Telerreabilitação para a síndrome do túnel cárpico: uma nova abordagem de tratamento com novas possibilidades: um ensaio clínico randomizado

Autores

  • Mohamed Gamal Hassan Physiotherapy Assistant Professor, School of Health and Social Work, University of Hertfordshire hosted by GAF ( UH-GAF), Egypt.
  • Aya Fawzy Mohamed Ali Lecturer, Department of Musculoskeletal disorders and its surgeries, Faculty of Physical Therapy, Modern University for Technology and Information, Cairo, Egypt & Assistant Professor, Department of Physical Therapy, Faculty of Allied Medical Sciences, Philadelphia University, Jordan.
  • Haidy Samy Faculty of Physical Therapy, Modern University for Technology and Information, Cairo, Egypt
  • Manar Hamdy Faculty of Physical Therapy, Kafrelsheikh University, Kafrelsheikh, Egypt
  • Abdelrahman Sameh Abdelkarim Attia Faculty of Physical Therapy, Benha University, Benha, Egypt.
  • Sara S. El-Din Assistant professor, Department of Physical Therapy, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
  • Shimaa Sayed Mahmoud Ahmed Assistant professor, Department of Physical Therapy for Internal Medicine and Geriatrics, Faculty of Physical Therapy, Egyptian Chinese University & Department of Physiotherapy, Faculty of Allied Medical Sciences Departments, Middle East University, Amman, Jordan
  • Shaimaa Mohamed Mabrouk Bondok Assistant professor, Department of Physiotherapy, Faculty of Allied Medical Sciences Departments, Middle East University, Amman, Jordan
  • Sarah Sami Abdelaziz Assistant Professor, Physiotherapy Program, Health & Science School, Queen Margaret University (UK), hosted by Capital University Foundation, New Administrative Capital, Egyptive Capital, Egypt
  • Eman J. Hassan Lecturer, Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Egyptian Chinese University.
  • Shaza Samir Hassan Assistant professor, Basic Science Department, Faculty of Physiotherapy, The British University in Egypt, El-Sherouk City, Egypt.

DOI:

https://doi.org/10.47197/retos.v72.117333

Palavras-chave:

Síndrome do túnel cárpico, função, dor, reabilitação, telemedicina

Resumo

Objectivo: Este estudo teve como objectivo avaliar a eficácia de um programa estruturado de telerreabilitação em comparação com a terapêutica convencional em clínica na melhoria da dor, função e amplitude de movimento (ADM) no punho em indivíduos com síndrome do túnel cárpico (STC).

Metodologia: Este ensaio clínico randomizado incluiu um total de 40 doentes (16 homens, 24 mulheres) com STC. Os doentes foram randomizados igualmente em dois grupos: o Grupo 1 foi submetido a fisioterapia convencional (n = 20). O Grupo 2 foi submetido a um programa de telerreabilitação (n = 20). A eficácia do tratamento foi avaliada através do registo de dados da EVA de 10 pontos, da Incapacidade do Braço, Ombro e Mão (DASH) e da amplitude de movimento ativa da articulação do punho (ADM) desde o pré-tratamento até às quatro semanas (12 sessões).

Resultados: O grupo de telerreabilitação demonstrou uma melhoria significativamente maior na pontuação do DASH em comparação com o grupo de controlo (p > 0,001) e na extensão da ADM (p > 0,001) após quatro semanas de tratamento. No entanto, não foi observada melhoria significativa entre os grupos na pontuação da EVA e nos desvios radial, ulnar e de flexão da ADM (p = 0,414, p = 0,96 e p = 0,799, respetivamente).

Conclusões: Estes achados sugerem que a telerreabilitação pode ser uma alternativa viável e eficaz ao tratamento convencional. A sua utilização pode ser especialmente benéfica para pacientes com acesso limitado à terapia presencial.

Referências

Aboonq, M. S. (2015). Pathophysiology of carpal tunnel syndrome. Neurosciences Journal, 20(1), 4–9.

Alahmri, F., Nuhmani, S., & Muaidi, Q. (2024). Effectiveness of telerehabilitation on pain and function in musculoskeletal disorders: A systematic review of randomized controlled trials. Musculoskeletal Care, 22(2). https://doi.org/10.1002/msc.1912

Alotaibi, N. M., Aljadi, S. H., & Alrowayeh, H. N. (2016). Reliability, validity and responsiveness of the Arabic version of the Disability of Arm, Shoulder and Hand (DASH-Arabic). Disability and Rehabilitation, 38(25), 2469–2478.

