). All patients were evaluated at baseline, and one and three months. Pain using the visual analog scale (VAS), finger pinch strength, Boston Carpal Tunnel Questionnaire (BCTQ), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and electrophysiological examination were assessed. RESULTS: A total of 168 patients completed the study. There was no significant difference among the four groups in terms of age, sex, comorbid diseases, symptom duration, VAS-pain, BCTQ, and LANSS scores (p > 0.05). Pain and functionality significantly improved in all groups (p < 0.05). In the group with ESWT and using wrist splint combined, a greater improvement of the hand function and electrophysiological measures was observed. CONCLUSION: Our study results show that ESWT is a valuable and reliable treatment modality for mild-to-moderate CTS.

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