Department of Physiotherapy, Universidad Católica, Valencia, Spain.
Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.
J Hand Ther. 2024 Apr-Jun;37(2):172-183. doi: 10.1016/j.jht.2022.07.005. Epub 2022 Aug 7.
Thumb carpometacarpal osteoarthritis (CMC OA) greatly affects post-menopausal women. It is characterized by pain and functional deficits that limit the performance of activities of daily life and affect quality of life.
Analyze the effects of 4/weeks strength training, with and without proprioceptive neuromuscular facilitation (PNF) on the disability among post-menopausal women with thumb CMC OA. Secondly, analyze the effects on pain, mobility, and strength.
Superiority randomized clinical trial.
42 women were randomly allocated to strength training program (SEG, n = 21) and to a strength training plus PNF therapy program (PNFG, n = 21). The Disability (disabilities of the arm, shoulder and hand questionnaire), pain (visual analogue scale), mobility (Kapandji Test), and hand strength were evaluated pre, post intervention (at 4 weeks) and follow-up (at 8 weeks).
Disability was significantly reduced in both groups after intervention, but reduction was statistically superior in PNFG (between-group mean difference [MD] = -16.69 points; CI = -21.56:-11.82; P<.001; d = 2.14). Similar results were observed for secondary outcomes: pain (MD = -2.03; CI = -2.83:-1.22; P<.001; d = 1.58), mobility (MD = 0.96; CI = 0.52:1.38; P<.001; d = 1.40) and strength (grip: MD = 3.47kg; CI = 1.25:5.69; P = .003; d = 0.97, palmar: MD = 0.97kg; CI = 0.14:1.80; P = .024; d = 0.72, tip: MD = 1.12kg; CI = 0.41:1.83; P = .003; d = 0.99 and key pinch: MD = 0.85kg; CI = 0.001:1.70; P = .049; d = 0.62). These improvements were maintained at follow-up.
The combination of PNF exercises and strength training is more effective for reducing disability pain and improve mobility and strength in post-menopausal women with CMC OA than a programme based solely on strength.
拇指腕掌关节骨关节炎（CMC OA）极大地影响绝经后妇女。其特征是疼痛和功能缺陷，限制了日常生活活动的表现，并影响生活质量。
分析每周 4 次的力量训练，有无本体感觉神经肌肉促进（PNF）对绝经后拇指 CMC OA 女性残疾的影响。其次，分析对疼痛、活动度和力量的影响。
优势随机临床试验。
42 名女性随机分配到力量训练计划（SEG，n = 21）和力量训练加 PNF 治疗计划（PNFG，n = 21）。使用残疾（手臂、肩部和手部问卷）、疼痛（视觉模拟量表）、活动度（Kapandji 测试）和手部力量评估，分别在干预前（4 周）、干预后（4 周）和随访时（8 周）进行。
两组干预后残疾均显著降低，但 PNFG 降低更具统计学意义（组间平均差异 [MD] = -16.69 分；CI = -21.56:-11.82；P<.001；d = 2.14）。次要结局也观察到类似结果：疼痛（MD = -2.03；CI = -2.83:-1.22；P<.001；d = 1.58）、活动度（MD = 0.96；CI = 0.52:1.38；P<.001；d = 1.40）和力量（握力：MD = 3.47kg；CI = 1.25:5.69；P =.003；d = 0.97，掌侧：MD = 0.97kg；CI = 0.14:1.80；P =.024；d = 0.72，指尖：MD = 1.12kg；CI = 0.41:1.83；P =.003；d = 0.99，和指尖握力：MD = 0.85kg；CI = 0.001:1.70；P =.049；d = 0.62）。这些改善在随访时仍保持。
PNF 运动与力量训练相结合，比单纯的力量训练更能有效减轻绝经后拇指 CMC OA 女性的残疾、疼痛，改善活动度和力量。