Baroni, M. P., Jacob, M. F. A., Rios, W. R., Fandim, J. V., Fernandes, L. G., Chaves, P. I., Fioratti, I., & Saragiotto, B. T. (2023). The state of the art in telerehabilitation for musculoskeletal conditions. Archives of Physiotherapy, 13(1), 1–14. https://doi.org/10.1186/s40945-022-00155-0

Chammas, M., Boretto, J., Burmann, L. M., Ramos, R. M., Santos Neto, F. C. dos, & Silva, J. B. (2014). Carpal tunnel syndrome-Part I (anatomy, physiology, etiology and diagnosis). Revista Brasileira de Ortopedia, 49(5), 429–436.

Costa, F., Janela, D., Molinos, M., Moulder, R. G., Lains, J., Francisco, G. E., Bento, V., Yanamadala, V., Cohen, S. P., & Correia, F. D. (2022). Digital rehabilitation for hand and wrist pain: a single-arm prospective longitudinal cohort study. Pain Reports, 7(5), e1026.

Erickson, M., Lawrence, M., Jansen, C. W. S., Coker, D., Amadio, P., Cleary, C., Altman, R., Beattie, P., Boeglin, E., Dewitt, J., & others. (2019). Hand pain and sensory deficits: Carpal tunnel syndrome: Clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of hand and upper extremity physical therapy and the academy of orthopae. Journal of Orthopaedic & Sports Physical Therapy, 49(5), CPG1--CPG85.

Fess, E. (1981). Clinical assessment recommendations. American Society of Hand Therapists, 6–8.

Gabrielli, A. S., Lesiak, A. C., & Fowler, J. R. (2020). The direct and indirect costs to society of carpal tunnel release. Hand, 15(2), NP1--NP5.

Gebrye, T., Jeans, E., Yeowell, G., Mbada, C., & Fatoye, F. (2024). Global and regional prevalence of carpal tunnel syndrome: A meta-analysis based on a systematic review. Musculoskeletal Care, 22(4), e70024.

Grigorovich, A., Xi, M., Lam, N., Pakosh, M., & Chan, B. C. F. (2022). A systematic review of economic analyses of home-based telerehabilitation. Disability and Rehabilitation, 44(26), 8188–8200.

Hamzeh, H., Madi, M., Alghwiri, A. A., & Hawamdeh, Z. (2021). The long-term effect of neurodynamics vs exercise therapy on pain and function in people with carpal tunnel syndrome: A randomized parallel-group clinical trial. Journal of Hand Therapy, 34(4), 521–530.

Hartantri, W., & Arfianti, L. (2020). Combination of telerehabilitation with conventional therapy in the treatment of bilateral carpal tunnel syndrome: a case report. Surabaya Phys Med Rehabil J, 2(2), 73.

Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF. Arthritis Care & Research, 63 Suppl 1(SUPPL. 11). https://doi.org/10.1002/ACR.20543

Horger, M. M. (1990). The reliability of goniometric measurements of active and passive wrist motions. The American Journal of Occupational Therapy, 44(4), 342–348.

Ijaz, M. J., Karimi, H., Ahmad, A., Gillani, S. A., Anwar, N., & Chaudhary, M. A. (2022). Comparative efficacy of routine physical therapy with and without neuromobilization in the treatment of patients with mild to moderate carpal tunnel syndrome. BioMed Research International, 2022(1), 2155765.

Jirasakulsuk, N., Saengpromma, P., & Khruakhorn, S. (2022). Real-Time Telerehabilitation in Older Adults With Musculoskeletal Conditions: Systematic Review and Meta-analysis. JMIR Rehabilitation and Assistive Technologies, 9(3), e36028. https://doi.org/10.2196/36028

Krzyzaniak, N., Cardona, M., Peiris, R., Michaleff, Z. A., Greenwood, H., Clark, J., Scott, A. M., & Glasziou, P. (2023). Telerehabilitation versus face-to-face rehabilitation in the management of musculoskeletal conditions: a systematic review and meta-analysis. Physical Therapy Reviews, 28(2), 71–87.

Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2010). CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Bmj, 340.

Namaz, Z. S., Afsar, E., & Akdeniz Leblebicier, M. (2025). The impact of symptoms, proprioception, and electrodiagnostic findings on activity and participation in idiopathic carpal tunnel syndrome: an ICF framework approach. Physiotherapy Theory and Practice, 1–12.

