Evaluation of electrophysiological and clinical changes in the treatment of carpal tunnel syndrome using electroacupuncture combined with therapeutic ultrasound

Abstract

Objectives: 1. To evaluate changes in nerve electrophysiological parameters in patients with carpal tunnel syndrome (CTS) before and after treatment with electroacupuncture combined with therapeutic ultrasound. 2. To assess changes in clinical symptoms of CTS before and after treatment with electroacupuncture combined with therapeutic ultrasound. 3. To determine the correlation between nerve electrophysiology and clinical symptoms in patients with CTS treated with electroacupuncture combined with therapeutic ultrasound. Method: A prospective, open-label clinical trial with before-and-after treatment comparison. Results: The mean electrophysiological parameters showed overall improvement following treatment. The greatest improvements were observed in motor latency difference (39.6%), sensory latency difference (32.14%), motor latency (20.8%), and sensory latency (15.16%) (all p<0.01). The proportion of patients with severe electrophysiological impairment decreased from 8.7% to 2.2%, those with moderate impairment decreased from 56.5% to 8.7%, and those with very mild impairment increased from 13% to 34.8%. The percentage of patients returning to normal electrophysiological status increased from 0% to 23.9%. Overall electrophysiological outcomes were: 23.9% recovered, 69.6% improved, and 6.5% showed no response. All clinical symptoms demonstrated significant improvement. Numbness, paresthesia, and pain improved by 76.1%, 58.7%, and 54.3%, respectively (p<0.01). Hand weakness or clumsiness improved by 23.9% (p<0.01), and sensory loss in the median nerve distribution improved by 15.2% (p<0.05). The Phalen, Tinel, and Durkan tests showed marked improvement, with reductions of 76.1%, 67.4%, and 58.7%, respectively (p<0.01). The mean BCTQ Symptom Severity Score decreased from 2.19 ± 0.65 to 1.35 ± 0.56, and the Functional Status Score decreased from 1.51 ± 0.54 to 1.07 ± 0.19 (p<0.01). Overall clinical outcomes were: 23.9% recovered, 71.7% improved, and 4.3% showed no response. There was a positive correlation between motor and sensory distal latency, as well as latency difference, and the BCTQ Symptom Severity Score (r = 0.552, 0.375, 0.531, 0.497; p<0.05). Sensory conduction velocity was negatively correlated with the Symptom Severity Score (r = –0.412; p<0.01). Motor and sensory latencies and their differences were positively correlated with the Functional Status Score (r = 0.577, 0.523, 0.542, 0.524; p < 0.01). Sensory amplitude and sensory conduction velocity were negatively correlated with the Functional Status Score (r = –0.348, –0.489; p<0.05). No correlation was found between motor amplitude or motor conduction velocity and the Functional Status Score (p>0.05).