Efektivitas Kombinasi Ultrasound Diathermy Dan Stretching Exercise Terhadap Pemulihan Fungsional Carpal Tunnel Syndrome: Studi Kasus
Keywords:
carpal tunnel syndrome, disabilitas tangan, fisioterapi, stretching exercise, ultrasound diathermyAbstract
Carpal tunnel syndrome (CTS) merupakan penyempitan neuropati akibat tekanan pada saraf medianus di bawah flexor retinaculum pergelangan tangan, yang memicu gangguan sensorik seperti nyeri dan paresthesia. Prevalensi kasus CTS di Indonesia mencapai 5,6% dan berdampak langsung pada produktivitas kerja harian. Penelitian ini bertujuan untuk mengidentifikasi efektivitas penatalaksanaan fisioterapi menggunakan kombinasi modalitas ultrasound diathermy (USD) dan stretching exercise dalam menurunkan nyeri, meningkatkan lingkup gerak sendi (LGS), serta mengembalikan fungsi aktivitas fisik pada pasien CTS. Metode yang digunakan adalah studi kasus klinis pada seorang pasien perempuan di Rumah Sakit Umum Muhammadiyah Babat yang menjalani intervensi sebanyak 4 sesi (1 kali/minggu). USD diaplikasikan dengan frekuensi 3 MHz, intensitas 1,5 W/cm², selama 5 menit per sesi, dilanjutkan dengan protokol stretching exercise pada gerakan fleksi dan ekstensi pergelangan tangan. Hasil evaluasi dari T0 (sebelum terapi) hingga T4 (sesudah terapi) menunjukkan metrik penurunan skala nyeri gerak VAS dari 6 menjadi 4, peningkatan kekuatan otot MMT dari nilai 3 menjadi 4 pada seluruh bidang gerak, serta perbaikan fungsional Wrist and Hand Disability Index (WHDI) dari 60% menjadi 52%. Peningkatan LGS aktif juga tercatat secara linier pada gerakan fleksi (dari 46° menjadi 52°) dan ekstensi (dari 40° menjadi 47°). Kesimpulannya, kombinasi USD dan stretching exercise secara sinergis dan efektif mampu mempercepat perbaikan jaringan lunak, menurunkan intensitas nyeri, serta memperbaiki kapasitas fungsional tangan secara signifikan pada penderita Carpal Tunnel Syndrome
References
Alnahdi, A. H. (2023). Responsiveness of the Arabic Upper Extremity Functional Index in Patients with Upper Extremity Musculoskeletal Disorders. International Journal of Environmental Research and Public Health, 20(5), 4370. https://doi.org/10.3390/ijerph20054370
Andayani, N. L. N., Wibawa, A., & Nugraha, M. H. S. (2020). Effective Ultrasound and Neural Mobilization Combinations in Reducing Hand Disabilities in Carpal Tunnel Syndrome Patients. Jurnal Keperawatan Indonesia, 23(2), 93–101. https://doi.org/10.7454/jki.v23i2.988
Bagcaci, S. (2023). Efficiency of therapeutic underwater ultrasound therapy in mild-to-moderate carpal tunnel syndrome: A randomized sham-controlled study. Turkish Journal of Physical Medicine and Rehabilitation, 69(2), 366–376. https://doi.org/10.5606/tftrd.2023.12467
Dewi, N. M. A. S., Made Hendra Satria Nugraha, & Kadek Arya Wiguna. (2024). Penatalaksanaan fisioterapi pada keterbatasan aktivitas fungsional pada carpal tunnel syndrome: A case report. Journal Physical Therapy UNISA, 4(1), 1–9. https://doi.org/10.31101/jitu.3472
Erickson, M., Lawrence, M., Jansen, C. W. S., Coker, D., Amadio, P., & Cleary, C. (2019a). 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 Orthopaedic Physical Therapy of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 49(5), CPG1–CPG85. https://doi.org/10.2519/jospt.2019.0301
Erickson, M., Lawrence, M., Jansen, C. W. S., Coker, D., Amadio, P., & Cleary, C. (2019b). 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 Orthopaedic Physical Therapy of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 49(5), CPG1–CPG85. https://doi.org/10.2519/jospt.2019.0301
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. https://doi.org/10.1002/msc.70024
Huisstede, B. M., Hoogvliet, P., Franke, T. P., Randsdorp, M. S., & Koes, B. W. (2018). Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials. Archives of Physical Medicine and Rehabilitation, 99(8), 1623-1634.e23. https://doi.org/10.1016/j.apmr.2017.08.482
Irmayani, I., Parinduri, A. I., Bangun, S. M., & Lismawati, L. (2021). Faktor – Faktor Yang Berhubungan Dengan Keluhan Carpal Tunnel Syndrome (CTS) Pada Supir Angkot Di Lubuk Pakam. Jurnal Keperawatan Dan Fisioterapi (JKF), 4(1), 95–99. https://doi.org/10.35451/jkf.v4i1.872
