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

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.

Study Overview

• Status: Completed
• Conditions: DeQuervain's Tendinopathy
• Intervention / Treatment: Other: Physical Therapist management

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 3

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients diagnosed with DeQuervain's tendinopathy.

Description

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

Study Plan

How is the study designed?

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Regis University

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2016
• Primary Completion (Actual): December 31, 2017
• Study Completion (Actual): December 31, 2017

Study Registration Dates

• First Submitted: June 18, 2019
• First Submitted That Met QC Criteria: November 13, 2019
• First Posted (Actual): November 15, 2019

Study Record Updates

• Last Update Posted (Actual): November 15, 2019
• Last Update Submitted That Met QC Criteria: November 13, 2019
• Last Verified: November 1, 2019

More Information

Terms related to this study

• Keywords: Physical Therapy; DeQuervain's tendinopathy; CMC manipulation
• Additional Relevant MeSH Terms: Wounds and Injuries; Musculoskeletal Diseases; Muscular Diseases; Tendon Injuries; Tendinopathy
• Other Study ID Numbers: 1407911-2

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No