Short-term effects of neurodynamic mobilization in 15 patients with secondary thumb carpometacarpal osteoarthritis

Abstract

The purpose of this study is to evaluate whether neurodynamic mobilization of the median nerve improves pressure pain threshold (PPT) and pinch and grip strength in patients with secondary thumb carpometacarpal osteoarthritis (TCOA). Fifteen patients with secondary TCOA (13 women and 2 men) between 70 and 90 years old were received by neurodynamic therapy. All patients received median nerve mobilization of the dominant hand by sliding technique during 4 sessions over 2 weeks. The outcome measures of this case series were monitored by using PPT measured by algometry as PPT at the trapeziometacarpal (TM) joint, tubercle of the scaphoid bone, and the unciform apophysis of the hamate bone. Tip and tripod pinch strength was also measured. Grip strength was measured by a grip dynamometer. These variables were measured at pretreatment, 5 minutes posttreatment, 1 week (first follow-up [FU]) and 2 weeks after treatment (second FU). Pressure pain threshold in the TM joint was 3.54 ± 0.04 kg/cm(2). After treatment, it increased to 4.38 ± 0.04 kg/cm(2) (P < .01) and maintained in the first FU (4.27 ± 0.04 kg/cm(2), P < .02) and second FU (4.08 ± 0.04 kg/cm(2), P < .02). In contrast, we found no differences in PPT in the other studied structures after treatment. Similarly, tip and tripod pinch strength remained without change after treatment. Grip strength was 10.77 ± 0.18 kg, and after treatment, it increased to 11.55 ± 0.16 kg (P < .05) and maintained in first FU (11.73 ± 0.18 kg, P < .02) and second FU (11.2 ± 0.17 kg, P < .05). In conclusion, median nerve mobilization decreased pain in the TM joint and increased grip strength in this group of patients with TCOA.