Hafif-orta dereceli karpal tünel sendromunda, el ve el bileği antropometrik ölçümlerinin, hastalık şiddeti ve tedavi sonuçları ile ilişkisi
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Date
2014
Authors
Avşaroğlu, Ahmet Hazım
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada, hafif-orta dereceli karpal tünel sendromunda, el ve el bileği antropometrik ölçümlerinin hastalık şiddeti ve tedavi sonuçları ile ilişkisinin araştırılması amaçlanmıştır. Çalışmamız, hafif-orta dereceli KTS olan 39 hasta ile prospektif olarak biçimlendirildi. Hastaların demografik verileri, yakınma süreleri ve baskın elleri belirlendikten sonra, boy, kilo, VKİ, el ve el bileği antropometrik ölçümleri, median sinir kesitsel alan ölçümü ve karpal açı ölçümü yapıldı. Hastalığın şiddetini belirlemek ve tedavi yanıtını takip etmek için, Boston Semptom Şiddet Skalası, Boston Fonksiyonel Durum Skalası, ağrı için Görsel Analog Skala ve uyuşma şiddeti için Likert Skalası'ndan faydalanıldı. Median duyusal ve motor sinir ileti çalışmaları yapıldı. Başlangıç ölçümleri yapıldıktan sonra hastalara splintleme tedavisi uygulandı. Tedaviye yanıtı değerlendirmek için 2., 4. ve 12. haftada, elektrofizyolojik değerlendirmeler için ise sadece 4. ve 12. haftada izlem vizitleri yapıldı. Antropometrik ölçümlerle başlangıç semptom şiddet ölçekleri arasında anlamlı bir ilişki saptanmamakla birlikte, tedaviye yanıt sonuçları ile arasındaki anlamlı korelasyon gösterilmiştir. Özellikle hastaların bilek oranındaki artış ile, 2. ve 4. haftadaki Boston Fonksiyonel Durum Skalası'ndaki iyileşme ve 12. haftadaki Görsel Analog Skala'daki iyileşme arasında anlamlı düzeyde negatif korelasyon saptanmıştır. Sonuç olarak el ve el bileği antropometrik ölçümleri, KTS'de splint tedavisine yanıtı öngörmede yardımcı olabilecek bir yöntem olarak önerilebilir.
This study aims to investigate the relationship between anthropometric measurements of hand and disease severity and treatment outcomes in patients with mild-moderate carpal tunnel syndrome (CTS). 39 patients with mild-modarate CTS were enrolled in this prospective study. After obtaining demographic information, symptom duration, dominant side, height, weight, BMI, anthropometric measurements of hand and wrist, cross sectional area of median nerve and carpal angle measurements were recorded. In order to determine the severity of disease and response to treatment, Boston Symptom Severity Scale, Boston Functional Status Scale were used. Pain severity and numbness were assessed with Visual Analogous Scale and Likert Scale respectively. Median sensory and motor conduction studies were performed. After getting baseline measurements patients were treated with wrist splints. Follow up visits were performed at 2nd, 4th and 12th weeks for respond to treatment and 4th and 12th week for electrophysiological studies. No significant correlation between anthropometric measurements and severity of symptoms at onset was found but evidence indicating a correlation to response to treatment was found. Especially, the increment in wrist ratio at 2th and 4th week correlated inversely with the improvement of Boston Functional Status Scale and at 12th week, correlated inversely with the improvement of Visual Analogous Scale. In conclusion, anthropometric measurements of hand and wrist can be considered as a useful adjunct to determine the effectiveness of splinting in CTS.
This study aims to investigate the relationship between anthropometric measurements of hand and disease severity and treatment outcomes in patients with mild-moderate carpal tunnel syndrome (CTS). 39 patients with mild-modarate CTS were enrolled in this prospective study. After obtaining demographic information, symptom duration, dominant side, height, weight, BMI, anthropometric measurements of hand and wrist, cross sectional area of median nerve and carpal angle measurements were recorded. In order to determine the severity of disease and response to treatment, Boston Symptom Severity Scale, Boston Functional Status Scale were used. Pain severity and numbness were assessed with Visual Analogous Scale and Likert Scale respectively. Median sensory and motor conduction studies were performed. After getting baseline measurements patients were treated with wrist splints. Follow up visits were performed at 2nd, 4th and 12th weeks for respond to treatment and 4th and 12th week for electrophysiological studies. No significant correlation between anthropometric measurements and severity of symptoms at onset was found but evidence indicating a correlation to response to treatment was found. Especially, the increment in wrist ratio at 2th and 4th week correlated inversely with the improvement of Boston Functional Status Scale and at 12th week, correlated inversely with the improvement of Visual Analogous Scale. In conclusion, anthropometric measurements of hand and wrist can be considered as a useful adjunct to determine the effectiveness of splinting in CTS.
Description
Keywords
Antropometrik ölçümler, Karpal tünel sendromu, Sinir ileti çalışması, Splint tedavisi, Anthropometric measurements, Carpal tunnel syndrome, Nerve conduction study, Splinting
Citation
Avşaroğlu, A. H. (2014). Hafif-orta dereceli karpal tünel sendromunda, el ve el bileği antropometrik ölçümlerinin, hastalık şiddeti ve tedavi sonuçları ile ilişkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.