Die Wirksamkeit der manuellen Therapie und der Neuromobilisation in der konservativen Behandlung des Karpaltunnelsyndroms – Vorbericht

Zusammenfassung

Einleitung: Das Karpaltunnelsyndrom (KTS) ist die am meisten auftretende und auch am meisten beschriebene Neuropathie im Bereich des ­peripheren Nervensystems. Epidemiologische Daten belegen, dass das Syndrom 90% aller Neuro­pathien bildet, die durch eine Kompression verursacht werden.

Ziel: Das allgemeine Ziel der Arbeit war die Beurteilung der Effizienz der auf der manuellen ­Therapie und der Neuromobilisation des Nervus medianus basierenden Physiotherapie bei der Behandlung des Karpaltunnelsyndroms.

Material und Methoden: An der Untersuchung nahmen 40 Personen teil, darunter 36 (90%) Frauen und 4 (10%) Männer. Jede weitere Person, die nicht ausgeschlossen wurde und die Aufnahmekriterien der Untersuchung erfüllte, wurde zufällig in die durch Neuromobilisation (RNM) oder durch physikalische Therapie (RPT) rehabilitierte Gruppe eingeteilt. Beurteilt wurde die Nervenleitfähigkeit, Schmerzbeschwerden, Anstieg der Symptome und der funktioneller Zustand. Die Therapie in der Gruppe RNM gründete auf manuellen Techniken und Neuromobilisation, in der Gruppe RPT dagegen auf Laser-Therapie und Ultraschall.

Ergebnisse: Die Therapiereihe resultierte mit einer Verbesserung in beiden untersuchten Gruppen, wobei die Ergebnisse in der Gruppe RNM signifikant höher waren. In dieser Gruppe erfolgte ein Anstieg der Leitgeschwindigkeit in den sensiblen Nervenfasern des Nervus medianus um 19,4% und in den motorischen Nervenfasern um 2,98%. Die Reduktion der Schmerzen betrug 27,3%. Die subjektiven Symptome des KTS verringerten sich um 11,11%, die Verbesserung der Funktionsfähigkeit betrug 5,31%.

Schlussfolgerungen: Das auf manueller Therapie und Neuromobilisation des Nervus medianus ­basierende Therapieprogramm beeinflusste positiv die objektiven und subjektiven Symptome bei Patienten mit Karpaltunnelsyndrom.

Abstract

Introduction: Carpal tunnel syndrome (CTS) is the most common and most commonly described neuropathy of the peripheral nervous ­system. Epidemiological data suggests that it is responsible for 90% of compression neuropathy cases.

Purpose: The main objective of the study was to evaluate the effectiveness of physiotherapy based on manual therapy and neural mobilization of the median nerve in the treatment of carpal tunnel syndrome.

Materials and methods: A total of 40 individuals, including 36 (90%) women and 4 (10%) men, have been evaluated. Each person who had met the inclusion criteria for the study was randomly assigned to either a neural mobilization exercises (NME) group or physical therapy exercises (PTE) group. Nerve conduction, pain severity and functional status were assessed. Therapy in the NME group was based on manual and neural mobilization techniques, while laser and ultrasound were used in the PTE group.

Results: A cycle of therapy resulted in an overall improvement in both groups, however benefits in the MNE group were more significant. In this group, median nerve sensory fiber conduction increased by 19.4%, while motor fiber conduction improved by 2.98%. Pain reduction was equal to 314%. Significant improvement in functional status (49.6%) and reduction of subjective symptoms of CTS (76.3%) were also observed. Therapeutic interventions in the PTF group had no significant impact on median nerve conduction. Reduction in pain was 27.3%. Subjective symptoms of CTS decreased by 11%, while functional status improvement was equal to 5.31%.

Conclusion: Therapeutic techniques applied in both groups had a positive effect on objective and subjective symptoms in individuals with carpal tunnel syndrome.

Schlüsselwörter

Wirksamkeit - konservative Therapie - Physiotherapie

Key words

physical therapies - conservative therapy - non-surgical treatment

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