Electrophysiological Effects of Adjunct Low-Level Laser Therapy and Median Nerve Mobilization After Carpal Tunnel Release: A Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- Change in Median Nerve Motor Distal Latency
研究概览
简要总结
This randomized controlled study investigated whether adding low-level laser therapy (LLLT) or median nerve mobilization after unilateral carpal tunnel release improves median nerve electrophysiological parameters compared with no adjunctive treatment. Forty-five patients were randomly assigned to receive LLLT, median nerve mobilization, or standard postoperative care. Interventions were delivered over six weeks, and nerve conduction studies were conducted before and after treatment to assess electrophysiological outcomes, with motor distal latency designated as the primary outcome measure.
详细描述
Carpal tunnel syndrome (CTS) is commonly managed surgically through carpal tunnel release (CTR); however, postoperative recovery may be accompanied by persistent neural dysfunction and delayed nerve conduction improvement. Adjunct rehabilitation strategies, such as low-level laser therapy (LLLT) and median nerve mobilization, have been proposed to enhance neural recovery, yet their electrophysiological effects following CTR remain insufficiently established.
This randomized controlled study aimed to examine and compare the effects of adjunct LLLT and median nerve mobilization on median nerve electrophysiological parameters after unilateral CTR. Forty-five patients diagnosed with unilateral CTS and treated surgically with CTR were recruited. Participants (aged 25-55 years) were randomly allocated into three equal groups. Group A received adjunct gallium arsenide (GaAs) infrared LLLT, Group B underwent median nerve mobilization exercises, and Group C received standard postoperative care without adjunctive therapy.
Both intervention protocols were applied three times per week for six consecutive weeks. Electrophysiological assessments were conducted at baseline (pre-intervention) and after six weeks using standardized nerve conduction studies. Measured parameters included motor distal latency (MDL), sensory distal latency (SDL), motor nerve conduction velocity (MCV), and compound motor action potential amplitude (CMAP), with MDL predefined as the primary outcome measure.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 25 Years 至 55 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age between 25 and 55 years Clinical diagnosis of unilateral carpal tunnel syndrome Underwent surgical carpal tunnel release (transverse carpal ligament release)
排除标准
- •Rheumatoid arthritis Diabetes mellitus History of wrist fracture or other wrist joint trauma Current use of anti-inflammatory medications or other interfering medications Receipt of alternative treatments (e.g., acupuncture, physical therapy modalities) Use of wrist orthoses
研究组 & 干预措施
LLLT (GaAs 904-nm Laser) Group
- Patients in group (A) had a regimen of infrared Gallium Arsenide low-level laser therapy (20 mW average power, 904 nm wavelength, laser probe diameter of 7 mm). The treatment was administered to the palmar region above the carpal tunnel and along the median nerve pathway, with a cumulative dosage of 4.8 J
干预措施: Gallium Arsenide (GaAs) 904-nm Low-Level Laser Device (Other)
Median Nerve Mobilization Group
Patients in the group (B) were instructed to do a series of movements that included the median nerve: lateral rotation of the shoulders, depression, wrist extension, supination, shoulder abduction, elbow extension, and bending the neck laterally to the other side.
干预措施: Therapist-Supervised Median Nerve Neural Mobilization Exercises (Other)
Standard Care Control Group
Control group
干预措施: Standard Postoperative Care (Other)
结局指标
主要结局
Change in Median Nerve Motor Distal Latency
时间窗: 6 weeks
Change in motor distal latency (milliseconds) of the median nerve from baseline (pre-treatment) to 6 weeks post-intervention, assessed using standardized nerve conduction testing (Neuropack) following American Association of Electrodiagnostic Medicine guidelines.
次要结局
- Change in Median Nerve Sensory Distal Latency(6 weeks)
- Change in Median Nerve Motor Conduction Velocity(6 weeks)
- Change in Compound Motor Action Potential Amplitude(6 weeks)
研究者
Eman Hamed
Lecturer of Clinical Pharmacy
Galala University