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本体感觉训练对拇指基底关节骨关节炎疼痛强度的影响:一项随机对照试验。

The Effect of Proprioception Training on Pain Intensity in Thumb Basal Joint Osteoarthritis: A Randomized Controlled Trial.

机构信息

Physical Therapy Section, Ampliación Campus Teatinos, Faculty of Health Sciences, University of Malaga C/Francisco Peñalosa, 29010 Málaga, Spain.

FE-17, Hand Research Team, IBIMA Área Tecnología en Salud e Innovación, 29010 Malaga, Spain.

出版信息

Int J Environ Res Public Health. 2022 Mar 17;19(6):3592. doi: 10.3390/ijerph19063592.

Abstract

A randomized controlled trial of forty-five females over 18 years of age with diagnosis of thumb basal osteoarthritis in their dominant hand and with a minimum pain rating of 4/10 on the Visual Analogue Scale (VAS) during activities of daily living (ADLs) were recruited from March to June 2021. The group receiving proprioception training was compared to routine conservative physiotherapy treatment. The main purpose of this clinical trial is to test the effect of proprioception training on pain intensity in subjects with thumb osteoarthritis. Primary outcome was joint position sense (JPS) for the assessment of CMC proprioception and secondary outcomes were Visual Analogue Scale (VAS) and Canadian Occupational Performance Measure (COPM) for the assessment of patient satisfaction and the Quick-DASH which assessed upper limb function. A block randomization was carried out for the control group (n = 22) and experimental group (n = 23). Participants and evaluator were blinded to the group assignment. Proprioception training produced a statistically significant reduction in pain post intervention, but this reduction was small (d = 0.1) at the 3-month follow-up. JPS accuracy demonstrated statistically significant differences between the groups (p = 0.001) post-intervention and at the 3-month follow-up (p < 0.003). Statistically significant differences between means were found in both the Quick-Dash and COPM post intervention (both, p < 0.001), as well as at the 3-month follow-up (both, p < 0.001). There was a significant time factor for the reduction of pain intensity over time but effect sizes between groups was small at the 3-month follow-up period. Proprioceptive training improves thumb JPS accuracy; however, it does not contribute to a reduction in pain intensity in the long term. The inclusion of a proprioceptive program may be beneficial for improving individuals with thumb CMC OA sensorimotor performance. The study was registered at ClinicalTrials.gov NCT04738201. No funding was provided for this study.

摘要

本研究共纳入 45 名 18 岁以上、单手拇指基底部骨关节炎诊断明确、日常活动(ADL)时疼痛视觉模拟评分(VAS)≥4 分的女性患者。将接受本体感觉训练的患者与常规保守物理治疗进行比较。本临床试验的主要目的是测试本体感觉训练对拇指骨关节炎患者疼痛强度的影响。主要结局为评估 CMC 本体感觉的关节位置觉(JPS),次要结局为评估患者满意度的视觉模拟评分(VAS)和加拿大职业表现量表(COPM),以及评估上肢功能的快速残疾评定量表(Quick-DASH)。对对照组(n=22)和实验组(n=23)进行了区组随机分组。参与者和评估者对分组情况均不知情。本体感觉训练在干预后即刻降低了疼痛,但在 3 个月随访时这种降低较小(d=0.1)。干预后和 3 个月随访时,两组间 JPS 准确性均有统计学差异(p=0.001 和 p<0.003)。干预后,Quick-DASH 和 COPM 评分均有统计学差异(均 p<0.001),3 个月随访时也有统计学差异(均 p<0.001)。随着时间的推移,疼痛强度的降低存在显著的时间因素,但在 3 个月随访时,组间差异较小。本体感觉训练可提高拇指 JPS 准确性,但长期来看不能降低疼痛强度。纳入本体感觉训练方案可能有利于改善拇指 CMC OA 患者的感觉运动功能。本研究已在 ClinicalTrials.gov 注册,注册号为 NCT04738201。本研究无资金支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01e8/8955750/647eacebb5ea/ijerph-19-03592-g001.jpg

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