1
|
Mitchell T, Hamilton N, Dean B, Rodgers S, Fowler-Davis S, McLean S. A scoping review to map evidence regarding key domains and questions in the management of non-traumatic wrist disorders. HAND THERAPY 2024; 29:3-20. [PMID: 38425437 PMCID: PMC10901165 DOI: 10.1177/17589983231219595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/21/2023] [Indexed: 03/02/2024]
Abstract
Introduction Non-traumatic wrist disorders (NTWD) are commonly encountered yet sparse resources exist to aid management. This study aimed to produce a literature map regarding diagnosis, management, pathways of care and outcome measures for NTWDs in the United Kingdom. Methods An interdisciplinary team of clinicians and academic researchers used Joanna Briggs Institute guidelines and the PRISMA ScR checklist in this scoping review. A mixed stakeholder group of patients and healthcare professionals identified 16 questions of importance to which the literature was mapped. An a-priori search strategy of both published and non-published material from five electronic databases and grey literature resources identified records. Two reviewers independently screened records for inclusion using explicit eligibility criteria with oversight from a third. Data extraction through narrative synthesis, charting and summary was performed independently by two reviewers. Results Of 185 studies meeting eligibility criteria, diagnoses of wrist pain, De Quervain's syndrome and ulna-sided pain were encountered most frequently, with uncontrolled non-randomised trial or cohort study being the most frequently used methodology. Diagnostic methods used included subjective questioning, self-reported pain, palpation and special tests. Best practice guidelines were found from three sources for two NTWD conditions. Seventeen types of conservative management, and 20 different patient-reported outcome measures were suggested for NTWD. Conclusion Substantial gaps in evidence exist in all parts of the patient journey for NTWD when mapped against an analytic framework (AF). Opportunities exist for future rigorous primary studies to address these gaps and the preliminary concerns about the quality of the literature regarding NTWD.
Collapse
Affiliation(s)
- Thomas Mitchell
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| | - Nick Hamilton
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| | - Ben Dean
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Sarah Rodgers
- The Hand Unit, Northern General Hospital, Sheffield, UK
| | | | - Sionnadh McLean
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
2
|
Challoumas D, Ramasubbu R, Rooney E, Seymour-Jackson E, Putti A, Millar NL. Management of de Quervain Tenosynovitis: A Systematic Review and Network Meta-Analysis. JAMA Netw Open 2023; 6:e2337001. [PMID: 37889490 PMCID: PMC10611995 DOI: 10.1001/jamanetworkopen.2023.37001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/28/2023] [Indexed: 10/28/2023] Open
Abstract
Importance There is a plethora of treatment options for patients with de Quervain tenosynovitis (DQT), but there are limited data on their effectiveness and no definitive management guidelines. Objective To assess and compare the effectiveness associated with available treatment options for DQT to guide musculoskeletal practitioners and inform guidelines. Data Sources Medline, Embase, PubMed, Cochrane Central, Scopus, OpenGrey.eu, and WorldCat.org were searched for published studies, and the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, The European Union Clinical Trials Register, and the ISRCTN registry were searched for unpublished and ongoing studies from inception to August 2022. Study Selection All randomized clinical trials assessing the effectiveness of any intervention for the management of DQT. Data Extraction and Synthesis This study was prospectively registered on PROSPERO and conducted and reported per Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA) and PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science (PERSIST) guidance. The Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluations tool were used for risk of bias and certainty of evidence assessment for each outcome. Main Outcomes and Measures Pairwise and network meta-analyses were performed for patient-reported pain using a visual analogue scale (VAS) and for function using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale. Mean differences (MD) with their 95% CIs were calculated for the pairwise meta-analyses. Results A total of 30 studies with 1663 patients (mean [SD] age, 46 [7] years; 80% female) were included, of which 19 studies were included in quantitative analyses. From the pairwise meta-analyses, based on evidence of moderate certainty, adding thumb spica immobilization for 3 to 4 weeks to a corticosteroid injection (CSI) was associated with statistically but not clinically significant functional benefits in the short-term (MD, 10.5 [95% CI, 6.8-14.1] points) and mid-term (MD, 9.4 [95% CI, 7.0-11.9] points). In the network meta-analysis, interventions that included ultrasonography-guided CSI ranked at the top for pain. CSI with thumb spica immobilization had the highest probability of being the most effective intervention for short- and mid-term function. Conclusions and Relevance This network meta-analysis found that adding a short period of thumb spica immobilization to CSI was associated with statistically but not clinically significant short- and mid-term benefits. These findings suggest that administration of CSI followed by 3 to 4 weeks immobilization should be considered as a first-line treatment for patients with DQT.
