Background Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome worldwide. Objective The current work aimed at determining the effect of extracorporeal shock wave therapy (ESWT) on different severities of carpal tunnel syndrome. Subjects and methods Sixty patients with unilateral carpal tunnel syndrome were participated in this study. They were divided into three equal groups according to severity (mild, moderate, and severe). All patients received shock wave therapy one session per week, for 6 weeks. Nerve conduction studies (NCs) were done for the median nerve. Pinch dynamometer was used to measure the degree of lateral pinch power, and Visual Analogue Scale (VAS) was used to assess degree of pain and Ultrasonography analysis measured cross-sectional area (CSA) of median nerve for all patients at the beginning and at the end of the study. Results There was significant improvement ( P < 0.05) in sensory conduction parameters, CSA, lateral pinch power, and VAS after shock wave therapy in all groups. Also, there was significant improvement in motor latency, motor, and sensory amplitudes after shock wave therapy in mild and moderate groups only ( P < 0.05). In all group samples, results revealed a highly significant correlations ( p < 0.001) between peak sensory latency (PSL) with VAS, CSA with motor latency (ML), CSA with PSL, CSA with VAS, CSA with lateral pinch, and ML with lateral pinch. Conclusion It is recommended to use ESWT as a conservative treatment in patients with different severities of CTS, except patients with severe motor affection. Trial registration PACTR201804003293116. Registered on 26 April 2018 as retrospective registration in the pan African clinical trial registry ( www.pactr.org ).

中文翻译：

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体外冲击波疗法对不同严重程度腕管综合征的影响

背景腕管综合征 (CTS) 是世界范围内最常见的周围神经卡压综合征。目的目前的工作旨在确定体外冲击波疗法（ESWT）对不同严重程度的腕管综合征的影响。对象和方法 60 名单侧腕管综合征患者参加了这项研究。他们根据严重程度（轻度、中度和重度）分为三个相等的组。所有患者每周接受一次冲击波治疗，持续 6 周。对正中神经进行了神经传导研究 (NCs)。捏力计用于测量横向捏力的程度，使用视觉模拟量表 (VAS) 评估疼痛程度，并在研究开始和结束时测量所有患者的正中神经横截面积 (CSA)。结果 各组冲击波治疗后感觉传导参数、CSA、侧捏力、VAS均有显着改善（ P < 0.05）。此外，仅轻度和中度组在冲击波治疗后运动潜伏期、运动和感觉振幅有显着改善（ P < 0.05）。在所有组样本中，结果显示峰值感觉潜伏期 (PSL) 与 VAS、CSA 与运动潜伏期 (ML)、CSA 与 PSL、CSA 与 VAS、CSA 与侧捏和 ML 之间存在高度显着的相关性 (p < 0.001)横向捏。结论 除重度运动障碍患者外，建议对不同严重程度的CTS患者采用ESWT作为保守治疗。试用注册PACTR201804003293116。于 2018 年 4 月 26 日在泛非临床试验注册中心 (www.pactr.org) 注册为回顾性注册。