thumb pain

  • 文章类型: Journal Article
    背景这项研究旨在调查沙特阿拉伯普通人群中智能手机用户拇指和手腕疼痛的患病率,检查智能手机使用的持续时间和频率之间的潜在联系,特定的智能手机活动,以及拇指和手腕不适的发生。方法这项描述性横断面研究是在Jazan大学进行的,沙特阿拉伯,2022年7月至2023年6月。问卷是在广泛的文献综述之后制定的,涵盖人口统计信息,智能手机使用模式,拇指或手腕疼痛的评估,并评估这种不适的影响。采用描述性统计方法,使用卡方和Wilcoxon秩和检验分析拇指或手腕疼痛与人口统计学变量之间的关系。结果总计,811名参与者被纳入本研究。大约322名(39.7%)研究参与者报告了手腕或拇指疼痛。值得注意的是,女性(P=0.001)和每天使用超过5小时的智能手机时间(P=0.045)与拇指或腕部疼痛有关.此外,在智能手机上发送电子邮件与拇指或手腕疼痛有关(P=0.04).关于智能手机人体工程学,大多数受访者报告单手拿着手机(215,66.77%),处于向下位置(290,90.06%),手腕向下弯曲(136,42.24%)。结论我们的研究强调了沙特阿拉伯普通人群中智能手机用户的腕部和拇指疼痛患病率相对较高。此外,我们确定了长时间使用智能手机与手腕和拇指疼痛之间的联系,在女性中观察到更明显的患病率。
    Background This study aims to investigate the prevalence of thumb and wrist pain among smartphone users in the general population of Saudi Arabia, examining the potential links between the duration and frequency of smartphone usage, specific smartphone activities, and the occurrence of discomfort in the thumb and wrist. Methodology This descriptive cross-sectional study was conducted at Jazan University, Saudi Arabia, between July 2022 and June 2023. The questionnaire developed following an extensive literature review, covered demographic information, smartphone usage patterns, assessment of thumb or wrist pain, and evaluation of the impact of this discomfort. Descriptive statistical methods were employed, and relationships between thumb or wrist pain and demographic variables were analyzed using chi-square and Wilcoxon rank-sum tests. Results In total, 811 participants were included in this study. Approximately 322 (39.7%) study participants reported wrist or thumb pain. Notably, female sex (P = 0.001) and prolonged daily smartphone usage exceeding five hours (P = 0.045) were linked to thumb or wrist pain. Additionally, emailing on smartphones was linked to thumb or wrist pain (P = 0.04). Concerning smartphone ergonomics, the majority of respondents reported holding their phones with one hand (215, 66.77%), in a downward position (290, 90.06%), and with their wrists bent downward (136, 42.24%). Conclusions Our study highlights a relatively high prevalence of wrist and thumb pain among smartphone users in the general Saudi Arabian population. Furthermore, we identified a connection between prolonged smartphone use and wrist and thumb pain, with a more pronounced prevalence observed among females.
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  • 文章类型: Case Reports
    背景:拇指腕掌(CMC)骨关节炎(OA)是一种疼痛状况,影响超过15%的30岁以上的个体和高达30%的绝经后妇女。已发现干针(DN)可以减轻各种神经肌肉骨骼疾病的疼痛和残疾;但是,DN在OA管理中的CMC还没有得到很好的研究。
    方法:连续有临床和影像学证据的CMCOA患者接受DN治疗。主要结果测量是在12周时使用数值疼痛评定量表(NPRS)的疼痛。次要结果指标是上肢功能指数(UEFI-20)和全球变化评分(GROC)量表。结果指标是在基线时收集的,4周,8周,和12周。
    结果:9例患者在3周内接受了6次骨膜DN治疗。与基线相比,12周时拇指疼痛(NPRS平均差异:2.6;p=0.029)和功能(UEFI-20平均差异:21.3;p=0.012)均有统计学意义和临床意义的改善.
    结论:在6次骨膜DN治疗后12周时,观察到拇指疼痛和功能的组内有统计学意义和临床意义的改善。DN可能是管理拇指CMCOA患者的有用干预措施。
    BACKGROUND: Carpometacarpal (CMC) osteoarthritis (OA) of the thumb is a painful condition that affects over 15% of individuals above the age of 30 and up to 30% of post-menopausal women. Dry needling (DN) has been found to reduce pain and disability in a variety of neuromusculoskeletal conditions; however, DN in the management of CMC OA has not been well studied.
    METHODS: Consecutive patients with clinical and radiographic evidence of CMC OA were treated with DN. The primary outcome measure was pain using the Numerical Pain Rating Scale (NPRS) at 12 weeks. Secondary outcome measures were the Upper Extremity Functional Index (UEFI-20) and the Global Rating of Change (GROC) scale. Outcome measures were collected at baseline, 4 weeks, 8 weeks, and 12 weeks.
    RESULTS: Nine patients were treated for six sessions of periosteal DN over 3 weeks. Compared to baseline, statistically significant and clinically meaningful improvements were observed in thumb pain (NPRS mean difference: 2.6; p = 0.029) and function (UEFI-20 mean difference: 21.3; p = 0.012) at 12 weeks.
    CONCLUSIONS: Statistically significant and clinically meaningful within-group improvements in thumb pain and function were observed at 12 weeks following six sessions of periosteal DN treatment. DN may be a useful intervention in the management of patients with CMC OA of the thumb.
