Akademik Veri Yönetim Sistemi
FESSH-EFSHT 2023 CONGRESS, Rimini, İtalya, 10 - 13 Mayıs 2023, ss.126-127
Introduction: It has been shown that the level of pain expressed by patients with thumb base osteoarthritis (OA) may not always correlate with the degree of degeneration in the joint. Pain is mostly the primary complaint in these patients besides being the origin of a decrease in function and grip strength. The superficial branch of the radial nerve, which is the primary sensory nerve of the joint, was shown to contribute to the pain level. Thus, radial nerve mobilization exercises may improve pain and function. In this study, we planned to assess the effect of radial nerve mobilization on pain, functional level, and grip strength in patients with thumb base OA.
Methods: In this prospective, randomized, and controlled study, a total of 23 patients with thumb base OA were included in two groups (mobilization and control groups). Patients were assessed before and after the completion of the 4-week treatment. Pain levels at rest, activity, and night, grip, and pinch strength (bipod and lateral) were measured. Dexterity was assessed by 9-Hole Peg Test (9HPT). Disability level was evaluated with the Michigan Hand Outcome Questionnaire (MHOQ) and Functional Index of Hand Osteoarthritis (FIHAO). All the patients received hand therapy twice a week for 4 weeks including patient education and training about correct gripping and pinching, massage, and ice. The mobilization group received radial nerve gliding exercises additionally. Patients were also instructed to repeat the exercises at home 3 times a day. Results were analyzed both within groups and between groups.
Results: A total of 13 patients in the mobilization group (53,76±8,49 years; 13 females) and 10 patients in the control group (61,9±10,96 years; 1 male and 9 females) completed the study. Groups were similar regarding age, gender distribution, and all clinical parameters at baseline (p>0.05) except the MHOQ work subscale (p=0.015). The frequency of the dominant hand as the symptomatic hand was also similar (p=0.305). Within-group analyses showed significant improvements in all parameters except the ‘appearance’ subscale of MHOQ in the mobilization group (p<0.05). No statistically significant improvement was found between the pre-and post-treatment results in the control group (p>0.05). Grip strength, bipod pinch strength, and 3 subscales of the MHOQ (‘general hand function’, ‘daily life activity’, and ‘satisfaction’) were superior to the control group in the mobilization group after treatment (p=0.047, p=0.019, p=0.041, p=0.01, p=0.006 consecutively).
Conclusion: This preliminary study showed that radial nerve mobilization is effective in improving clinical outcomes in patients with thumb base OA when compared to conventional treatment. It is concluded that radial nerve gliding can be added to the hand therapy program in those patients for pain relief and functional improvement.
Keywords: Osteoarthritis, thumb, nerve mobilization, radial superficial nerve, first carpometacarpal joint