Thumb carpometacarpal osteoarthritis Musculoskeletal Diseases Arthrosis of first carpometacarpal joint
Conditions
Interventions
Radial nerve mobilization (treatment group):
1. Treatment was performed in six sessions over four weeks and was applied to the dominant hand three times during a four-minute period with one-minute pau
Sponsors
Azienda Sanitaria Locale 3 (Italy)
Rey Juan Carlos University (Universidad Rey Juan Carlos)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patients who used the dominant hand systematically such as ex-factory workers and home workers, and were diagnosed with secondary thumb carpometacarpal osteoarthritis (TCOA) in the dominant hand by X-ray detection of stage III and IV according to the Eaton-Littler-Burton Classification.
Exclusion criteria
Exclusion criteria: 1. Patients if they scored more than 4 on the Beck?s Depression Inventory and/or more than 30 on the State Trait Anxiety Inventory (STAI) 2. Patients with a medical history of carpal tunnel syndrome, arthritis, surgical interventions on trapeziometacarpal (TM) joint, or D?Quervain?s tenosynovitis 3. Patients presenting degenerative or non-degenerative neurological conditions in which pain perception was altered
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Mechanical pain sensitivity: 1.1. Pain sensitivity was determined by measuring pressure pain threshold (PPT) 1.2. Measurements were performed with a Mechanical Pressure Algometer (Wagner Instruments, Greenwich, Connecticut, USA) with a 1cm2 rubber-tipped plunger mounted on a force transducer was used for measuring PPT 1.3. Pressure was applied at a rate of 30 kPa/s 1.4. The mean of three measurements was calculated and used for the main analysis 1.5. Previous papers have reported an intraexaminer reliability of this procedure ranging from 0.6 to 0.97, while the interexaminer reliability ranged from 0.4 to 0.98 1.6. The following points were evaluated: 1.6.1. TM joint at the bottom of the anatomical snuffbox, tubercle of the scaphoid bone and unciform apophysis of the hamate bone 1.6.2. Three measurements were made with a one-minute pause between them 1.6.3. Although pain from deep tissue is difficult to assess precisely, PPT have been found useful in assessing pain reactions in OA patients 2. Motor performance: 2.1. Pinch strength 2.1.1. The pinch strength was evaluated with a mechanical pinch gauge (Baseline, NY, USA) in the sitting position with the shoulder adducted and neutrally rotated and the elbow flexed at 90° 2.1.2. Two different measurements were taken. First we measured the tip pinch between index and thumb fingers. Then we measured tripod pinch, between index and, middle fingers and the thumb. 2.1.3. The reliability of pinch strength has been found to be high (Intra-class correlation coefficient [ICC]= 0.93) (34) 3. Measurements were taken before intervention, after 1 month, 1st Follow-up and 2 months, 2nd follow up | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. The Beck Depression Inventory (BDI) 1.1. Review of internal consistency for the BDI ranges from 0.73 to 0.92, with a mean of 0.86, with alpha coefficients of 0.86 and 0.81 for psychiatric and non-psychiatric populations, respectively 1.2. The BDI observed showed high discrimination of depressive symptoms (75-100%) 2. State-Trait Anxiety Inventory (STAI) 2.1. This is a self rated questionnaire divided in two parts: anxiety-trait (referring to personality aspects) and anxiety-state (referring to systemic aspects of the context) 2.2. Responses are in a 1-4 scale 2.3. Anxiety-state refers to how individuals feel ?at the moment? and anxiety-trait to how they ?generally feel? 2.4. Each part varies from 20 to 80 points, and the scores indicate low (0-30), medium (31-49) or high (50 or more) anxiety levels 3. Measurements were taken before intervention, after 1 month (1st follow-up) and 2 months (2nd follow up) | — |
Countries
Italy
Outcome results
None listed