ROLE OF THERAPEUTIC EXERCISES IN NEUROGENIC THORACIC OUTLET SYNDROME

Authors

  • Saquib Hanif
  • Noreen Tassadaq
  • M. Farooq Azam Rathore
  • Pervaiz Rashid
  • Nadeem Ahmed
  • Farooq Niazi

Abstract

Background: Neurogenic Thoracic Outlet Syndrome (TOS) is a set of signs and symptomsexisting due to compression of brachial plexus in the cervical area. We performed the study tohighlight the role of therapeutic exercises on patients with neurogenic thoracic Outlet Syndrome.Methods: This quasi-experimental study was carried out at Armed Forces Institute ofRehabilitation Medicine (AFIRM), Rawalpindi. Fifty consecutive patients of neurogenic TOS ofboth genders and all ages were selected. Patients were diagnosed clinically and the diagnosis wasconfirmed by electrodiagnosis. These patients were asked to follow a therapeutic exercisesprogram for 6 months. Outcome measures included Visual Analogue Scale (VAS) and UlnarNerve Conduction Velocity across neck. Results were compared by applying relevant tests ofsignificance on follow up visits at 3 and 6 months. Results: Mean age was 39.1±7.79 years.Thirty seven (74%) cases were females and thirteen (26%) were males. On each visit, statisticalanalysis showed significant improvement with therapeutic exercises. After 6 months ofconservative treatment, 17 (34%) of patients showed full recovery, 14 (28%) had markedimprovement, 16 (32%) had partial improvement while 3 (6%) patients reported with persistentsevere symptoms. Conclusion: Current study shows that a trial of therapeutic exercises providesrelief of symptoms of Neurogenic Thoracic Outlet Syndrome in majority of patients.Key Words: Thoracic Outlet Syndrome, entrapment syndromes, Electrodiagnosis, TherapeuticExercises, Rehabilitation

References

Woods WW: Personal experiences with the surgical

treatment of 250 cases of cervicobrachial neurovascular

compression syndrome. J Int Coll Surg. 1965;44:273–83.

R. A. Cooke. Thoracic outlet syndrome-aspects of diagnosis

in the differential diagnosis of hand-arm vibration syndrome,

Occup Med (Lond). 2003;53(5):331–6.

Brantigan CO, Roos DB. Diagnosing thoracic outlet

syndrome, Hand Clin, 2004;20:27–36.

England JD, Tiel RL: AAEM case report 33: costoclavicular

mass syndrome. Amr. Ass. Of Electrodiagnostic Medicine.

Muscle Nerve 1999;22:412–8.

Gruss D. Thoracic outlet syndrome. Acta Chir Aust

;32:15–19.

Tolson TD. EMG for thoracic outlet syndrome. Hand Clin

;20:37–42.

Balci AE, Balci TA, Cakiro, Eren S, Eren MN. Surgical

treatment of thoracic outlet syndrome: effects and results of

surgery. Ann Thoracic Surgery 2003;75:1091–6.

J Ayub Med Coll Abbottabad;19(4)

Niazi PHK, Ahmad K, Hussain A, Waheed A, Alam A.

Electrodiagnosis of Thoracic Outlet Syndrome. J Med Armed

Forces Pak. 2001;51(1):6–9.

Andrew KC, Bohan JS. Thoracic outlet syndrome [online]

[cited 2006 October 06]; Available form: URL:

http://www.emedicine.com/emerg/topic578.htm.

Nancy AK. Evaluation and treatment of thoracic outlet

syndrome [online] 2003 [cited 2004 Apr 5]; Available form

URL: http://www.therasite-thoracic outlet handouts.htm

Benjamin MS: Thoracic outlet syndrome [online] 2006 [cited

December 13]; Available from URL:

http://www.emedicine.com/PMR/topic136.htm.

Landry GJ, Moneta GL, Taylor LM Jr, Edwards JM, Porter

JM. Long-term functional outcome of neurogenic thoracic

outlet syndrome in surgically and conservatively treated

patients. J Vasc Surg 2001;33:312–7, 317–9.

Nakatsuchi Y, Saitoh S, Hosaka M, Matsuda S. Conservative

treatment of thoracic outlet syndrome using an orthosis. J

Hand Surg [Br]. 1995;20:34–9.

Buonocore M, Manstretta C, Mazzucchi G, Casale R. The

clinical evaluation of conservative treatment in patients with

the thoracic outlet syndrome. G Ital Med Lav Ergon

;20:249–54.

Tariq M, Zahir J, Saleem SA. Role of acupuncture in thoracic

outlet syndrome. BMJ Acupuncture in Med 2000;18:122–3.

Kenny RA, Traynor GB, Withington D, Keegan DJ. Thoracic

outlet syndrome: a useful exercise treatment option. Am J

Surg 1993;165:282–3.

Singh MK, Patel J. Thoracic outlet syndrome [online] 2006

[cited 2006 January 31]; Available from: URL:

http://www.emedicine.com/neuro/topic369.htm.

Dubuisson AS. The thoracic outlet syndrome [online] 2002

[cited 2005 May 25]; Available from URL:

http://www.medschool.lsuhsc.edu/neurosurgery/nervecenter/

TOS.html

Garcia ND, Eskandari M, Tehrani H, Morasch MD. Thoracic

outlet obstruction [online] 2007 [cited 2007 May 23]; Available

from URL: http://www.emedicine.com/med/topic2774.htm.

Lindgren KA. Conservative treatment of thoracic outlet

syndrome: a 2-year follow-up. Arch Phys Med Rehabil.

;78(4):373–8.

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