[Study of short term effects of low level laser therapy [LLLT] vs. local steroid injection on patients with carpal tunnel syndrome]

Carpal tunnel syndrome is the most common entrapment neuropathy. Non-surgical treatment for carpal tunnel syndrome is frequently offered to those with mild to moderate symptoms. The effectiveness of some non-surgical treatment for carpal tunnel syndrome remain unknown. This study designed to compare the short term efficacy of local corticosteroid injection and laser treatment for mild to moderate idiopathic carpal tunnel syndrome. 44 hands in 33 consecutive patients with carpal tunnel syndrome confirmed by electrodiagnostic study were allocated randomly in two experimental groups. One group received local corticosteroid injection and the other received low level lasertherapy. Measurements were performed before and 8 weeks after treatments, and included pain assessment by visual analogue scale [VAS] and electrodiagnostic measurement [motor and sensory latencies and motor and sensory action potential amplitudes]. There was a significant symptomatic and electrodiagnostic improvement in both the injection and laser groups [P<0.05]. However, there was no significant difference in any of the outcome measures between the two groups [P>0.05]. LLLT was effective in treating carpal tunnel syndrome as well as local corticosteroid injection at least in short-term Long-term efficacy needs more investigation

[Comparative study of central motor conduction time by using magnetic stimulation and F-wave study in normal subjects]

Central motor conduction time [CMCT] includes time for excitation of the corticospinal pathways and transmission along those tracts. Data obtained by cortical magnetic stimulation are helpful in some clinical situations such as multiple sclerosis, cervical spondylosis, motor neuron disease, and etc. However, using different methods for peripheral motor conduction time [PMCT] demonsrates two different results. In this study, we used two methods to compare CMCT from F-wave latency and spinal root magnetic stimulation. Also, this study was performed to determine normal values, effects of sex, age and upper limb length. Magnetic stimulation of the cortex and cervical spinal roots was performed on 39 healthy subjects. Responces were recorded from the abductor pollicis brevis [APB] muscle. F-wave study was performed in the median nerve. Subtraction of total motor conduction time [TMCT: cortical response] and PMCT by F-wave and cervical root stimulation, shows CMCT. The results showed 19.7 ms for TMCT, 7.3 ms for CMCT of root stimulation and 4.8 for Fwave based CMCT. CMCT to the APB correlates with upper limb length but no with age or sex. The CMCT calculated by subtracting F- wave latencies measured to APB after transcranial stimulation was shorter than the one obtained after magnetic root stimulation

[Effect of Cervical Spinal Manipulation on Lateral epicondylalgia]

Background: lateral epicondylalgia is relatively a common musculoskeletal problem. Some recent studies have shown the possible relationship between segmental cervical spine dysfunction and lateral epicondylalgia in noticeable portion of patients. The aim of this study was to assess the effects of cervical manipulation on lateral epicondylalgia in the presence of painful minor intervertebral dysfunction [PMID]

Methods and materials: in this randomized double blind clinical trial study, 30 patients with lateral epicondylalgia referred to Physical Medicine and Rehabilitation Clinic of 501 Amy Hospital were studied. 15 patients received rotatory high velocity, low amplitude manipulative therapy in pain free direction. The others received mobilization without thrust [no manipulation]

Results: immediately after manipulation, there was 2.8 cm decrement in VAS and 51.9, and 20.4 increment in PPT and PFG, respectively. After a week, improvement was 2.1 cm in VAS, 30.7% in PPT and 8.5% in PFG

Conclusion: manipulated group produced significant improvement in visual analogue scale and pressure pain threshold not only immediately after treatment but also a week later. Pain free grip strength had no significant increment one week after manipulation in comparison with non-manipulated group. Improvement of all variables decreased with time, justifying the need for repetition of manipulation. Duration of efficacy and correlation between PMID and pain of lateral epicondyl requires longtime evaluation of patients and more studies