PHYSICAL THERAPY & REHAB
Radial nerve mobilization decreases pain sensitivity and improves motor performance in patients with thumb carpometacarpal osteoarthritis: a randomized controlled trial
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(14):8 Arch Phys Med Rehabil. 2012 Mar;93(3):396-403. doi: 10.1016/j.apmr.2011.08.045. Epub 2012 Jan 260 patients with dominant-hand thumb carpometacarpal osteoarthritis (OA) were randomized into two groups to measure the effects of either radial nerve mobilization treatment or a nontherapeutic placebo treatment on pain sensitivity and pinch strength. At 2 months follow-up, patients who underwent radial nerve mobilization experienced a decrease in pain sensitivity in the trapeziometacarpal joint and an increase in tip and tripod pinch strength.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
4/4
Randomization
4/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
Thumb carpometacarpal OA affects many people, especially women, in Europe and the United States. The cause of this upper limb-related disability is a result of the modification of the trapeziometacarpal joint. Consequently, those with the condition have difficulty with pinch and grip strength and experience much pain. Thumb carpometacarpal OA may be treated by undergoing surgery, but it only results in partial improvement. Neurodynamic techniques have been suggested as additional treatments on top of surgery in managing pain and improving pinch strength, but not many studies have tested the outcomes of applying such methods. Hence, this study aimed to test the efficacy of the neurodynamic technique, radial nerve mobilization, in treating thumb carpometacarpal OA.
主な研究課題は何ですか？
Did radial nerve mobilization treatment for dominant-hand thumb carpometacarpal OA decrease pain sensitivity in the thumb and increase pinch strength, when measured over a 2 month period?
重要な知見は？
- PP-There was a significant improvement in PPT of the trapeziometacarpal joint between all assessments for the Radial Nerve Mobilization group (p<0.001), but not for the placebo group.
- There were significant improvements in PPT of the scaphoid and hamate bones between the first and second months of assessments for both groups, but no significant difference between groups (p=0.06).
- There was a significant difference in tip and tripod pinch strength between pre-treatment and post-treatment assessments for the Radial Nerve Mobilization group (p=0.04).
- There were no significant differences in tip and tripod pinch strength during assessments at 1 and 2 months following treatment between the Radial Nerve Mobilization group and the placebo group (p>0.05).T and pinch strength were measured prior to and 5 minutes, 1, and 2 months following to treatment.
最も覚えておくべきことは？
The results displayed that radial nerve mobilization treatment of dominant-hand thumb carpometacarpal OA was effective in increasing mechanical pain sensitivity in the trapeziometacarpal joint and increasing tip and tripod pinch strength.
それが私の患者ケアにどのように影響するか？
Radial nerve mobilization was successful when focussing on its effects on neurophysiological function of patients. However, it is uncertain whether improvements would be observed if pain or disability scales for the hand were used instead. Future studies should incorporate these scales to measure outcomes and a larger sample size should be included.
免責事項
このページに記載されている内容は、情報提供のみを目的としたものであり、専門的な医療アドバイス、診断、治療の代わりとなるものではありません。治療が必要な場合は、必ず医師の診断を仰ぐか、最寄りの救急外来を受診してください。このページに記載されている内容に関して個人が表明した意見、信念、見解は、OrthoEvidenceの意見、信念、見解を反映するものではありません。
0の4 月間無料記事のロック解除
