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Carpal tunnel syndrome treated with guided brain plasticity : a randomised, controlled study

Flondell, Magnus LU ; Rosen, Birgitta LU ; Andersson, Gert LU and Björkman, Anders LU (2016) In Journal of Plastic Surgery and Hand Surgery p.1-6
Abstract

Introduction: Guided plasticity, induced by cutaneous forearm anaesthesia, improves hand sensibility in patients with nerve injury and vibration-induced neuropathy. This study investigated whether patients with carpal tunnel syndrome (CTS) would benefit from cutaneous forearm anaesthesia. Methods: Seventy patients with clinical and electroneurography-verified CTS were randomised to sensory training combined with either an anaesthetic cream (EMLA®) (n = 34) or a placebo cream (n = 36) on the volar part of the forearm. The treatment was repeated at increasing intervals over 8 weeks. The primary outcome was the Boston carpal tunnel questionnaire (BCTQ) symptom severity scale after 8 weeks. Secondary outcomes included activity... (More)

Introduction: Guided plasticity, induced by cutaneous forearm anaesthesia, improves hand sensibility in patients with nerve injury and vibration-induced neuropathy. This study investigated whether patients with carpal tunnel syndrome (CTS) would benefit from cutaneous forearm anaesthesia. Methods: Seventy patients with clinical and electroneurography-verified CTS were randomised to sensory training combined with either an anaesthetic cream (EMLA®) (n = 34) or a placebo cream (n = 36) on the volar part of the forearm. The treatment was repeated at increasing intervals over 8 weeks. The primary outcome was the Boston carpal tunnel questionnaire (BCTQ) symptom severity scale after 8 weeks. Secondary outcomes included activity limitations, sensory function, and nerve conduction. This study compared the longitudinal changes between the two groups, and with correction for multiple comparisons it also compared the longitudinal change within the groups. Results: There were no significant differences in primary or secondary outcomes between the groups. However, the BCTQ symptom severity scale improved significantly within the EMLA® group over the 8-week period (p = 0.001). Apart from this, no significant improvements in activity limitations, sensory function, or nerve conduction were seen in the two groups compared to baseline. Altogether, 47% of patients in the EMLA® group and 61% in the placebo group had been operated on with carpal tunnel release by 12 months. Conclusion: An 8-week treatment protocol with cutaneous forearm anaesthesia to guide brain plasticity gave no significant subjective or objective improvements in hand function compared to placebo.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
CTS, EMLA, PROM, RCT, sensibility
in
Journal of Plastic Surgery and Hand Surgery
pages
6 pages
publisher
Taylor & Francis
external identifiers
  • scopus:84978149832
ISSN
2000-656X
DOI
10.1080/2000656X.2016.1205503
language
English
LU publication?
yes
id
9c00e3b1-55c2-4eca-8990-ff4f24244269
date added to LUP
2016-07-25 12:32:41
date last changed
2017-01-01 08:31:00
@article{9c00e3b1-55c2-4eca-8990-ff4f24244269,
  abstract     = {<p>Introduction: Guided plasticity, induced by cutaneous forearm anaesthesia, improves hand sensibility in patients with nerve injury and vibration-induced neuropathy. This study investigated whether patients with carpal tunnel syndrome (CTS) would benefit from cutaneous forearm anaesthesia. Methods: Seventy patients with clinical and electroneurography-verified CTS were randomised to sensory training combined with either an anaesthetic cream (EMLA<sup>®</sup>) (n = 34) or a placebo cream (n = 36) on the volar part of the forearm. The treatment was repeated at increasing intervals over 8 weeks. The primary outcome was the Boston carpal tunnel questionnaire (BCTQ) symptom severity scale after 8 weeks. Secondary outcomes included activity limitations, sensory function, and nerve conduction. This study compared the longitudinal changes between the two groups, and with correction for multiple comparisons it also compared the longitudinal change within the groups. Results: There were no significant differences in primary or secondary outcomes between the groups. However, the BCTQ symptom severity scale improved significantly within the EMLA<sup>®</sup> group over the 8-week period (p = 0.001). Apart from this, no significant improvements in activity limitations, sensory function, or nerve conduction were seen in the two groups compared to baseline. Altogether, 47% of patients in the EMLA<sup>®</sup> group and 61% in the placebo group had been operated on with carpal tunnel release by 12 months. Conclusion: An 8-week treatment protocol with cutaneous forearm anaesthesia to guide brain plasticity gave no significant subjective or objective improvements in hand function compared to placebo.</p>},
  author       = {Flondell, Magnus and Rosen, Birgitta and Andersson, Gert and Björkman, Anders},
  issn         = {2000-656X},
  keyword      = {CTS,EMLA,PROM,RCT,sensibility},
  language     = {eng},
  month        = {07},
  pages        = {1--6},
  publisher    = {Taylor & Francis},
  series       = {Journal of Plastic Surgery and Hand Surgery},
  title        = {Carpal tunnel syndrome treated with guided brain plasticity : a randomised, controlled study},
  url          = {http://dx.doi.org/10.1080/2000656X.2016.1205503},
  year         = {2016},
}