Jerosch-Herold, C., Leite, J. C. D. C., & Song, F. (2006). A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF) as a reference tool. BMC Musculoskeletal Disorders, 7(1), 96. https://doi.org/10.1186/1471-2474-7-96
Leelamani, V., Shankar, S., Zoubi, M. A. A., Ali, M. R., Elawady, A., Raju, R., Leelamani, V., Shankar, S., Zoubi, M. A. A., Ali, M. R., Elawady, A., & Raju, R. (2025). Retrospective Analysis of Carpal Tunnel Syndrome: Clinical Profile, Demographics, and Risk Factors at Sohar Hospital Over a Two-Year Period. Cureus, 17. https://doi.org/10.7759/cureus.86777
Lepley, A. S., & Lepley, L. K. (2022). Mechanisms of Arthrogenic Muscle Inhibition. Journal of Sport Rehabilitation, 31(6), 707–716. https://doi.org/10.1123/jsr.2020-0479
Lina, R. K., B.l, A. B., & Parwati, S. (2022). Pengaruh Intervensi Ultrasound Terhadap Perubahan Nyeri Carpal Tunnel Syndrome Di Klinik Fisioterapi Sayang Jatinangor Tahun 2022. Jurnal Fisioterapi dan Kesehatan Indonesia, 2(2), 1–10. https://doi.org/10.59946/jfki.2022.152
McDonough, C. M., & Jette, A. M. (2010). The Contribution of Osteoarthritis to Functional Limitations and Disability. Clinics in Geriatric Medicine, 26(3), 387–399. https://doi.org/10.1016/j.cger.2010.04.001
Morishita, K., Karasuno, H., Yokoi, Y., Morozumi, K., Ogihara, H., Ito, T., Hanaoka, M., Fujiwara, T., Fujimoto, T., & Abe, K. (2014). Effects of Therapeutic Ultrasound on Range of Motion and Stretch Pain. Journal of Physical Therapy Science, 26(5), 711–715. https://doi.org/10.1589/jpts.26.711
Osiak, K., Elnazir, P., Walocha, J. A., & Pasternak, A. (2022). Carpal tunnel syndrome: State-of-the-art review. Folia Morphologica, 81(4), 851–862. https://doi.org/10.5603/FM.a2021.0121
Peris Moya, A., Pérez Mármol, J. M., Khoury Martín, E. F., & García Ríos, M. C. (2022). Ultrasound improves motor distal latency on patients with carpal tunnel syndrome: Systematic review and meta-analysis. European Journal of Physical and Rehabilitation Medicine, 58(2). https://doi.org/10.23736/S1973-9087.21.07021-0
Qomariyah, Q., Filmasari, F., Rania, R., Adelin, S. P., Dianingtyas, A. S., Kinanti, D. K. A., Herawati, I., & Wahyuni, W. (2023). Efektivitas Transcutaneous (Tens), Ultrasound (Us) Dan Terapi Latihan Pada Kondisi Carpal Tunnel Syndrome (Cts): Study Kasus. Fisio MU: Physiotherapy Evidences, 4(3), 140–144. https://doi.org/10.23917/fisiomu.v4i3.22021
Ranjani, A. A., Rini, W. N. E., & Aswin, B. (2026). Analisis Faktor Ergonomi dan Individu terhadap Risiko Carpal Tunnel Syndrome (CTS) pada Dokter Gigi: Systematic Literature Review. PubHealth Jurnal Kesehatan Masyarakat, 4(3), 297–305. https://doi.org/10.56211/pubhealth.v4i3.1583
Repilda, N., Entianopa, E., & Kurniawati, E. (2022). Faktor-Faktor yang Berhubungan dengan Keluhan Carpal Tunnel Syndrome (CTS) pada Pekerja di Kantor Jambi Ekspress. Indonesian Journal of Health Community, 3(2), 39–46. https://doi.org/10.31331/ijheco.v3i2.2299
Sugiantini, N. S., & Tejamaya, M. (2022). Prevalensi Carpal Tunnel Syndrome (Cts) Pada Dokter Gigi Di Puskesmas Wilayah Dki Jakarta Tahun 2023. Jurnal Cahaya Mandalika ISSN 2721-4796 (Online), 3(2), 835–840. https://doi.org/10.36312/jcm.v3i2.1920
Thanaya, S. A. P., Saraswati, P. A. S., & Barani, M. D. S. P. (2023). The effectiveness of combining ultrasound therapy with splinting and exercise therapy for patients with carpal tunnel syndrome. Physical Therapy Journal of Indonesia, 4(2), 155–159. https://doi.org/10.51559/ptji.v4i2.90
Ticoalu, E. R., Tuda, J. S. B., & Sumampouw, O. J. (2025). Faktor Risiko Carpal Tunnel Syndrome pada Operator Stasiun Pengisian Bahan Bakar Umum: Studi Cross-Sectional di Kota Manado. Jurnal Promotif Preventif, 8(3), 625–633. https://doi.org/10.47650/jpp.v8i3.2080
Verbrugge, L. M., & Jette, A. M. (1994). The disablement process. Social Science & Medicine, 38(1), 1–14. https://doi.org/10.1016/0277-9536(94)90294-1
Wibisono, I. (2025). Nyeri Otot Ekstensor Jari Tangan Pada Pekerja Kantor: Perbandingan Mendalam Dengan Lateral Epicondylitis. Jurnal Ners Widya Husada, 12(2). https://doi.org/10.33666/jnwh.v12i2.691
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jurnal Kesehatan Terpadu
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
