Villafañe Jorge H, Silva Guillermo B, Chiarotto Alessandro
Department of Physical Therapy, Residenze Sanitarie Assistenziali A. Maritano, Sangano, Italy.
J Manipulative Physiol Ther. 2012 Nov-Dec;35(9):735-42. doi: 10.1016/j.jmpt.2012.10.012.
The purpose of this case series is to report on the effects of passive joint mobilization (PJM) of the shoulder, elbow, and wrist on pain intensity, pain sensitivity, and function in elderly participants with secondary carpometacarpal osteoarthritis (CMC OA).
Fifteen inpatients from the Department of Physical Therapy, Residenze Sanitarie Assistenziali, Collegno (Italy), with secondary CMC OA (70-90 years old) were included in this study. All patients received PJM of the dominant arm (shoulder, elbow, and wrist) for 4 sessions for 2 weeks. Pain severity was measured by visual analog scale, and pain sensitivity was measured with pressure pain threshold (PPT) at CMC joint, at the tubercle of the scaphoid bone, and at the unciform apophysis of the hamate bone. Tip and tripod pinch strength were measured by a pinch gauge.
Passive joint mobilization reduced pain severity after the first follow-up by 30%, in addition to increased PPT by 13% in the hamate bone. Strength was enhanced after treatment. Tripod pinch increased by 18% in the dominant hand after treatment.
This case series provides preliminary evidence that PJM of upper extremity joints diminished pain and may increase PPT tip and tripod pinch in some participants with secondary CMC OA.
本病例系列旨在报告肩部、肘部和腕部的被动关节松动术（PJM）对患有继发性腕掌骨骨关节炎（CMC OA）的老年参与者的疼痛强度、疼痛敏感性和功能的影响。
本研究纳入了来自意大利科莱尼奥Residenze Sanitarie Assistenziali物理治疗科的15名继发性CMC OA患者（年龄70 - 90岁）。所有患者均接受优势臂（肩部、肘部和腕部）的PJM治疗，共4次，为期2周。采用视觉模拟量表测量疼痛严重程度，并在腕掌关节、舟骨结节和钩骨钩突处用压力疼痛阈值（PPT）测量疼痛敏感性。用捏力计测量指尖捏力和三指捏力。
首次随访时，被动关节松动术使疼痛严重程度降低了30%，此外钩骨处的PPT增加了13%。治疗后力量增强。治疗后优势手的三指捏力增加了18%。
本病例系列提供了初步证据，表明上肢关节的PJM可减轻继发性CMC OA患者的疼痛，并可能增加部分患者的指尖捏力和三指捏力。