Collapse
Affiliation(s)
- Dimitris Challoumas
- School of Infection and Immunity, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland
| | - Rohan Ramasubbu
- School of Infection and Immunity, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland
| | - Elliot Rooney
- School of Infection and Immunity, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland
| | - Emily Seymour-Jackson
- School of Infection and Immunity, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland
| | - Amit Putti
- Department of Orthopaedic Surgery, Forth Valley Royal Hospital, Larbert, Scotland
| | - Neal L. Millar
- School of Infection and Immunity, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland
| |
Collapse
|
3
|
Fakoya AO, Tarzian M, Sabater EL, Burgos DM, Maldonado Marty GI. De Quervain's Disease: A Discourse on Etiology, Diagnosis, and Treatment. Cureus 2023; 15:e38079. [PMID: 37252462 PMCID: PMC10208847 DOI: 10.7759/cureus.38079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 05/31/2023] Open
Abstract
Since Fritz De Quervain first postulated stenosing tenosynovitis within the radial dorsum of the wrist, much research has been conducted to provide further insights. De Quervain's Disease (DQD) is a condition that affects the tendons that control the movement of the thumb, specifically the abductor pollicis longus and extensor pollicis brevis. Numerous studies have shown that structural divergence from normal anatomy is partly related to contingency for developing DQD. Even though this condition was discovered many years ago, its exact etiology remains a subject of debate. Two schools of thought exist, one that contends an inflammatory-mediated pathway and the other degenerative changes. Substantial evidence exists for both theories, thus necessitating further studies into the etiology of DQD. Classically, Finkelstein's and Eichhoff's tests have been used as the physical examinations of choice for clinically diagnosing this condition. However, these tests have been shown to have low specificity, hence, the emergence of the wrist hyperflexion and abduction of the thumb test. Evidence also suggests that ultrasonography may become a critical diagnostic tool, especially to identify anatomical variations before invasive treatment, reducing the risk of further complications. The management of DQD is typically conservative, with escalation to steroid injections before surgery is indicated. Future research into this disease should focus on establishing a clearer picture of how anatomical variations and other pathological and occupational factors may interplay to bring about this condition. While current research has suggested possible novel approaches for diagnosing and treating DQD, more studies are required to gain greater insights into the effectiveness of these interventions.
Collapse
Affiliation(s)
- Adegbenro O Fakoya
- Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Martin Tarzian
- Psychiatry, University of Medicine and Health Sciences, Basseterre, KNA
| | - Enrique L Sabater
- Anatomy, University of Medicine and Health Sciences, Basseterre, KNA
| | - Daiana M Burgos
- Anatomy, University of Medicine and Health Sciences, Basseterre, KNA
| | | |
Collapse
|
4
|
Drapeza RC, Navasca SB, Dones V, Rimando CR. The effects of taping on de Quervain’s disease: A systematic review and meta-analysis. J Bodyw Mov Ther 2022; 32:218-227. [DOI: 10.1016/j.jbmt.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 01/05/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
|
5
|
Karlıbel İA, Aksoy MK, Alkan A. Paraffin bath therapy in De Quervain's tenosynovitis: a single-blind randomized controlled trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1391-1398. [PMID: 33675398 DOI: 10.1007/s00484-021-02111-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
Data on the efficacy of treatment modalities in De Quervain's tenosynovitis (DQT) is limited. Paraffin therapy is routinely used in treating hand osteoarthritis and neuropathies. However, there are not enough studies investigating paraffin effectiveness. This study evaluates the effectiveness of paraffin bath therapy on pain, functional status, muscle strength, and quality of life in patients with DQT. This prospective, single-blind, randomized, controlled study enrolled 51 DQT patients. Group 1 (n = 26) received paraffin bath + splint + exercise; Group 2 (n = 25) received splint + exercise therapy. Pain, handgrip strength, thumb palmar pinch strength, functional status, and quality of life were evaluated. Both treatment combinations improved pain, grip strength, palmar pinch strength of the thumb, functional status, and quality of life. The paraffin group provided more effective pain control than the paraffin-free group and was more effective in improving functional status, handgrip strength, and quality of life (p < 0.05). Apparently, adding paraffin therapy to the combination of the splint and therapeutic exercise positively affects the patient's treatment outcomes. For this reason, paraffin therapy should be included in the conservative treatment combinations in DQT.
Collapse
Affiliation(s)
- İlknur Aykurt Karlıbel
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yuksek İhtisas Training and Research Hospital, 16800 Yildirim, Bursa, Turkey.
