Palmar Fibromatosis
Conditions
Brief summary
The objective of the present study is to explore the effect of Transfer Energy Capacitive and Resistive Therapy (TECAR) therapy on pain, range of motion (ROM) and hand function in dupuytren's contracture patients (palmar fibromatosis).
Detailed description
Dupuytren contracture is a benign, progressive disease of the palmar fascia which results in shortening, thickening, and fibrosis of the fascia and aponeurosis of the palm driven by myofibroblastic proliferation. TECAR therapy is considered a special form of energy that uses frequencies between 300 KHz and 1 MHz and is characterized as a non-invasive high-frequency energy that awakens the body's natural ability to self-regenerate. The TECAR therapy can work in two modes of electric charge transfer: capacitive and resistive mode. The reactions produced by the capacitive system through the capacitive electrode are focused on tissues with higher electrolyte content, such as soft tissues and muscles, as opposed to the resistive system that focuses on larger and more resistant tissues such as tendons, bones and articulations. With these two modes of energy transfer, the therapy allows an increase in vasodilation, oxygenation, increase in microcirculation and increase in internal temperature. So, this study aimed to to explore the effect of Transfer Energy Capacitive and Resistive Therapy (TECAR) therapy on pain, range of motion (ROM) and hand function in dupuytren's contracture patients (palmar fibromatosis).
Interventions
The apparatus used is comprised of a generator that supplies a signal at the frequency of 0.5 MHz and a maximum power of 300 watts (HCR900).The power can be regulated by controlling the quantity of transferred energy and the relative biological action. The counter electrode (Return Plate) that closes the circuit consists of a metal plate that is applied in opposition or a cylinder that is clasped. The head of the device will be applied over the treated area for 20 minutes (min) (10 min of capacitive head and 10 min of resistive head), moderate to high intensity. It will be applied along and in circles over the affected palm, 3 sessions weekly for 6 weeks.
OTHERTraditional therapy
The patients will receive the traditional physical therapy program 3 sessions / week , for 6 weeks totally. It consists of stretching exercise, flexor tendon glide and splinting.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Ages of patients will be ranged from 40 to 70 years. * Presence of palpable cords and/or digital contracture ≥ 20° at the metacarpophalengeal joint or Proximal interphalengeal joint joints . * Clinical diagnosis confirmed by a hand surgeon or relevant specialist. * All patients will enter the study having their informed consent
Exclusion criteria
* Patient with severe contracture \>30° or multiple digit involvement requiring surger. * History of surgical release (fasciotomy, fasciectomy) or collagenase injection in the affected hand. * Presence of infection, ulceration, or skin lesions on the treatment area. * Presence of pacemakers, metal implants, or other electronic implants in the treatment area. * Active cancer or tumor in the treatment region. * Pregnancy. * Conditions such as stroke, Parkinson's disease, or rheumatoid arthritis that may confound results. * Cognitive impairment, psychiatric illness, or other barriers to protocol adherence
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Active range of motion (ROM) assessment of metacarpophalangeal joint (MCP): | 6 weeks | * Patient Position: Sitting on a chair while his/her forearm will be in a mid position and supported with the involved hand on the plinth beside him/her. * The therapist will stabilize the metacarpal bone. * The goniometer axis will be placed over the dorsal surface of the MCP joint. The stationary arm of the goniometer will be placed parallel to the longitudinal axis of the metacarpal bone and the movable arm of the goniometer will be placed parallel to the longitudinal axis of the proximal phalanx. * The patient will be asked to flex then extend his MCP joint to the limit of the motion (normally 0º-100º extension-flexion) then range of motion (ROM) will be documented. |
| Active range of motion (ROM) assessment of proximal interphalangeal joint (PIP): | 6 weeks | * Patient Position: Sitting on a chair while his/her forearm will be in a mid position and supported with the involved hand on the plinth beside him/her. * The therapist will stabilize the proximal phalanx. * The goniometer axis will be placed over the dorsal surface of the PIP joint. The stationary arm of the goniometer will be placed parallel to the longitudinal axis of the proximal phalanx and the movable arm of the goniometer will be placed parallel to the longitudinal axis of the middle phalanx. * The patient will be asked to flex then extend his PIP joint to the limit of the motion (normally 0º-100º extension-flexion) then range of motion ROM will be documented. |
| Pain intensity measurement | 6 weeks | The Visual Analogue Scale (VAS) consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' and 'pain as bad as it could be'. The patient is asked to mark his pain level on the line between the two endpoints. The distance between 'no pain at all' and the mark then defines the subject's pain From 0 to 10 , (0 )means no pain and up to (10) means intolerable pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Southampton Dupuytren's Scoring Scale | 6 weeks | The Southampton Dupuytren's Scoring Scheme (SDSS) is a 5-item, 20-point patient-reported outcome measure (PROM) developed in 2014 to assess functional disability from Dupuytren's disease. It measures impairment across personal, domestic, work, and hobby activities, with scores from 0 (no problem) to 20 (worst), offering high sensitivity to change. |
Countries
Egypt
Contacts
CONTACTPeter Haroun, Master
CONTACTAhmed Zarraa, PHD
STUDY_DIRECTORAmir Zaki, PHD
Cairo University
STUDY_CHAIRHussein Mogahed, Professor
Cairo University
Outcome results
None listed