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DOI: 10.1055/a-0582-9664
Der Einfluss von standardisierter Kälte- und Kompressionstherapie auf Schwellung, Schmerzhaftigkeit und das funktionelle Ergebnis nach Spaltung des Retinaculum flexorum bei Karpaltunnelsyndrom
The effects of standardised cold and compression therapy on swelling, pain and functional outcome after division of the transverse carpal ligament in carpal tunnel syndromePublication History
07/09/2017
02/21/2018
Publication Date:
28 March 2018 (online)

Zusammenfassung
Ziel Diese prospektiv randomisierte Studie untersucht den Einfluss von standardisierter Kälte- und Kompressionstherapie auf Schwellung, Schmerzhaftigkeit und das funktionelle Ergebnis nach Spaltung des Retinaculum flexorum bei Karpaltunnelsyndrom im Vergleich zu einer reinen Kühlung.
Patienten und Methoden Fünfzig Patienten zur Spaltung des Retinaculum flexorum wurden in zwei Gruppen randomisiert. Für eine Woche führte Gruppe 1 postoperativ eine konventionelle Kühlungstherapie durch, Gruppe 2 eine standardisierte Kühlungs- u. Kompressionstherapie mit dem Cryo/Cuff™-System (3 × 10 min zweimal täglich). Nachuntersuchungen erfolgten am 1., 8. und 21. Tag nach der Operation. Ein Patient der Gruppe 1 und 3 Patienten der Gruppe 2 konnten nicht nachuntersucht werden. Die Untersuchungsparameter waren Schmerz, Schwellung, Beweglichkeit, Kraft, DASH- und MHQ-Score.
Ergebnisse Bzgl. der untersuchten Parameter fanden sich zu keinem Untersuchungszeitpunkt signifikante Unterschiede zwischen beiden Gruppen.
Schlussfolgerung Ein Vorteil der standardisierten kombinierten Kühlungs- und Kompressionstherapie mit dem Cryo/Cuff™-System gegenüber einer konventionellen Kühlung nach Spaltung des Retinaculum flexorum konnte in dieser Studie nicht nachgewiesen werden.
Abstract
Objective This prospective, randomised study examines the effect of standardised cold compression therapy on swelling, pain and functional outcome after division of the transverse carpal ligament in carpal tunnel syndrome in comparison to cooling alone.
Patients and methods Fifty patients for division of the transverse carpal ligament were randomised into two groups. In group 1, postoperative conventional cooling therapy was performed. Group 2 was given standardised cooling and compression therapy with the Cryo/Cuff™-system (3 × 10 min twice daily). Follow-up examinations were performed on days 1, 8 and 21 after the operation. One patient in group 1 and 3 patients in group 2 could not be followed up. Test parameters were pain, swelling, mobility, strength, and the DASH and MHQ score.
Results There were no significant differences between the two groups at any time point.
Conclusion In this study, no advantage could be demonstrated for standardised cooling and compression therapy with the Cryo/Cuff™-system in comparison with conventional cooling after division of the transverse carpal ligament.
