Effect of thumb joint mobilization on pressure pain threshold in elderly patients with thumb carpometacarpal osteoarthritis

J Manipulative Physiol Ther. 2012 Feb;35(2):110-20. doi: 10.1016/j.jmpt.2011.12.002. Epub 2012 Jan 16.


Objective: This study evaluated the effects of Maitland's passive accessory mobilization on local hypoalgesia and strength in thumb carpometacarpal osteoarthritis (TCOA).

Methods: Twenty-eight patients between 70 and 90 years old with secondary TCOA were randomized into glide mobilization and sham groups. This study was designed as a double-blind, randomized controlled trial. Therapy consisted of Maitland's passive accessory mobilization of the dominant hand during 4 sessions over 2 weeks. We measured pressure pain threshold (PPT) at the trapeziometacarpal joint (TMJ), the tubercle of the scaphoid bone, and the unciform apophysis of the hamate bone by algometry. The tip and tripod pinch strength was also measured. Grip strength was measured by a grip dynamometer. Measurements were taken before treatment and after 1 week (first follow-up [FU]) and 2 weeks (second FU).

Results: All values in sham group remained unchanged along the treatment period. In the treated group, the PPT in the TMJ was 3.85 ± 0.35 kg/cm(2), which increased after treatment to 3.99 ± 0.37 and was maintained at the same level during the first FU 3.94 ± 0.39 and second FU 4.74 ± 0.40. In contrast, we found no differences in PPT in the other studied structures after treatment. Similarly, tip, tripod pinch, and grip strength remained without change after treatment.

Conclusions: Passive accessory mobilization increased PPT in the TMJ; however, it did not increase motor function in patients with TCOA.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carpometacarpal Joints / physiopathology
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Musculoskeletal Manipulations / methods*
  • Osteoarthritis / diagnosis
  • Osteoarthritis / therapy*
  • Pain Measurement
  • Pain Threshold / physiology*
  • Physical Therapy Modalities
  • Pinch Strength / physiology
  • Range of Motion, Articular / physiology*
  • Reference Values
  • Risk Factors
  • Thumb*
  • Treatment Outcome