{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:10:55Z","timestamp":1780103455138,"version":"3.54.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007693","name":"King Chulalongkorn Memorial Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007693","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the effects of phonophoresis of piroxicam (PH\u2010P) and phonophoresis of dexamethasone sodium phosphate (PH\u2010Dex) on mild to moderate carpal tunnel syndrome (CTS), and to compare each of them with the control group of nondrug ultrasound (US) therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A randomized, double\u2010blind controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Department of rehabilitation medicine, university hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients with clinical signs and symptoms of CTS underwent an electrophysiological study to confirm the diagnosis of CTS and severity grading. Thirty\u2010three patients, 50 hands (52% of the patients had bilateral CTS, n\u2009=\u200917) with mild to moderate CTS were randomly allocated into three study groups: PH\u2010P, PH\u2010Dex, or US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>All three groups received 10 sessions of 1\u2010MHz frequency, 1.0 w\/cm<jats:sup>2<\/jats:sup> intensity ultrasound wave with stroking technique, continuous mode, at the palm side of the hand over the carpal tunnel area\u201410 minutes per session, two to three times per week for 4 weeks, for a total of 10 sessions. During each session, the patients received 15\u2009cm<jats:sup>3<\/jats:sup> of study gel according to the study groups. The PH\u2010P group received 0.5% piroxicam gel mixture (equivalence of 20\u2009mg of piroxicam). The PH\u2010Dex group received 0.4% dexamethasone sodium phosphate gel mixture (equivalence 60\u2009mg of dexamethasone). The US group received nondrug gel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>Boston Carpal Tunnel Questionnaire for symptom severity (BCTQ SYMPT), Boston Carpal Tunnel Questionnaire for functional status (BCTQ FUNCT) and electrophysiological parameters of the median nerve including distal sensory latency (DSL) and distal motor latency (DML) were evaluated before the first treatment and after the last treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After treatment, all treatment groups (PH\u2010P, PH\u2010Dex, and US) showed significant improvements of the BCTQ SYMPT (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, \u22120.74\u2009\u00b1\u20090.73 [\u22121.12, \u22120.37], \u22120.91\u2009\u00b1\u20090.96 [\u22121.41, \u22120.42], and\u2009\u2212\u20090.68\u2009\u00b1\u20090.71 [\u22121.05, \u22120.30], respectively) and the BCTQ FUNCT (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, \u22120.68\u2009\u00b1\u20090.89 [\u22121.14, \u22120.22], \u22120.74\u2009\u00b1\u20090.84 [\u22121.17, \u20100.30], and\u2009\u2212\u20090.80\u2009\u00b1\u20090.80 [\u22121.22, \u22120.37], respectively). For the BCTQ SYMPT, only the PH\u2010Dex showed an improvement score above MCID at 0.8 level [\u22120.91\u2009\u00b1\u20090.96]. The improvement of BCTQ FUNCT score of all groups was above Minimal Clincally Important Difference (MCID) at 0.5 level (\u22120.68\u2009\u00b1\u20090.89, \u22120.74\u2009\u00b1\u20090.84 and\u2009\u2212\u20090.80\u2009\u00b1\u20090.80, respectively).The DSL was decreased in all groups but the changes were not statistically significant (<jats:italic>P<\/jats:italic>\u2009=\u2009.70, \u22120.11\u2009\u00b1\u20090.34 [\u22120.28, 0.06], \u22120.09\u2009\u00b1\u20090.32 [\u22120.26, 0.07], and\u2009\u2212\u20090.14\u2009\u00b1\u20090.29 [\u22120.29, 0.02], respectively). The DML showed decrease only in PH\u2010DEX and the US group but it was not statistically significant (<jats:italic>P<\/jats:italic>\u2009=\u2009.68, 0.05\u2009\u00b1\u20090.44 [\u22120.17, 0.27], \u22120.09\u2009\u00b1\u20090.51[\u22120.34, 0.17], and\u2009\u2212\u20090.27\u2009\u00b1\u20090.49 [\u22120.53, 0.01], respectively). All measured outcomes were not statistically different in between\u2010group\u2010comparison of BCTQ SYMPT, BCTQ FUNCT, DSL, and DML (<jats:italic>P<\/jats:italic>\u2009=\u2009.58, <jats:italic>P<\/jats:italic>\u2009=\u2009.79, <jats:italic>P<\/jats:italic>\u2009=\u2009.20 and <jats:italic>P<\/jats:italic>\u2009=\u2009.39, respectively). However, there was a clinically significant difference of the improvement of BCTQ SYMPT in between\u2010group comparison; only the PH\u2010DEX was above the MCID level, while the PH\u2010P and US were not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neither nondrug US nor phonophoresis treatments (PH\u2010P and PH\u2010Dex) were effective to improve the DSL and DML in mild to moderate CTS. All three groups showed significant improvements in clinical symptoms (BCTQ SYMPT) and functional status (BCTQ FUNCT). At 1 MHz frequency and 1.0 w\/cm<jats:sup>2<\/jats:sup> intensity of ultrasound wave, there is no statistically significant difference between phonophoresis and the nondrug US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>I<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12171","type":"journal-article","created":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T02:03:24Z","timestamp":1555898604000},"page":"8-15","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effectiveness of Phonophoresis Treatment in Carpal Tunnel Syndrome: A Randomized Double\u2010blind, Controlled Trial"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8534-0690","authenticated-orcid":false,"given":"Jariya","family":"Boonhong","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Worakan","family":"Thienkul","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.2.153"},{"issue":"1","key":"e_1_2_7_3_1","first-page":"6","article-title":"Carpal tunnel syndrome","volume":"77","author":"Aroori S","year":"2008","journal-title":"Ulster Med J"},{"key":"e_1_2_7_4_1","first-page":"410","article-title":"Ultrasound thermotherapy effect on the recovery of nerve conduction in experimental compression neuropathy","volume":"69","author":"Hong CZ","year":"1988","journal-title":"Arch Phys Med 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