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Literaturverzeichnis
- 1 Knight K. Crytherapy in sports injury management. Int Perspect Physiother 1989; 4: 163-185
- 2 Knobloch K, Grasemann R, Spies M. et al. Midportion achilles tendon microcirculation after intermittent combined cryotherapy and compression compared with cryotherapy alone: a randomized trial. Am J Sports Med 2008; 36: 2128-2138
- 3 Edwards DJ, Rimmer M, Keene GC. The use of cold therapy in the postoperative management of patients undergoing arthroscopic anterior cruciate ligament reconstruction. Am J Sports Med 1996; 24: 193-195
- 4 Meyer-Marcotty M, Jungling O, Vaske B. et al. Standardized combined cryotherapy and compression using Cryo/Cuff after wrist arthroscopy. Knee Surg Sports Traumatol Arthrosc 2011; 19: 314-319
- 5 Germann G, Harth A, Wind G. et al. Standardisierung und Validierung der deutschen Version 2.0 des “Disability of Arm, Shoulder, Hand” (DASH)-Fragebogens zur Outcome-Messung an der oberen Extremität. Unfallchirurg 2003; 106: 13-19
- 6 Germann G, Wind G, Harth A. Der DASH-Fragebogen – Ein neues Instrument zur Beurteilung von Behandlungsergebnissen an der oberen Extremität. Handchir Mikrochir Plast Chir 1999; 31: 149-152
- 7 Moher D, Hopewell S, Schulz KF. et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 2010; 340: c869
- 8 Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 2010; 1: 100-107
- 9 Bian ZX, Shang HC. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med 2011; 154: 290-291 author reply 291–292
- 10 King 2nd TI. The effect of water temperature on hand volume during volumetric measurement using the water displacement method. J Hand Ther 1993; 6: 202-204
- 11 Knobloch K, Kraemer R, Papst S. et al. German version of the brief Michigan Hand Outcomes Questionnaire: implications for early quality of life following collagenase injection in dupuytren contracture. Plast Reconstr Surg 2012; 129: 886e-887e
- 12 Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sports Med 2004; 32: 251-261
- 13 Dixon D, Johnston M, McQueen M. et al. The Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) can measure the impairment, activity limitations and participation restriction constructs from the International Classification of Functioning, Disability and Health (ICF). BMC Musculoskelet Disord 2008; 9: 114
- 14 Chung BT, Morris SF. Reliability and internal validity of the michigan hand questionnaire. Ann Plast Surg 2014; 73: 385-389
- 15 Knobloch K, Kuehn M, Papst S. et al. German standardized translation of the michigan hand outcomes questionnaire for patient-related outcome measurement in Dupuytren disease. Plast Reconstr Surg 2011; 128: 39e-40e
- 16 Knobloch K, Grasemann R, Jagodzinski M. et al. Changes of Achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a Cryo/Cuff. Am J Sports Med 2006; 34: 1953-1959
- 17 Knobloch K, Kraemer R, Lichtenberg A. et al. Microcirculation of the ankle after Cryo/Cuff application in healthy volunteers. Int J Sports Med 2006; 27: 250-255
- 18 Knobloch K, Grasemann R, Spies M. et al. Intermittent KoldBlue cryotherapy of 3 × 10 min changes mid-portion Achilles tendon microcirculation. Br J Sports Med 2007; 41: e4
- 19 Mac Auley DC. Ice therapy: how good is the evidence?. Int J Sports Med 2001; 22: 379-384
- 20 Martin SS, Spindler KP, Tarter JW. et al. Cryotherapy: an effective modality for decreasing intraarticular temperature after knee arthroscopy. Am J Sports Med 2001; 29: 288-291
- 21 Martin SS, Spindler KP, Tarter JW. et al. Does cryotherapy affect intraarticular temperature after knee arthroscopy?. Clin Orthop Relat Res 2002; 184-189
- 22 Sanchez-Inchausti G, Vaquero-Martin J, Vidal-Fernandez C. Effect of arthroscopy and continuous cryotherapy on the intra-articular temperature of the knee. Arthroscopy 2005; 21: 552-556
- 23 Lessard LA, Scudds RA, Amendola A. et al. The efficacy of cryotherapy following arthroscopic knee surgery. J Orthop Sports Phys Ther 1997; 26: 14-22
- 24 Singh H, Osbahr DC, Holovacs TF. et al. The efficacy of continuous cryotherapy on the postoperative shoulder: a prospective, randomized investigation. J Shoulder Elbow Surg 2001; 10: 522-525
- 25 Speer KP, Warren RF, Horowitz L. The efficacy of cryotherapy in the postoperative shoulder. J Shoulder Elbow Surg 1996; 5: 62-68
- 26 Woolf SK, Barfield WR, Merrill KD. et al. Comparison of a continuous temperature-controlled cryotherapy device to a simple icing regimen following outpatient knee arthroscopy. J Knee Surg 2008; 21: 15-19
- 27 Dervin GF, Taylor DE, Keene GC. Effects of cold and compression dressings on early postoperative outcomes for the arthroscopic anterior cruciate ligament reconstruction patient. J Orthop Sports Phys Ther 1998; 27: 403-406
- 28 Radkowski CA, Pietrobon R, Vail TP. et al. Cryotherapy temperature differences after total knee arthroplasty: a prospective randomized trial. J Surg Orthop Adv 2007; 16: 67-72