Pressure algometry and palpation of the upper limb peripheral nervous system in subjects with hand osteoarthritis are repeatable and suggest central changes

• Published in: Journal of hand therapy Vol. 33; no. 1; pp. 103 - 111
• Main Authors: Pedersini, Paolo, Negrini, Stefano, Cantero-Tellez, Raquel, Bishop, Mark D., Villafañe, Jorge Hugo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2020; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Arm; Arthritis; Biomedical materials; Brachial Plexus - physiopathology; Case-Control Studies; Change detection; Clinical trials; Correlation coefficient; Correlation coefficients; Disabilities; Disability; Error analysis; Female; Hand; Hand Joints - innervation; Hand Strength; Humans; Hyperalgesia; Hypersensitivity; Joints (anatomy); Male; Mathematical analysis; Median nerve; Middle Aged; Nerves; Nervous system; Older people; Osteoarthritis; Osteoarthritis - diagnosis; Osteoarthritis - physiopathology; Pain; Pain Measurement; Pain perception; Palpation; Patients; Peripheral nervous system; Phenotypes; Pressure; Range of Motion, Articular; Reliability; Reproducibility; Reproducibility of Results; Standard error; Studies; Upper Extremity - innervation; Upper Extremity - physiopathology; Variance analysis; Visual perception; Italy; Pain; Osteoarthritis; Hand; Hypersensitivity
• ISSN: 0894-1130; 1545-004X; 1545-004X
• DOI: 10.1016/j.jht.2018.06.003

Case-control study. A subset of patients with hand osteoarthritis (OA) shows evidence of central pain phenotypes. To examine whether differences exist in experimental pain responses in the affected and nonaffected sides of patients with unilateral hand OA. To investigate the test-retest reliability of pressure algometry and manual digital palpation in patients with unilateral hand OA. The hand OA group consisted of 20 patients, and the control group consisted of 20 healthy subjects. Pressure pain threshold (PPT) measurements were made 2 times, consisting of 3 repeat trials, each using computerized algometry and manual digital palpation. Grip and key strength (dynamometer), pain (visual analog scale), and function (Disabilities of the Arm, Shoulder and Hand [short version]) were also measured. The 2-way analysis of variance was conducted to determine the differences between sides and groups. Intraclass correlation coefficient (ICC) and standard error of measurement were calculated. Patients with hand OA had decreased PPTs over the thumb carpometacarpal joint as well as radial and median nerves compared with controls (all P < .01). No significant group effect by side interaction was detected for any measure. The minimal detectable change values needed to detect change in subjects with hand OA were C5-C6 joint (0.3-0.5 kg/cm2), carpometacarpal joint (0.3-0.5 kg/cm2), hamate bone (0.2-0.4 kg/cm2), radial nerve (0.2-0.8 kg/cm2), median nerve (0.3-0.6 kg/cm2), and ulnar nerve (0.2-0.4 kg/cm2) for PPT. Test-retest reliability was calculated for both hands of participants with OA (ICC, 0.98-0.99) and healthy participants (ICC, 0.74-0.99). Although pressure algometry and manual digital palpation are techniques already used in previous studies and have been shown to be reproducible and moderately reliable for joint palpation, this current study suggests that pressure algometry and manual digital palpation could also be reliable methods of determining nerve sensitivity of the radial, ulnar and median nerves in subjects with hand OA. Hyperalgesia in patients with hand OA might be associated with clinical measures, and bilateral signs in unilateral OA could suggest central changes. •A subset of OA patients shows evidence of central pain phenotypes.•Is Pressure Algometry (PPT) a reliable method of determining nerves sensivity?.•Is manual digital palpation a reliable method of determining nerves sensivity?.•This study suggests that PPT and manual digital palpation are reliable methods.•Patients with hand OA showed bilaterally lower PPTs over radial and median nerves.•Bilateral signs in unilateral OA could suggest central changes.