Conservative Management of DeQuervain's Tendinopathy With an Orthopaedic Manual Therapy Approach Emphasizing First CMC Manipulation: A Retrospective Case Series

Completed

• Conditions: DeQuervain's Tendinopathy

• Registration Number: NCT04164303
• Lead Sponsor: Regis University

Brief Summary

This is a retrospective review of three patients with DeQuervain's Tendinopathy (DQT) that had successful outcomes with a manual therapy focused approach provided by Physical Therapist management.

Detailed Description

DeQuervain's tendinopathy (DQT) is a musculoskeletal disorder that limits hand function of affected individuals. Management of DQT can include splinting, activity modification, medications, corticosteroid injections, Physical Therapy, and surgery. There is limited evidence to support the combination of manual therapy and exercise interventions within an Orthopaedic Manual Physical Therapy (OMPT) approach when managing patients with DQT. Three patients identified with DQT underwent a multi-modal treatment regimen including carpometacarpal (CMC) thrust and non-thrust manipulation, end range radiocarpal mobilization, mobilization with movement (MWM), strengthening exercises, and grip proprioception training. Outcomes were assessed using the numeric pain rating scale (NPRS), Jamar hand dynamometer grip strength, and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire. These measures were administered at baseline and discharge.

Study Timeline

• Study Start: 2016-07-01
• Primary Completion: 2017-12-31
• Study Completion: 2017-12-31
• Study First Submitted: 2019-06-18
• Status Verified: 2019-11
• Study First Submitted QC: 2019-11-13
• Last Update Submitted: 2019-11-13
• Study First Posted: 2019-11-15
• Last Update Posted: 2019-11-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 3

Inclusion Criteria

Five or more items present on the DQT screening tool devised by Batteson et al.:

• Pain over the radial styloid
• Tenderness over the dorsal thumb
• Pain with active thumb flexion
• Localized swelling over the thumb
• Positive Finkelsteins test
• Thickening of the tendon sheath of the first dorsal extensor compartment
• Pain with resisted thumb extension.

Exclusion Criteria

• Cardiovascular disorders
• Non-musculoskeletal complaints
• Auto-immune disorders
• Patients who had received previous treatment for their condition

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Change from Baseline Quick Disabilities of the Arm, Shoulder, and Hand questionnaire at 8 weeks	up to 8 weeks	Quick DASH (0% disability to 100% disability)
Change from Baseline Numeric Pain Rating Scale at 8 weeks	up to 8 weeks	Numeric Pain Rating Scale (0-10 point scale)
Change from Baseline Grip strength at 8 weeks	up to 8 weeks	Jamar hand dynamometer Grip strength