KARPAL TÜNEL SENDROMU TANILI BİREYLERDE TRANSKÜTANÖZ AURİKÜLER VAGUS SİNİR UYARIMININ SİNİR İLETİ HIZI, KAVRAMA KUVVETİ, AĞRI VE ÜST EKSTREMİTE FONKSİYONELLİĞİNE ETKİSİ

Öz

Amaç: Transkütanöz auriküler vagus uyarımının(taVNS) KTS’de sinir ileti hızı, kavrama kuvveti, ağrı ve üst ekstremite fonksiyonelliği gibi parametrelerdeki etkisinin araştırılması amaçlanmaktadır. Yöntem: Çalışmaya karpal tünel sendromu tanısı almış, yaşları 18-58 aralığında değişen 51 hasta (90 el) 12 erkek 39 kadın dahil edilmiştir. Katılımcılar, rastgele randomizasyon yöntemi ile gruplara ayrılmışlardır. Tedavi öncesi ve sonrasında olacak şekilde median sinirin duyusal dalının ileti hızını ölçmek amacı ile elektromyografi (EMG) değerlendirmesi, bir dijital dinamometre yardımı ile el kavrama kuvveti, vizüel analog skalası (VAS) ölçeği ile ağrı sorgulaması ve üst ekstremitenin fonksiyonelliğini ölçmek amacı ile üst ekstremite fonksiyonel indeksi (ÜEFİ) ölçeği uygulanmıştır. Çalışmada yer alan deney, sham ve kontrol gruplarına konvansiyonel fizyoterapi programı 10 seans olacak şekilde uygulanırken, deney grubuna konvansiyonel fizyoterapi programıyla birlikte ek olarak 10 seans auriküler vagus sinir uyarımı da gerçekleştirilmiştir. Sonuçlar: Çalışmada gruplar arasında VKİ, yaş, cinsiyeti eğitim durumu, sigara kullanma durumu gibi parametreler açısından anlamlı farklılıklar bulunmamıştır (p>0,05). Grup içi yapılan değerlendirmelerde kavrama kuvveti dışında kalan sinir ileti hızı, ağrı ve üst ekstremite fonksiyonelliği açısından başlangıç durumuna göre anlamlı farklılık bulunmuştur (p<0,05). Grupların karşılaştırılması için yapılan analizde ise kavrama kuvveti parametresi dışında kalan tüm parametrelerde deney grubu lehine anlamlı farklılık bulunurken (p<0,05), sham ve kontrol grupları arasında anlamlı bir farklılık bulunmamıştır (p>0,05). Tartışma: Çalışma sonucunda KTS tanısı almış bireylerde konvansiyonel rehabilitasyon programına ek olarak uygulanan taVNS’nin duyusal sinir ileti hızını ve üst ekstremite fonksiyonellik seviyesini yükselttiği, ağrıyı azalttığı ancak kavrama kuvveti üzerinde herhangi bir etki oluşturmadığı bulunmuştur.

Anahtar Kelimeler

• x.kranial sinir
• karpal tünel
• sinir ileti çalışmaları

THE EFFECTS OF TRANSCUTANEOUS AURICULAR VAGUS NERVE STIMULATION ON NERVE CONDUCTION VELOCITY, GRIP STRENGTH, PAIN, AND UPPER EXTREMITY FUNCTIONALITY IN INDIVIDUALS WITH CARPAL TUNNEL SYNDROME

Abstract

Purpose: This study aims to investigate the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on key parameters, including nerve conduction velocity, grip strength, pain, and upper extremity functionality in individuals with carpal tunnel syndrome (CTS). Methods: The study involved 51 patients (90 hands) diagnosed with carpal tunnel syndrome, comprising 12 males and 39 females, ranging in age from 18 to 58 years. Participants were divided into groups by random randomization method. Sensory branch conduction velocity of the median nerve was assessed via electromyography (EMG), hand grip strength was measured using a digital dynamometer, and pain intensity was quantified with a visual analog scale (VAS); additionally, upper extremity functionality was evaluated using the Upper Extremity Functional Index (UEFI) scale before and after the treatment. In the experimental group, in addition to the conventional physiotherapy program, 10 sessions of auricular vagus nerve stimulation were administered; for the sham and control groups, the conventional physiotherapy program alone was conducted over the course of 10 sessions. Results: The analysis revealed no statistically significant differences between the groups concerning variables such as body mass index (BMI), age, gender, educational background, and smoking status (p>0.05). However, within-group evaluations exhibited significant differences compared to baseline values in terms of nerve conduction velocity, pain perception, and upper extremity functionality, with no such difference observed in grip strength (p<0.05). The intergroup comparisons indicated a significant difference in favor of the experimental group across all parameters, except for grip strength (p<0.05); conversely, no substantial differences were observed between the sham and control groups (p>0.05). Conclusion: The findings suggest that the adjunctive use of taVNS alongside conventional rehabilitation programs in individuals diagnosed with CTS results in increased sensory nerve conduction velocity and enhanced upper extremity functional capacity, accompanied by a reduction in pain; nevertheless, grip strength remains unaffected.

Keywords

• cranial nerve x
• carpal tunnel
• Nerve Conduction Studies

Kaynakça

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