Post burn Cubital Tunnel Syndrome Electrophysiological and Functional Responses to High intensity Laser Therapy versus Extracorporeal Shock Wave Therapy: A Randomized Controlled Trial.

OBJECTIVE

To compare the additional effects of high-intensity laser therapy (HILT) and extracorporeal shock wave therapy (ESWT), combined with ulnar nerve gliding exercises (UNGE), on electrophysiological and functional outcomes in patients with post burn cubital tunnel syndrome (CuTS).

DESIGN

Prospective assessor blinded, parallel-group randomized controlled trial.

SETTING

University outpatient rehabilitation clinic.

PARTICIPANTS

Seventy-five participants with post burn CuTS involving upper extremity.

INTERVENTIONS: Participants were randomized (1:1:1) to HILT+UNGE (n = 25), ESWT+UNGE (n = 25), or UNGE alone (n = 25) for 4 weeks.

OUTCOME MEASURES: Primary outcomes were ulnar motor nerve conduction velocity (MNCV) across the elbow and compound muscle action potential (CMAP) amplitudes recorded from the abductor digiti minimi during ulnar nerve stimulation at three standardized sites. The secondary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) score. Assessments were performed at baseline, post-treatment, and 12-week follow-up.

RESULTS

All participants completed the intervention, and 69 completed the 12-week follow-up. Significant post vs pretreatment changes were observed for MNCV, CMAP amplitudes, and DASH scores (all P < .001). Both HILT and ESWT produced greater improvements than UNGE alone at post-treatment and follow-up (all P < .001). HILT resulted in significantly greater improvements than ESWT across all electrophysiological outcomes and DASH scores. No intervention-related adverse events were reported.

CONCLUSION

Both HILT and ESWT combined with UNGE improved nerve conduction and upper-limb function more than UNGE alone in patients with post-burn CuTS. HILT produced superior electrophysiological and functional outcomes compared with ESWT, with benefits maintained at 12-week follow-up.