Mobilization with movement as an adjunct intervention in a patient with complicated de Quervain's tenosynovitis: a case report.
METHODS
Case study.


OBJECTIVE
To describe the use of conventional physical therapy interventions together with Mobilization With Movement (MWM) techniques in the treatment of an individual with a complicated scenario of de Quervain's tenosynovitis.


BACKGROUND
The patient was a 61-year-old woman who presented with signs and symptoms consistent with de Quervain's tenosynovitis of the right hand. Range limitations in all motions of the right wrist and first carpometacarpal joint complicated her presentation.


METHODS
Physical therapy included conventional intervention with superficial heat, ice, iontophoresis, and transverse friction massage directed to the first dorsal tunnel. Conventional joint mobilization techniques addressed the motion limitations of the first carpometacarpal, radiocarpal, and midcarpal joints. In addition, MWM techniques were utilized to promote pain-free wrist and thumb mobility. The specific MWM techniques used with this patient involved active movements of the thumb and wrist superimposed on a passive radial glide of the proximal row of carpal bones.


RESULTS
The described treatment regime, which involved conventional physical therapy interventions, along with MWM, aided in the complete resolution of this patient's impairments and functional limitations.


CONCLUSIONS
The combination of conventional physical agents, exercise, and manual therapy, and the less conventional MWM techniques, proved successful with this patient. MWM involving the correction of minutejoint malalignments, coupled with active motion of the wrist and first carpometacarpal joints, was an effective and efficient adjunct physical therapy intervention. Because subtle changes injoint alignment may contribute to painful syndromes in the tendon complexes that cross a malaligned joint, use of MWM as a treatment technique warrants continued research.
Backstrom
Karen Maloney
KM
Physical Therapy Program, University of Colorado Health Sciences Center, Denver 80262, USA. Karen.Backstrom@UCHSC.edu
D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D013717:Tenosynovitis / Q000534:rehabilitation*; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology