Efficacy of Paraffin Wax Bath with and without Joint Mobilization Techniques in Rehabilitation of post-Traumatic stiff hand
Fozia Sibtain, Asghar Khan, Syed Shakil-Ur-Rehman, Fozia Sibtain, Asghar Khan, Syed Shakil-Ur-Rehman
Abstract
Objective: Post-traumatic stiff hand is common a condition which causes pain and disability, the paraffin wax bath and joint mobilizations have the key role in its rehabilitation. We conducted the present study to determine the efficacy of paraffin wax bath with mobilization techniques compared with joint mobilization alone.
Methodology: This single blind randomized control trial was conducted on 71 patients in department of physical therapy and rehabilitation, Riphah International University Islamabad, and patients with post-traumatic stiff hand after distal upper extremity fractures, were included. The patients were randomized into two groups: the joint mobilization techniques with paraffin wax bath were included in group A, and joint mobilization techniques without paraffin wax bath in group B. The study variables were pain score on visual analogue scale (VAS) 0/10, thumb function score (TFS) and passive range of motion (PROM) of wrist flexion, extension, radial and ulnar deviation, and were compared at baseline and at completion on plan-of-care after six weeks.
Results: Seventy one patients with post-traumatic stiff hand were enrolled and placed randomly into two groups. The baseline characteristics were similar in both groups. Six week after intervention, patients in group A had more improvement in pain score (p=0.001), TFS (p=0.003), and PROM of wrist flexion (p=0.002), extension (p=0.003), radial deviation (p=0.013), and ulnar deviation (p=.004), as compared to group B. However, in group B the improvement was less in pain score (p=0.104), TFS (p=0.520), and PROM of wrist flexion (p=0.193), extension (p=0.1081), radial deviation (p=0.051), and ulnar deviation (p=.168), as compared to group A.
Conclusion: Paraffin wax bath with joint mobilization techniques are more effective than mobilization techniques without paraffin wax bath in the rehabilitation of post traumatic stiff hand.
Keywords: Joint mobilization techniques; Paraffin wax bath; Post-traumatic stiff hand.
References
- Hoch MC, Andreatta RD, Mullineaux DR, English RA, Medina-McKeon JM, Mattacola CG, et al. Two‐week joint mobilization intervention improves self‐reported function, range of motion, and dynamic balance in those with chronic ankle instability. J Orthop Res. 2012;30(11):1798–1804.
- Morey KR, Watson AH. Team approach to treatment of post-traumatic stiff hand. Physical Ther. 1986;66(2):225–228.
- Randall T, Portney L, Harris B. Effects of joint mobilization on joint stiffness and active motion of the metacarpal-phalangeal joint. J Orthopedic Sports Med. 2012;16(1):30–36.
- Welch V, Brosseau L, Casimiro L, Judd M, Shea B, Tugwell P, et al. Thermotherapy for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2002;(2):CD002826.
- Harris R, Millard J. Paraffin-wax baths in the treatment of rheumatoid arthritis. Annals of the Rheumatic Diseases. 1955;14(3):278–283.
- Dellhag B, Wollersjo I, Bjelle A. Effect of active hand exercise and wax bath treatment in rheumatoid arthritis patients: randomized trial. Arthritis & Rheumatism. 2005;5(2):87–92.
- Ayling J, Marks R. Efficacy of paraffin wax baths for rheumatoid arthritic hands. Physiotherapy. 2000;86(4):190–201.
- Sandqvist G, Akesson A, Eklund M. Evaluation of paraffin bath treatment in patients with systemic sclerosis. Disabil Rehabil. 2004;26(16):981–987.
- Valdes K, Marik T. A systematic review of conservative interventions for osteoarthritis of the hand. J Hand Ther. 2010;23(4):334–351.
- Glasgow C, Tooth LR, Fleming J. Mobilizing the stiff hand: combining theory and evidence to improve clinical outcomes: a systematic review. J Hand Ther. 2012;23(4):392–401.
- Sultana SS, MacDermid JC, Grewal R, Rat S. The Effectiveness of Early Mobilization after Tendon Transfers in the Hand: A Systematic Review. J Hand Ther. 2012 [Epub ahead of print]
Source: PubMed