정중신경가동기법이 수근관증후군 환자의 악력과 통증에 미치는 영향

Effects of the Median Nerve Mobilization on Change of Grip Strength and Pain in Patients with Carpal Tunnel Syndrome

  • 발행 : 2009.05.30

초록

Purpose:This study was to determine whether median nerve mobilization has any effect on the recovery of muscle power and the reduction of pain for the patients with carpal tunnel syndrome. Methods:20 patients suffering from carpal tunnel syndrome were randomly divided into two groups: 10 subjects treated both with electrical therapy and median nerve mobilization(experimental group) and the other 10 subjects treated only with electrical therapy(control group). The therapy was taken three times a week for 3 weeks. Results:The grip strength increased in both groups. However, the experimental group showed more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. In terms of pain, both groups showed significant effects. But the experimental group showed but more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. Conclusions:It was significantly more effective for the patients with carpal tunnel syndrome to apply median nerve mobilization during the electrical therapy in order to reduce pain and to increase grip strength, compared with the method only using electrical therapy. Further research should be conducted to generalize these results in terms of the clinical effectiveness of the nerve mobilization.

키워드

참고문헌

  1. 강세윤, 고영진, 김혜원. 수근터널증후군의 임상 및 근전도 소견. 대한재활의학회지. 1991;15:179-85.
  2. 김관민. 수근관증후군에서 수술적 치료와 보전적 치료의 비교. 전북대학교 석사학위논문. 2004.
  3. 김덕수. 자동차 부품업체 생산직 근로자의 수근관증후군 위험요인 평가. 동국대학교 박사학위논문. 2001.
  4. 김익동, 김충택, 박병철 등. 수근터널 증후군. 대한정형외과학회지. 1990;25: 339-46.
  5. 김정원, 박인선, 이영준 등. 반복작업에 의해 발생한 척골관 증후군 1례. 대한산업의학지. 2000;12(2):310-8.
  6. 박준성, 박병순, 이영진. 수근관 증후군에서 근육 내 자극술의 치료 효과. 대한마취과학회지. 2005;48(6):666-70.
  7. 박종, 김양옥, 류소연 등. 전자렌지 조립작업자에서 발생한 경견완증후군의 조사연구. 대한산업의학지, 1995;7(2):320-31.
  8. 양익, 최상희. 손과 손목관절의 초음파 진단. 대한초음파의학회지. 2006;25:159-72.
  9. 이상선. 수근관 증후군에서 개방적 감압술과 단일 입구를 이용한 내시경적 감압술 후의 결과 비교. 순천향대학교대학원 의학과 석사학위논문. 2006
  10. 이상헌, 박윤형, 이은하 등. 수근관 증후군 치료로서 스테로이드 국소주사의 효과. 대한 근전도.전기진단의학회지. 1999;1(2):179-83.
  11. 이창렬, 손길수, 이수연 등. 신경가동기법이 뇌졸중환자의 족관절 저측굴근 경직에 미치는 영향. 대한물리치료학회지. 2007;19(1):79-90.
  12. 장정훈, 구봉오, 김상수 등. 물리치료대백과사전. 서울: 도서출판 나눔의 집. 2001:87, 118-9.
  13. 정연우, 서현규, 김병곤 등. 신경가동술이 악력에 미치는 영향. 대한물리치료학회지. 2004;16(4):813- 9.
  14. 차재오. 수근관 증후군의 진단에 있어서 자가 기입식 수부증상도표의 유용성. 부산대학교의과대학원 석사학위논문. 2001.
  15. 手根管症候群 作成委員會. 標準的神經治療: 日本神經治療學會, 2008;25(1):65-84.
  16. Akalin E, El O, Peker O et al. Treatment of carpal tunnel syndrome with nerve and tendon gliding exercise. Am J Phys Med Rehabil. 2002;81(2):108-13. https://doi.org/10.1097/00002060-200202000-00006
  17. Amori S, Spence RA. Carpal tunnel syndrome. Ulster Med J. 2008;77(1):6-17.
  18. Anderson M, Tichenor CJ. A patient with De Quervain's tenosynovitis. Phys Ther. 1994;74(4):314-26. https://doi.org/10.1093/ptj/74.4.314
  19. Baykal S, Boz C, Cakir E et al. The Effects of Pentoxifylline in Experimental Nerve Injury. Turk J Med Sci. 2002;32:207-10.
  20. Butler DS. Mobilization of the nervous system. London: Churchill Livingstone. 1991:10-212
  21. Butler DS, Gifford L. The concept of adverse mechanical tension in the nervous system. Physiotherapy. 1989;75(11):622-36. https://doi.org/10.1016/S0031-9406(10)62374-7
  22. Kleinrensink GJ, Stoeckart R, Mulder PGH et al. Upper limb tension tests as tools in the diagnosis of nerve and plexus lesions. Clinl Biomech. 2000;15:9-14. https://doi.org/10.1016/S0268-0033(99)00042-X
  23. Millesi H. The nerve gap. Hand Clin. 1986;2:651-63.
  24. Nee RJ, Butler D. Management of peripheral neuropathic pain: Integrating neurobiology, neurodynamics, and clinical evidence. Phys Ther sport. 2006;7:36-49. https://doi.org/10.1016/j.ptsp.2005.10.002
  25. Rozmaryn LM, Dovelle S, Rothman ER et al. Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome. J Hand Ther. 1998;11(3):171-9. https://doi.org/10.1016/S0894-1130(98)80035-5
  26. Sweeney J, Harms A. Persistent mechanical allodynia following injury of the hand : Treatment through mobilization of the nervous system. J hand Ther. 1996;9(4):328-38. https://doi.org/10.1016/S0894-1130(96)80038-X