this study will be conducted to investigate the effect of Russian current on hand grip strength and functional outcome after carpal tunnel release
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy syndrome of the upper extremities , the estimated prevalence is 4-5% in the general population ,it occurs due to median nerve compression in carpal tunnel and it is ten times more common in women ,the most common symptoms are numbness and tingling in the radial 3-1/2 finger, night pain, and paresthesias. Although it is most commonly idiopathic, other causes include trauma, oral contraceptive use, pregnancy, arthritis, diabetes hypothyroidism, and repetitive wrist movements. It is well known that distal radius fractures and their sequelae can cause CTS, this suggests that anatomic changes in bony structures of wrist may also contribute to the development of CTS.Russian current (RC), a well-known neuromuscular electrical stimulation operating at 2500 Hz, has demonstrated significant strength improvement over traditional exercises due to its high tolerance and low pain provocation.There are studies about efficacy of Transcutaneous electrical nerve stimulation on wrist pain in patients with CTR but there is lack of literature about efficacy of RC on hand grip strength and function after CTR so this stidu will be conducted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
52
russian current will be is applied in 50Hz sinusoidal bursts with a duty cycle of 50% (10ms on/10ms off). Russian Stimulation (at 2500Hz or 2.5kHz) has been shown to be effective in increasing muscle strength and torque generation through stimulation of type II muscle fiber. The stimulation will be given for duration of 10 minutes on followed by 50 sec off and again 10 sec on, three tims per week plus selsected physical therapy program.
the patients will receive selected physical therapy program in the form of TENS for 15 min, US for 5 min and exercise for 20 min
hand grip strength
hand grip strength will be measured by hand held dynamometer.
Time frame: up to four weeks
fine and gross hand function
jebsen taylor hand test will be used to assess fine and gross hand function.this test includes series of seven subtests representing fine motor, nonweighted and weighted hand function in ADL, which includes printing a 24-letter, third-grade reading difficulty sentence, Turning over 7.6×12.7 cm (3×5-inch) cards (simulated page turning), Picking up small, common objects (e.g. pennies, paper clips, bottle caps) and placing them in a container,Stacking checkers (test of eye-hand co-ordination),Simulated feeding, Moving large empty cans, Moving large weighted \[0.45 kg (l lb)\] cans.The subtests are scored by recording the number of seconds required to complete each test
Time frame: up to four weeks
hand function
hand function will be measured by boston carpal tunnel questionnaire.The Boston Carpal Tunnel Questionnaire (BCTQ) is a patient-reported questionnaire used to assess symptoms and functional limitations in people with carpal tunnel syndrome (CTS). It consists of two modules: an 11-item Symptom Severity Scale (SSS) and an 8-item Functional Status Scale (FSS), which are scored independently on a 1-to-5 Likert scale.A mean score between 1 and 5 is generated for both the SSS and FSS, with higher scores indicating more severe symptoms or greater functional limitation.
Time frame: up to four weeks
wrist range of motion
goniometer device will be used to assess wrist range of motion
Time frame: up to four weeks
pain intensity
pain will be measured by visual analogue scale. Scores are based on self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale-"no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).
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Time frame: up to four weeks