Effectiveness of proprioceptive neuromuscular facilitation therapy and strength training among post-menopausal women with thumb carpometacarpal osteoarthritis. A randomized trial

Cristina Campos-Villegas; Sofía Pérez-Alenda; Juan J Carrasco; Celedonia Igual-Camacho; José Manuel Tomás-Miguel; Sara Cortés-Amador

doi:10.1016/j.jht.2022.07.005

Effectiveness of proprioceptive neuromuscular facilitation therapy and strength training among post-menopausal women with thumb carpometacarpal osteoarthritis. A randomized trial

J Hand Ther. 2022 Aug 7:S0894-1130(22)00080-1. doi: 10.1016/j.jht.2022.07.005. Online ahead of print.

Authors

Cristina Campos-Villegas¹, Sofía Pérez-Alenda², Juan J Carrasco³, Celedonia Igual-Camacho⁴, José Manuel Tomás-Miguel⁵, Sara Cortés-Amador⁶

Affiliations

¹ Department of Physiotherapy, Universidad Católica, Valencia, Spain.
² Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.
³ Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain. Electronic address: Juan.J.Carrasco@uv.es.
⁴ Group of Physiotherapy in the Ageing Process, Department of Physiotherapy, University of Valencia, Valencia, Spain.
⁵ Department of Methodology for the Behavioural Sciences, University of Valencia, Valencia, Spain.
⁶ UBIC research group, Department of Physiotherapy, University of Valencia, Valencia, Spain.

PMID: 35948454
DOI: 10.1016/j.jht.2022.07.005

Abstract

Background: 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.

Purpose: 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.

Study design: Superiority randomized clinical trial.

Methods: 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).

Results: 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.

Conclusions: 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.

Keywords: Hand osteoarthritis; Menopause; Pain; Proprioceptive training; Strength training.