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Effectiveness of proprioceptive neuromuscular facilitation therapy and strength training among post-menopausal women with thumb carpometacarpal osteoarthritis. A randomized trial [with consumer summary]
Campos-Villegas C, Perez-Alenda S, Carrasco JJ, Igual-Camacho C, Tomas-Miguel JM, Cortes-Amador S
Journal of Hand Therapy 2022 Aug 7:Epub ahead of print
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 to -11.82; p < 0.001; d = 2.14). Similar results were observed for secondary outcomes: pain (MD -2.03; CI -2.83 to -1.22; p < 0.001; d = 1.58), mobility (MD 0.96; CI 0.52 to 1.38; p < 0.001; d = 1.40) and strength (grip: MD 3.47kg; CI 1.25 to 5.69; p = 0.003; d = 0.97, palmar: MD 0.97kg; CI 0.14 to 1.80; p = 0.024; d = 0.72, tip: MD 1.12kg; CI 0.41 to 1.83; p = 0.003; d = 0.99 and key pinch: MD 0.85kg; CI 0.001 to 1.70; p = 0.049; 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.

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