Manual Therapy for Hand Osteoarthritis
- Conditions
- Hand Osteoarthritis
- Interventions
- Device: Neural mobilizationDevice: Gloreha deviceDevice: Standardized exercise
- Registration Number
- NCT02701335
- Lead Sponsor
- Fondazione Don Carlo Gnocchi Onlus
- Brief Summary
Osteoarthritis (OA) of the hand is a major cause of pain and functional limitation, central sensitization of pain can be one of the causes: this hypothesis opens avenues for research in the modulation of pain pathways. The peripherally directed therapies may modulate pain perception bilaterally. This hypothesis opens avenues for future research in the modulation of pain pathways, perhaps offering targets to optimize peripheral manual and physical therapies for pain management in hand OA.
Several studies have reported the outcomes of multimodal approach to central sensitization evaluated by generalized pressure pain hypersensitivity in patients with carpometacarpal (CMC) OA. Neurodynamic techniques are a form of manual therapy directed to the neural structures through positioning and movement of multiple joints. Recent technologies have facilitated the use of robots as tools to assist patients in the rehabilitation process thus maximizing patient outcomes. These robotic tools assist the patient with carrying out exercise protocols, optimal for the activity of the control group.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 72
- Osteoarthritis of the dominant hand. To be included in the study, the subjects need to have a history of repetitive use of their dominant hand (eg, ex-factory worker) and a diagnosis of hand OA in the dominant hand, according on radiographic findings.
- If they score greater than 6 points on the Beck Depression Inventory (BDI) or more than 30 points in the State Trait Anxiety Inventory (STAI). Patients with a medical history of carpal tunnel syndrome, surgical interventions to the hand, DeQuervain's tenosynovitis, or with degenerative or non-degenerative neurological conditions in which pain perception is altered will be excluded. None of the individuals in this study will have received prior interventions for hand OA.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Experimental group Standardized exercise Neural mobilization and standardized exercise . 12 sessions over 4 weeks (3 sessions per week). Experimental group Neural mobilization Neural mobilization and standardized exercise . 12 sessions over 4 weeks (3 sessions per week). Control group Standardized exercise Gloreha device and standardized exercise. 12 sessions over 4 weeks (3 sessions per week). Control group Gloreha device Gloreha device and standardized exercise. 12 sessions over 4 weeks (3 sessions per week).
- Primary Outcome Measures
Name Time Method Change from Pain intensity at 3 months baseline, immediately post-intervention, and at 1- and 3-month post-interventions, Baseline up to 5 minutes. visual analogue scale
Change from QuickDASH questionnaire at 3 months baseline, immediately post-intervention, and at 1- and 3-month post-interventions Baseline, up to 5 minutes. will be used to measure upper extremity function
Change from Pressure Pain Thresholds (PPT) at 3 months Baseline and immediately post-interventionand, at 1- and 3-month post-interventions. is a quantitative sensory test of tissue sensitivity and it is defined as the minimal amount of pressure that produces pain, measured via a pressure algometer. PPT will be assessed bilaterally over the hand (first CMC at the center of the anatomical snuffbox, and unciform apophysis of the hamate bone), the C5-C6 zygapophyseal joint, the median, ulnar and radial nerves, and tibialis anterior muscle by an assessor blinded to the subjects condition.
- Secondary Outcome Measures
Name Time Method Motor conduction velocity Baseline up to 5 minutes Range of Motion Baseline up to 5 minutes
Trial Locations
- Locations (1)
Jorge Hugo Villafañe
🇮🇹Piossasco, Turin, Italy