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yuksek İhtisas Training and Research Hospital, 16800 Yildirim, Bursa, Turkey
| | - Ayşe Alkan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yuksek İhtisas Training and Research Hospital, 16800 Yildirim, Bursa, Turkey
| |
Collapse
|
6
|
Ferrara PE, Codazza S, Cerulli S, Maccauro G, Ferriero G, Ronconi G. Physical modalities for the conservative treatment of wrist and hand's tenosynovitis: A systematic review. Semin Arthritis Rheum 2020; 50:1280-1290. [DOI: 10.1016/j.semarthrit.2020.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/10/2020] [Accepted: 08/26/2020] [Indexed: 12/22/2022]
|
7
|
Cupler ZA, Alrwaily M, Polakowski E, Mathers KS, Schneider MJ. Taping for conditions of the musculoskeletal system: an evidence map review. Chiropr Man Therap 2020; 28:52. [PMID: 32928244 PMCID: PMC7491123 DOI: 10.1186/s12998-020-00337-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background Taping is a common treatment modality used by many rehabilitation providers. Several types of tapes and taping methods are used in the treatment of musculoskeletal dysfunction and pain. Purpose To summarize and map the evidence related to taping methods used for various joints and conditions of the musculoskeletal system, and to provide clinicians and researchers with a user-friendly reference with organized evidence tables. Data sources The PEDro, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register for Controlled Trials, PubMed, and PROSPERO databases were searched from inception through October 31, 2019. Study selection Eligible studies were selected by two independent reviewers and included either systematic reviews (SRs) or randomized controlled trials (RCTs) and included a musculoskeletal complaint using a clinical outcome measure. Data extraction Data was extracted by two investigators independently. Risk of bias and quality were assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) for SRs or the Physiotherapy Evidence Database (PEDro) scale for RCTs. The protocol was registered with PROSPERO (CRD42019122857). Data synthesis Twenty-five musculoskeletal conditions were summarized from forty-one SRs and 127 RCTs. There were 6 SRs and 49 RCTs for spinal conditions. Kinesio tape was the most common type of tape considered. Four evidence tables representing the synthesized SRs and RCTs were produced and organized by body region per condition. Limitations Inclusion of only English language studies. Also, the heterogeneous nature of the included studies prevented a meta-analysis. Conclusions There is mixed quality evidence of effectiveness for the different types of taping methods for different body regions and conditions. All of the SRs and RCTs found during our search of the taping literature have been organized into a series of appendices. A synthesis of the results have been placed in evidence tables that may serve as a useful guide to clinicians and researchers.
Collapse
Affiliation(s)
- Zachary A Cupler
- Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, 353 N. Duffy Road, Butler, Pennsylvania, USA.
| | - Muhammad Alrwaily
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, West Virginia, USA.,Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Emily Polakowski
- Private Practice, Independence Physical Therapy, Mystic, Connecticut, USA
| | - Kevin S Mathers
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Michael J Schneider
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
8
|
Young SW, Young TW, MacDonald CW. Conservative management of De Quervain's tendinopathy with an orthopedic manual physical therapy approach emphasizing first CMC manipulation: a retrospective case series. Physiother Theory Pract 2020; 38:587-596. [PMID: 32478626 DOI: 10.1080/09593985.2020.1771800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
De Quervain'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 therapist management, and surgery. There is limited evidence to support the combination of manual therapy and exercise interventions within an Orthopedic 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. Each patient demonstrated improvements in all outcome measures and required ten visits or less to reach a satisfactory outcome. The NPRS improved by a mean of 7.1 points on a 0-10 scale, Quick DASH improved by an average of 37.1%, and grip strength improved by a mean of 27.6 pounds. Each patient was able to return to daily tasks without pain and all improvements were maintained at six month follow-up. An impairment based OMPT management approach was effective in managing three patients with DQT. The inclusion of first CMC manipulation within this multi-modal approach may enhance conservative management of patients with DQT. Because a cause and effect relationship cannot be inferred from a case series, further research is recommended to investigate the efficacy of this management approach.
Collapse
Affiliation(s)
- Scott W Young
- Rueckert-Hartman College for Health Professions, School of Physical Therapy, Regis University, Denver, Colorada, USA
| | - Thomas W Young
- Rueckert-Hartman College for Health Professions, School of Physical Therapy, Regis University, Denver, Colorada, USA
| | - Cameron W MacDonald
- Rueckert-Hartman College for Health Professions, School of Physical Therapy, Regis University, Denver, Colorada, USA
| |
Collapse
|
9
|
Huisstede BM, Gladdines S, Randsdorp MS, Koes BW. Effectiveness of Conservative, Surgical, and Postsurgical Interventions for Trigger Finger, Dupuytren Disease, and De Quervain Disease: A Systematic Review. Arch Phys Med Rehabil 2018; 99:1635-1649.e21. [DOI: 10.1016/j.apmr.2017.07.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/13/2017] [Accepted: 07/20/2017] [Indexed: 12/18/2022]
|
10
|
D’Angelo K, Sutton D, Côté P, Dion S, Wong JJ, Yu H, Randhawa K, Southerst D, Varatharajan S, Cox (Dresser) J, Brown C, Menta R, Nordin M, Shearer HM, Ameis A, Stupar M, Carroll LJ, Taylor-Vaisey A. The Effectiveness of Passive Physical Modalities for the Management of Soft Tissue Injuries and Neuropathies of the Wrist and Hand: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. J Manipulative Physiol Ther 2015; 38:493-506. [DOI: 10.1016/j.jmpt.2015.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/05/2015] [Accepted: 06/05/2015] [Indexed: 01/18/2023]
|
11
|
Lim ECW, Tay MGX. Kinesio taping in musculoskeletal pain and disability that lasts for more than 4 weeks: is it time to peel off the tape and throw it out with the sweat? A systematic review with meta-analysis focused on pain and also methods of tape application. Br J Sports Med 2015; 49:1558-66. [DOI: 10.1136/bjsports-2014-094151] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2014] [Indexed: 11/04/2022]
|