Radial nerve mobilization decreases pain sensitivity and improves motor performance in patients with thumb carpometacarpal osteoarthritis: a randomized controlled trial.
OBJECTIVE
To examine the effects of radial nerve mobilization on pain sensitivity and motor performance in subjects with secondary thumb carpometacarpal osteoarthritis.


METHODS
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).


METHODS
Patients from the Department of Physical Therapy, Azienda Sanitaria Locale 3, Collegno (Italy).


METHODS
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 No patients were withdrawn from the study.


METHODS
Sliding mobilization of the proximal-distal radial nerve or intermittent ultrasound therapy, used as placebo.


METHODS
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.


RESULTS
Treatment increased PPT by 3.33±.24 kg/cm(2) (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±.22 kg (P<.04) and tripod pinch strength by 2.83±.24 kg (P<.019).


CONCLUSIONS
Radial nerve mobilization decreases pain sensitivity in the trapeziometacarpal joint and increases tip pinch strength.
Department of Physical Therapy, Residenze Sanitarie Assistenziali A. Maritano, Sangano, Italy. mail@villafane.it
Jorge H
JH
Villafañe
Guillermo B
GB
Silva
Mark D
MD
Bishop
Josue
J
Fernandez-Carnero
D000368:Aged; D000369:Aged, 80 and over; D052737:Carpometacarpal Joints / Q000473:pathology*; D004311:Double-Blind Method; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations; D010003:Osteoarthritis / Q000534:rehabilitation*; D017288:Pain Threshold / Q000502:physiology; D026741:Physical Therapy Modalities; D011597:Psychomotor Performance; D011826:Radial Nerve; D016059:Range of Motion, Articular; D013933:Thumb / Q000502:physiology