Mobilization With Movement Versus Joint-Specific Manipulation in De Quervain's Tenosynovitis

Riphah International University32 enrolled

Overview

A comparative study on the effectiveness of mobilization with movement (MWM) versus joint-specific manipulation (JSM) in patients with De Quervain's tenosynovitis typically aims to assess how each technique impacts pain relief and functional improvement. De Quervain's tenosynovitis is an inflammation of the tendons around the thumb and wrist, often causing pain, swelling, and difficulty in performing everyday tasks. The study would likely compare the two interventions by measuring pain levels, range of motion, and overall functional outcomes before and after treatment. MWM involves applying specific, controlled movements while the patient is actively engaging in their joint motion, targeting the tissue's mobility and reducing pain. JSM, on the other hand, focuses on manipulating the joint directly to restore normal function, specifically targeting the wrist and thumb regions affected by the condition.

A comparative study on the effectiveness of Mobilization with Movement (MWM) versus Joint-Specific Manipulation (JSM) in patients with De Quervain's Tenosynovitis would delve deeper into the physiological mechanisms and clinical outcomes associated with each technique, providing valuable evidence for therapeutic decision-making. De Quervain's Tenosynovitis is a condition characterized by the inflammation of the tendons at the base of the thumb, particularly affecting the abductor pollicis longus and extensor pollicis brevis tendons. This condition is commonly caused by repetitive strain, overuse, or trauma, leading to pain, swelling, and restricted movement, which significantly impacts the patient's daily activities.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Enrollment

Interventions

Mobilization with MovementOTHER

Mobilization with Movement * The proximal row of carpals glides passively radially. * Active thumb and wrist movements superimposed on the glide. Therapeutic excercises: * Ball Toss * Static web gripping * Gentle ROM activities to maintain mobility * Isometric exercises in all direction

Joint Specific ManipulationOTHER

Joint Specific Manipulation * High-velocity, low-amplitude thrust to the first carpometacarpal joint * Radiocarpal wrist mobilization .Grade III-IV applied at end range. 2. Therapeutic excercises: * Ball Toss * Static web gripping * Gentle ROM activities to maintain mobility * Isometric exercises in all direction Ergonomics modifications

Eligibility

Sex: ALLMin age: 18 YearsMax age: 50 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria:o Patients clinically diagnosed with De Quervain's tenosynovitis * Age between 25-45 years. * Positive Finkelstein test. * Pain over the first dorsal compartment. * Limited wrist and thumb function. * Willingness to take part and adhere to the study's guidelines. Exclusion Criteria:Participants fall in this category would be excluded of the study. * Previous surgery of wrist or thumb. * Presence of neurological symptoms like numbness, weakeness. * Rheumatological conditions like rheumatoid arthritis. * Pregnancy. * Presence of wrist fracture or osteoporosis. * Carpel tunnel syndrome.

Outcomes

Primary Outcomes

Pain Reduction - Measured using the Numeric Pain Rating Scale (NPRS) (0-10 scale).

Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), a validated tool where participants rate their pain on a scale from 0 no pain to 10 worst possible pain.

Time frame: 6 Months

Secondary Outcomes

Wrist Function - Assessed with the Patient-Rated Wrist Evaluation (PRWE) (0-100 scale).

Functional wrist use will be assessed using the Patient-Rated Wrist Evaluation (PRWE), which evaluates pain and disability on a 100-point scale, with higher scores indicating greater impairment. Clinical signs will be assessed using Finkelstein's Test, a standard diagnostic test for De Quervain's tenosynovitis, recorded as positive or negative. Data will be analyzed using pre- and post-intervention comparisons within and between groups to determine the effectiveness of each intervention.

Time frame: 6months