Villafañe Jorge H, Silva Guillermo B, Fernandez-Carnero Josue
Department of Physical Therapy, Residenze Sanitarie Assistenziali A. Maritano, Sangano, Italy.
J Manipulative Physiol Ther. 2012 Feb;35(2):110-20. doi: 10.1016/j.jmpt.2011.12.002. Epub 2012 Jan 16.
This study evaluated the effects of Maitland's passive accessory mobilization on local hypoalgesia and strength in thumb carpometacarpal osteoarthritis (TCOA).
Twenty-eight patients between 70 and 90 years old with secondary TCOA were randomized into glide mobilization and sham groups. This study was designed as a double-blind, randomized controlled trial. Therapy consisted of Maitland's passive accessory mobilization of the dominant hand during 4 sessions over 2 weeks. We measured pressure pain threshold (PPT) at the trapeziometacarpal joint (TMJ), the tubercle of the scaphoid bone, and the unciform apophysis of the hamate bone by algometry. The tip and tripod pinch strength was also measured. Grip strength was measured by a grip dynamometer. Measurements were taken before treatment and after 1 week (first follow-up [FU]) and 2 weeks (second FU).
All values in sham group remained unchanged along the treatment period. In the treated group, the PPT in the TMJ was 3.85 ± 0.35 kg/cm(2), which increased after treatment to 3.99 ± 0.37 and was maintained at the same level during the first FU 3.94 ± 0.39 and second FU 4.74 ± 0.40. In contrast, we found no differences in PPT in the other studied structures after treatment. Similarly, tip, tripod pinch, and grip strength remained without change after treatment.
Passive accessory mobilization increased PPT in the TMJ; however, it did not increase motor function in patients with TCOA.
本研究评估梅特兰被动附属活动对拇指腕掌骨关节炎（TCOA）局部痛觉减退和力量的影响。
28例70至90岁的继发性TCOA患者被随机分为滑动活动组和假手术组。本研究设计为双盲、随机对照试验。治疗包括在2周内进行4次梅特兰对优势手的被动附属活动。我们通过压力测量法测量大多角骨-第一掌骨关节（TMJ）、舟骨结节和钩骨钩突的压力痛阈（PPT）。还测量了指尖捏力和三指捏力。握力通过握力计测量。在治疗前、1周（首次随访[FU]）和2周（第二次FU）后进行测量。
假手术组的所有值在治疗期间保持不变。在治疗组中，TMJ的PPT为3.85±0.35kg/cm²，治疗后增加到3.99±0.37，并在首次FU时保持在3.94±0.39的相同水平，第二次FU时为4.74±0.40。相比之下，我们发现治疗后其他研究结构的PPT没有差异。同样，指尖捏力、三指捏力和握力在治疗后保持不变。
被动附属活动增加了TMJ的PPT；然而，它并未增加TCOA患者的运动功能。
