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Article type: Research Article
Authors: Barbosa, Rafael Inácioa; b; * | Fonseca, Marisa de Cássia Registroa; c | Rodrigues, Eula Katucha da Silvaa | Tamanini, Guilhermea | Marcolino, Alexandre Marcioa; b | Mazzer, Niltonc | Guirro, Rinaldo Roberto de Jesusa; c | MacDermid, Joyd
Affiliations: [a] Rehabilitation and Performance Program, University of São Paulo, Ribeirão Preto, Brazil | [b] Federal University of Santa Catarina, Araranguá, Brazil | [c] Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, University of São Paulo, Ribeirão Preto, Brazil | [d] School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
Correspondence: [*] Corresponding author: Rafael Inácio Barbosa, Federal University of Santa Catarina, Governador Jorge Lacerda Road, 3201, Araranguá-SC 88900-000, Brazil. Tel.: +55 48 96887711; E-mail:rafael.barbosa@ufsc.br
Abstract: OBJECTIVE: Compare the efficacy of orthoses and patient education with and without the addition to Low-Level Laser Therapy (LLLT - 660 nm, 30 mW, a continuous regime and bean area of 0.06 cm2). The laser irradiation was delivered with the fluency of 10J/cm2 in patients with mild and moderate Carpal Tunnel Syndrome (CTS). METHODS: 48 patients were randomized and 30 finished the protocol (a sample loss of 37.5%), 90% female and 10% males. Randomization was applied to allocate the patients in each one of the groups, with association or not to LLLT (group orthoses or LLLT and orthoses). All of them were submitted to ergonomic home orientations. The short-term symptoms and function outcome were assessed through: Boston Carpal Tunnel Questionnaire (BCTQ) - Severity of Symptoms (SS) Functional Score (FS). Pain (VAS), Semmes-Weinstein monofilaments, 2PD and pinch strength was used for characterization of the sample. Most of the participants were women, over 4th decade enrolled on heavy hand duties occupations, right-handed, 66.7% affected on dominant hand, without alterations in sensory median nerve thresholds or pinch strength. RESULTS: Both groups showed a reduction of total BCTQ score and its subdomains after six weeks, with significant difference (p< 0.05), comparing to baseline. No significant difference was found between groups. A Minimal clinical change was observed after the intervention in 92.3% of participants for BCTQ subdomain severity of symptoms at individual comparison for LLLT and orthoses group and 76.5% for the orthoses group, demonstrating clinical relevance. Effect size Cohen's index was moderate for the severity of symptoms. CONCLUSION: LLLT in association to orthoses and ergonomic orientation seems to be effective in short-term symptoms relieve for patients with mild and moderate CTS.
Keywords: Carpal tunnel syndrome, rehabilitation, conservative treatment, low-level laser therapy, orthoses, ergonomics
DOI: 10.3233/BMR-150640
Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 29, no. 3, pp. 459-466, 2016
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