Carpal Tunnel Syndrome (CTS) in Breast Cancer Patients
Conditions
Keywords
LASER ACUPUNCTURE -CARPAL TUNNEL SYNDROME -AROMATASE INHIBITORS-BREAST CANCER PATIENT
Brief summary
The study will be carried out on a total number of fifty-four females with age ranged 40 - 60 years old suffering from CTS post mastectomy ,the patients will be randomly assigned into two groups equal in number (27 patients for each group from Damanhur Medical National institute). 1. -Group (A): This group will include 27 patients will receive laser acupuncture technique 3 times per week in addition to traditional physical therapy program (myofascial release, nerve flossing ex., Tendon gliding ex. strengthening ex., ROM ex. and night splint) for 8 weeks. 2. -Group (B): This group will include 27 patients will receive traditional physical therapy program (myofascial release, nerve flossing ex., Tendon gliding ex., strengthening ex., ROM ex. and night splint) for 8 weeks.
Detailed description
The study will be carried out on a total number of fifty-four females with age ranged 40 - 60 years old suffering from CTS post mastectomy , the patients will be randomly assigned into two groups equal in number (27 patients for each group from Damanhur Medical National institute). 1. -Group (A): This group will include 27 patients will receive laser acupuncture technique 3 times per week in addition to traditional physical therapy program (myofascial release, nerve flossing ex., Tendon gliding ex. strengthening ex., ROM ex. and night splint) for 8 weeks. 2. -Group (B): This group will include 27 patients will receive traditional physical therapy program (myofascial release, nerve flossing ex., Tendon gliding ex., strengthening ex., ROM ex. and night splint) for 8 weeks. Equipment: 1. Measurement equipment: 1. Nerve Conduction Studies (NCSs) 2. Boston Carpal Tunnel Questionnaire (BCTQ) 3. Hand-Held Dynamometer 2. Therapeutic equipment: 1. Laser Acupuncture technique for group (A). 2. Traditional Physical therapy program for both groups.
Interventions
DEVICELASER acupuncture technique
LASER Acupuncture technique: * Device: PR999, Medical Italia, Italy. * Maximum frequency: 5000 Hz * Dosage: 4j/point * Wave length :830 nm * Power output :50 m.W * Duration:12 min. * Frequency of treatment: 3 sessions/week. * Total treatment period: 8 weeks. * Total number of sessions: 24 sessions. The laser device will be positioned perpendicular to the skin over CTS area especially over each acupuncture point, for one minute duration for each point and the sessions will be conducted three times a week for eight weeks .
OTHERTraditional physical therapy
Active assisted ROM exercises. Each exercise was performed for all movements namely flexion, extension, ulnar \& radial deviations, supination and pronation, one set of each 10-15 repetitions within pain-free range and instructed to carry out their ADLs, Patient education regarding work modification and ergonomic recommendations and Tendon gliding exercises. Each exercise begins with the wrist and fingers fully extended. During tendon-gliding exercises, the fingers were placed in five discrete positions: straight, hook, tabletop, full fist and straight fist .
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
40 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* The subject selection will be according to the following criteria: * Patients' age will be ranged between 40-60 years old. * 54 Female patients had breast cancer will participate in this study. * All patients will have wrist pain and disability post AIS. * All patients will suffer from moderate to severe pain. * All patients will enroll to the study will have their informed consent
Exclusion criteria
* The potential participants will be excluded if they met one of the following criteria: * Patients with previous history of fracture at the wrist fracture. * History of any arthritis related to wrist. * Rheumatoid arthritis wrist secondary to fracture, dislocation, * Reflex sympathetic dystrophy and neurological disorder, Malignancy. * Epilepsy or any psychological disorders.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Median Motor Nerve Conduction Study | 8weeks | With the help of electrode /conducting jelly, the recording was placed closed to motor of Abductor Policis Brevis and referance electrode 3 cm distal at the metacarpophalangeal joint. The ground electrode is placed between stimulation and recording electrode. A supramaximal stimulation was given at first to wrist and then at below. The difference between two latent period in msec gives the time taken by the impulses to travel from the elbow to the wrist. |
| Median Sensory Nerve Conduction Study: | 8 weeks | The Orthodromic conduction recording was done in this case. Here the recording electrode was placed 3cm proximal to the distal wrist crease 3cm proximal to the recording electrode. The ring electrode were placed in the second and third digit and it was used for stimulation of the nerve with the cathode placed at the proximal inter phalangeal. The grounding electrode was placed between stimulating electrode and grounding electrode. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Boston Carpal Tunnel Questionnaire (BCTQ) | 8weeks | The Boston Carpal Tunnel Questionnaire (BCTQ) is a widely recommended patient-reported outcome measure to evaluate symptoms and functions in carpal tunnel syndrome (CTS) patients. The BCTQ is a disease-specific PROM for CTS patients. It contains 2 measurement scales: a symptom severity scale (BCTQ-S) and a functional status scale (BCTQ-F). The BCTQ-S uses 11 questions to evaluate the intensity and frequency of pain, numbness, weakness and loss of dexterity on a five-point scale ranging from 1 (no symptoms) to 5 (severe symptoms). The results are interpreted as the average scores of the 11 questions. The BCTQ-F has 8 questions to evaluate the level of difficulty in performing daily tasks, each rated on a five-point scale ranging from 1 (no diffculty) to 5 (cannot do at all due to hand or wrist symptoms). The results are interpreted as the average scores of the 8 questions |
| Hand-Held Dynamometer (HHD) | 8weeks | Hand-held dynamometers are portable devices usually incorporating a wireless load cell with an inbuilt microprocessor to measure isometric muscle force with good to excellent reliability across both clinical and healthy populations. These characteristics have made hand-held dynamometers a feasible and widely used tool to quantify muscle strength in a range of clinical populations. To assess hand grip, participants were seated comfortably in a chair with their feet supported. The hand and forearm being assessed was positioned with the shoulder adducted and in neutral rotation, with the elbow in 90◦ of flexion, forearm in neutral, and the wrist in 0 to 30◦ of extension and 0 to 15◦ of ulnar deviation. The participant was asked to grasp the hand-held dynamometer with the fingers wrapped around the handle. The clinical evaluator instructed the participant to perform a maximal contraction lasting three to five seconds, saying, "when I say go, I want you to squeeze the handle as hard as you |
Countries
Egypt
Contacts
CONTACTResearch Ethical Committee Faculty of Physical Therapy - Cairo University
CONTACTResearch Ethical Committee Faculty of Physical Therapy
PRINCIPAL_INVESTIGATORResearch Ethical Committee Faculty of Physical Therapy
Cairo University
Outcome results
None listed