The Effects of Steroid Phonophoresis on Clinical Parameters and Nerve Conduction Velocities in Carpal Tunnel Syndrome

Objective: This study was aimed to investigate the effects of steroid phonophoresis on electroneurophysiological and clinical parameters and to compare these effects with ultrasound (US) and sham US in carpal tunnel syndrome (CTS). Material-Method: 39 patients with CTS (69 hands) were included in the study. Patients were randomized to phonophoresis (n=13 patients, 21 hands), US (n=13 patients, 24 hands) and sham US (n=13 patients, 24 hands) groups. Steroid phonophoresis, using dexamethasone as conductive agent, was applied at 1.0 W/cm2 to the phonophoresis group. Ultrasound at 1.0 W/cm2 and imitative US at 0.0 W/cm2 were applied to the US and sham US groups respectively. All groups were asked to perform tendon and nerve gliding exercises. Distal motor latency (mMDL) and sensory nerve conduction velocity (mSNCV) of median nerve, visual analogue scale (VAS) and Boston Scale were assessed at the beginning, 2nd week and in the 12th week. Results: All of the variables were significantly improved in the 12th week in steroid phonophoresis group, whereas VAS, symptom severity and functional capacity of Boston scale were improved in US and sham US groups. mSNCV was also improved in sham US group. The differences between 12th week-pre treatment values (delta) were used for group comparisons. Delta values of electroneurophysiological parameters of phonophoresis group were found to be significantly different, whereas no significant differences were found between the groups for the other variables. Conclusion: Steroid phonophoresis has favorable effects on electroneurophysiological studies and these effects last longer. Favorable effects on clinical findings and patient based assessments were observed in all groups. The improvements seen in sham US group may suggest the effectiveness of tendon and nerve gliding exercises. [Cukurova Med J 2012; 37(1): 17-26

The Effects of Steroid Phonophoresis on Clinical Parameters and Nerve Conduction Velocities in Carpal Tunnel Syndrome

Objective: This study was aimed to investigate the effects of steroid phonophoresis on electroneurophysiological and clinical parameters and to compare these effects with ultrasound (US) and sham US in carpal tunnel syndrome (CTS). Material-Method: 39 patients with CTS (69 hands) were included in the study. Patients were randomized to phonophoresis (n=13 patients, 21 hands), US (n=13 patients, 24 hands) and sham US (n=13 patients, 24 hands) groups. Steroid phonophoresis, using dexamethasone as conductive agent, was applied at 1.0 W/cm2 to the phonophoresis group. Ultrasound at 1.0 W/cm2 and imitative US at 0.0 W/cm2 were applied to the US and sham US groups respectively. All groups were asked to perform tendon and nerve gliding exercises. Distal motor latency (mMDL) and sensory nerve conduction velocity (mSNCV) of median nerve, visual analogue scale (VAS) and Boston Scale were assessed at the beginning, 2nd week and in the 12th week. Results: All of the variables were significantly improved in the 12th week in steroid phonophoresis group, whereas VAS, symptom severity and functional capacity of Boston scale were improved in US and sham US groups. mSNCV was also improved in sham US group. The differences between 12th week-pre treatment values (delta) were used for group comparisons. Delta values of electroneurophysiological parameters of phonophoresis group were found to be significantly different, whereas no significant differences were found between the groups for the other variables. Conclusion: Steroid phonophoresis has favorable effects on electroneurophysiological studies and these effects last longer. Favorable effects on clinical findings and patient based assessments were observed in all groups. The improvements seen in sham US group may suggest the effectiveness of tendon and nerve gliding exercises. [Cukurova Med J 2012; 37(1.000): 17-26

Bioelectrical Impedance for Detecting and Monitoring Lymphedema in Patients with Breast Cancer. Preliminary Results of the Florence Nightingale Breast Study Group

The aim of this study was to evaluate the efficacy of bioimpedance spectroscopy for the follow-up of patients with lymphedema in Turkey and its benefits in the diagnosis of stage 0, 1, and 2 lymphedema in patients who are under treatment for breast cancer. Thirty-seven female patients with breast cancer who underwent surgical procedures in our Breast Health Centre were followed up for lymphedema using bioimpedance, and clinical measurements were taken for a minimum period of 1 year at 3-month intervals. Patients who had been monitored regularly between November, 2011, and September, 2013, were enrolled to the study. In total, 8 patients developed lymphedema with an overall rate of 21.6%. Among the 8 patients who developed lymphedema, 4 had Stage 2, 1 had Stage 1, and 3 had Stage 0 lymphedema. Stage 0 lymphedema could not be detected with clinical measurements. During the patients' 1-year follow-up period using measurements of bioimpedance, a statistically significant relationship was observed between the occurrence of lymphedema and the disease characteristics. including the number of the extracted and remaining lymph nodes and the region of radiotherapy (p=0.042, p=0.024, p=0.040). Bioimpedance analysis seems to be a practical and reliable method for the early diagnosis of lymphedema. It is believed that regular monitoring of patients in the high-risk group using bioimpedance analyses increases the ability to treat lymphedema