Radial Nerve Mobilization Decreases Pain Sensitivity and Improves Motor Performance in Patients With Thumb Carpometacarpal Osteoarthritis: A Randomized Controlled Trial

• Published in: Archives of physical medicine and rehabilitation Vol. 93; no. 3; pp. 396 - 403
• Main Authors: Villafañe, Jorge H., Silva, Guillermo B., Bishop, Mark D., Fernandez-Carnero, Josue
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2012; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Carpometacarpal Joints - pathology; Diseases of the osteoarticular system; Double-Blind Method; Female; Hand strength; Hand Strength - physiology; Humans; Male; Medical sciences; Miscellaneous; Miscellaneous. Osteoarticular involvement in other diseases; Musculoskeletal Manipulations; Osteoarthritis; Osteoarthritis - rehabilitation; Pain Threshold - physiology; Physical Medicine and Rehabilitation; Physical Therapy Modalities; Psychomotor Performance; Radial Nerve; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Range of Motion, Articular; Rehabilitation; Thumb; Thumb - physiology; OA; Hand strength; Radial nerve; ANOVA; PPT; Thumb; ICC; SEM; Rehabilitation; Osteoarthritis; analysis of variance; intraclass correlation coefficient; standard error of the mean; pressure pain threshold; Performance evaluation; Human; Muscle strength; Diseases of the osteoarticular system; Hand; Mobilization; Sensitivity; Pain; Reeducation; Orthopedics; Arthropathy; Degenerative disease; Osteoarthritis of the thumb; Strength
• ISSN: 0003-9993; 1532-821X; 1532-821X
• DOI: 10.1016/j.apmr.2011.08.045

Villafañe JH, Silva GB, Bishop MD, Fernandez-Carnero J. Radial nerve mobilization decreases pain sensitivity and improves motor performance in patients with thumb carpometacarpal osteoarthritis: a randomized controlled trial. To examine the effects of radial nerve mobilization on pain sensitivity and motor performance in subjects with secondary thumb carpometacarpal osteoarthritis. Randomized controlled trial. Treatment and placebo were given for 4 weeks. Measurements were taken before intervention, after 1 month (first follow-up), and after 2 months (second follow-up). Patients from the Department of Physical Therapy, Azienda Sanitaria Locale 3, Collegno (Italy). Participants (N=60; age range, 70–90y) with right-dominant hand secondary thumb carpometacarpal osteoarthritis without other motor-related pathology. All patients completed the study. No patients were withdrawn from the study. Sliding mobilization of the proximal-distal radial nerve or intermittent ultrasound therapy, used as placebo. We hypothesized that radial nerve mobilization induces hypoalgesia and increases strength in secondary thumb carpometacarpal osteoarthritis. We measured pressure pain threshold (PPT) at the trapeziometacarpal joint, the tubercle of the scaphoid bone, and the unciform apophysis of the hamate bone by algometry. Tip pinch strength and tripod pinch strength were measured by a mechanical pinch gauge. Treatment increased PPT by 3.33±.24kg/cm2 (P<.001) in the trapeziometacarpal joint and was maintained until first follow-up and second follow-up. Also, PPT in the scaphoid bone and hamate bone was increased (P<.001 and P<.02, respectively). Variables in the placebo group remained unchanged. Tip pinch strength increased by 2.22±.22kg (P<.04) and tripod pinch strength by 2.83±.24kg (P<.019). Radial nerve mobilization decreases pain sensitivity in the trapeziometacarpal joint and increases tip pinch strength.