Norkin, C. C., & White, D. J. (2016). Measurement of joint motion: a guide to goniometry. FA Davis.

Núñez-Cortés, R., Cruz-Montecinos, C., Torreblanca-Vargas, S., Tapia, C., Gutiérrez-Jiménez, M., Torres-Gangas, P., Calatayud, J., & Pérez-Alenda, S. (2023). Effectiveness of adding pain neuroscience education to telerehabilitation in patients with carpal tunnel syndrome: A randomized controlled trial. Musculoskeletal Science and Practice, 67(May). https://doi.org/10.1016/j.msksp.2023.102835

Núñez-Cortés, R., Cruz-Montecinos, C., Torres-Castro, R., Tapia, C., Püschel, T. A., & Pérez-Alenda, S. (2022). Effects of Cognitive and Mental Health Factors on the Outcomes Following Carpal Tunnel Release: A Systematic Review and Meta-analysis. Archives of Physical Medicine and Rehabilitation, 103(8), 1615–1627. https://doi.org/10.1016/j.apmr.2021.10.026

Padua, L., Coraci, D., Erra, C., Pazzaglia, C., Paolasso, I., Loreti, C., Caliandro, P., & Hobson-Webb, L. D. (2016). Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology, 15(12), 1273–1284.

Pech-ArguÓelles, R. C., Miranda-Ortiz, Y. J., Velázquez-Hernández, H. E., Domínguez-Cordero, R., Ruiz-Pacheco, C., Figueroa-García, J., & Rojano-Mejía, D. (2024). Tele-rehabilitation program in patients with distal radius fracture: a controlled clinical trial. Cirugía y Cirujanos (English Edition), 92(1). https://doi.org/10.24875/cirue.m22000599

Salehi, S., Hesami, O., Esfehani, M. P., Khosravi, S., Rashed, A., Haghighatzadeh, M., Hassabi, M., & Yekta, A. H. A. (2019). The effectiveness of exercise therapy and dry needling on wrist range of motion, pinch and grip force in carpal tunnel syndrome: a randomized clinical trial. Asian J Sports Med, 10(4), 1–9.

Salud, R. A. P., Leochico, C. F. D., Ignacio, S. D., Mojica, J. A. P., & Ang-Muñoz, C. D. (2022). Continuing care through telerehabilitation for patients in a COVID-19 referral center in the Philippines: a case series. Acta Med Philipp [Internet], 56(4), 89–93.

Shem, K., Wong, J., & Dirlikov, B. (2020). Effective self-stretching of carpal ligament for the treatment of carpal tunnel syndrome: A double-blinded randomized controlled study. Journal of Hand Therapy, 33(3), 272–280.

Shi, Q., & MacDermid, J. C. (2011). Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? A systematic review. Journal of Orthopaedic Surgery and Research, 6, 1–9.

Suero-Pineda, A., Oliva-Pascual-Vaca, Á., Durán, M. R.-P., Sánchez-Laulhé, P. R., Garc’ia-Frasquet, M. Á., & Blanquero, J. (2023). Effectiveness of a telerehabilitation evidence-based tablet app for rehabilitation in traumatic bone and soft tissue injuries of the hand, wrist, and fingers. Archives of Physical Medicine and Rehabilitation, 104(6), 932–941.

Tousignant, M., Boissy, P., Moffet, H., Corriveau, H., Cabana, F., Marquis, F., & Simard, J. (2011). Patients’ satisfaction of healthcare services and perception with in-home telerehabilitation and physiotherapists’ satisfaction toward technology for post-knee arthroplasty: An embedded study in a randomized trial. Telemedicine and E-Health, 17(5), 376–382. https://doi.org/10.1089/tmj.2010.0198

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Publicado

08-10-2025

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Artigos de caráter científico: trabalhos de pesquisas básicas e/ou aplicadas.

Como Citar

Hassan, M. G., Mohamed Ali, A. F., Samy, H., Hamdy, M., Abdelkarim Attia, A. S., El-Din, S. S., Mahmoud Ahmed, S. S., Mabrouk Bondok, S. M., Abdelaziz, S. S., Hassan, E. J., & Hassan, S. S. (2025). Telerreabilitação para a síndrome do túnel cárpico: uma nova abordagem de tratamento com novas possibilidades: um ensaio clínico randomizado. Retos, 72, 1141-1150. https://doi.org/10.47197/retos.v72.117333