Conservative Management of DeQuervain's Tendinopathy With an Orthopaedic Manual Therapy Approach Emphasizing First CMC Manipulation: A Retrospective Case Series

Study Overview
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Brief Summary
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This is a retrospective review of three patients with DeQuervain's Tendinopathy (DQT) that had successful outcomes with a manual therapy focused approach provided by Physical Therapist management.

Detailed Description
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DeQuervain's tendinopathy (DQT) is a musculoskeletal disorder that limits hand function of affected individuals. Management of DQT can include splinting, activity modification, medications, corticosteroid injections, Physical Therapy, and surgery. There is limited evidence to support the combination of manual therapy and exercise interventions within an Orthopaedic Manual Physical Therapy (OMPT) approach when managing patients with DQT. Three patients identified with DQT underwent a multi-modal treatment regimen including carpometacarpal (CMC) thrust and non-thrust manipulation, end range radiocarpal mobilization, mobilization with movement (MWM), strengthening exercises, and grip proprioception training. Outcomes were assessed using the numeric pain rating scale (NPRS), Jamar hand dynamometer grip strength, and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire. These measures were administered at baseline and discharge.

Official Title
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Conservative Management of DeQuervain's Tendinopathy With an Orthopaedic Manual Therapy Approach Emphasizing First CMC Manipulation: A Retrospective Case Series

Conditions
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DeQuervain's Tendinopathy

Intervention / Treatment
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* Other: Physical Therapist management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Five or more items present on the DQT screening tool devised by Batteson et al.: Pain over the radial styloid Tenderness over the dorsal thumb Pain with active thumb flexion Localized swelling over the thumb Positive Finkelsteins test Thickening of the tendon sheath of the first dorsal extensor compartment Pain with resisted thumb extension. Exclusion Criteria: Cardiovascular disorders Non-musculoskeletal complaints Auto-immune disorders Patients who had received previous treatment for their condition

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Physical Therapist management|Physical Therapist management included joint manipulation, mobilization with movement, strengthening exercises, and grip proprioception training.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Quick Disabilities of the Arm, Shoulder, and Hand questionnaire at 8 weeks | Quick DASH (0% disability to 100% disability) | up to 8 weeks | 
| Change from Baseline Numeric Pain Rating Scale at 8 weeks | Numeric Pain Rating Scale (0-10 point scale) | up to 8 weeks | 
| Change from Baseline Grip strength at 8 weeks | Jamar hand dynamometer Grip strength | up to 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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DeQuervain's tendinopathy, CMC manipulation, Physical Therapy