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  • 文章类型: Randomized Controlled Trial
    方法:随机对照试验。
    背景:拇指CMC关节OA是一种常见的诊断。目前,没有证据表明本体感觉神经肌肉训练是否是该人群的有效干预措施。
    目的:建立本体感觉训练计划作为拇指CMC关节OA患者补充治疗的有效性。
    方法:对照组(n=26)和实验组(n=26)接受标准保守拇指CMC联合OA治疗,为期12周。实验组在同一干预期间接受了本体感觉训练计划。结果测量包括根据数字评定量表(NRS)的活动疼痛的严重程度,QuickDASH,加拿大职业绩效评估(COPM)和通过关节位置感觉(JPS)的本体感受。
    结果:52名女性参与了这项研究。随着时间的推移,实验组和对照组的平均VAS和COPM评分在临床上和统计学上均有显着变化。随着时间的推移,只有实验组实现了JPS误差评分的统计学和临床上显著的变化。
    结论:实验组的JPS随时间变化具有统计学意义,与以前的研究一致。疼痛评分的变化与先前的调查不同,组间比较无统计学意义。QuickDASH的变化与以前的发现相似。
    结论:除了传统的康复计划外,本体感觉训练还降低了关节位置感觉测试的误差分数。
    Randomized Control Trial.
    Thumb CMC joint OA is a common diagnosis. Currently there is no evidence available to under if proprioceptive neuromuscular training is an effective intervention for this population.
    To establish the effectiveness of a proprioceptive training program as a complementary therapy for patients with thumb CMC joint OA.
    Standard conservative thumb CMC joint OA treatments were received by both the control (n = 26) and experimental groups (n = 26) for a period of 12 weeks. The experimental group received a proprioceptive training program during the same intervention period. Outcome measures included severity of pain with activity according to the numerical rating scale (NRS), QuickDASH, Canadian Occupational Performance Measure (COPM), and proprioception via joint position sense (JPS).
    Fifty-two females participated in the study. Both the experimental and control group made both clinically and statistically significant changes in the mean VAS and COPM scores over time. Only the experimental group achieved a statistically and clinically significant change in JPS error score over time.
    Experimental group achieved a statistically significant change in JPS over time in concordance with previous investigations. Changes in pain scores differed from prior investigations and the between-group comparison was not statistically significant. Changes in the Quick DASH was similar to previous findings.
    Proprioceptive training in addition to a traditional rehabilitation program decreased error scores on the joint position sense test.
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  • 文章类型: Journal Article
    拇指关节炎经常非手术治疗,矫形器使用,抗炎药(口服和/或局部),和关节内注射。本文回顾了目前的文献,并探讨了拇指关节炎保守治疗的新方法和未来方向。
    Thumb arthritis frequently is managed nonoperatively with activity modification, orthotic use, anti-inflammatory medications (oral and/or topical), and intra-articular injections. This article reviews the current literature and touches on novel modalities and future directions in the conservative treatment of thumb arthritis.
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  • 文章类型: Journal Article
    一项对45名年龄超过18岁的女性进行的随机对照试验,这些女性的优势手诊断为拇指基底骨关节炎,并且在日常生活活动(ADLs)中的视觉模拟评分(VAS)最低疼痛评分为4/10。招募时间为2021年3月至6月。将接受本体感觉训练的组与常规保守物理治疗进行比较。这项临床试验的主要目的是测试本体感觉训练对拇指骨关节炎受试者疼痛强度的影响。主要结果是用于评估CMC本体感觉的关节位置感(JPS),次要结果是用于评估患者满意度的视觉模拟量表(VAS)和加拿大职业绩效评估(COPM)以及用于评估上肢功能的Quick-DASH。对对照组(n=22)和实验组(n=23)进行区组随机化。参与者和评估者对小组分配视而不见。本体感觉训练在干预后的疼痛中产生了统计学上的显着减少,但在3个月随访时,这种减少幅度很小(d=0.1).JPS准确性显示干预后(p=0.001)和3个月随访时(p<0.003)两组之间的统计学差异。在干预后的Quick-Dash和COPM中,均值之间存在统计学上的显着差异(两者,p<0.001),以及在3个月的随访中(两者,p<0.001)。随着时间的推移,疼痛强度的降低是一个显著的时间因素,但在3个月的随访期内,组间的效应大小很小。本体感觉训练提高了拇指JPS的准确性;然而,从长远来看,它不会降低疼痛强度。包含本体感受程序可能有利于改善拇指CMCOA感觉运动表现的个体。该研究在ClinicalTrials.govNCT04738201注册。没有为这项研究提供资金。
    A randomized controlled trial of forty-five females over 18 years of age with diagnosis of thumb basal osteoarthritis in their dominant hand and with a minimum pain rating of 4/10 on the Visual Analogue Scale (VAS) during activities of daily living (ADLs) were recruited from March to June 2021. The group receiving proprioception training was compared to routine conservative physiotherapy treatment. The main purpose of this clinical trial is to test the effect of proprioception training on pain intensity in subjects with thumb osteoarthritis. Primary outcome was joint position sense (JPS) for the assessment of CMC proprioception and secondary outcomes were Visual Analogue Scale (VAS) and Canadian Occupational Performance Measure (COPM) for the assessment of patient satisfaction and the Quick-DASH which assessed upper limb function. A block randomization was carried out for the control group (n = 22) and experimental group (n = 23). Participants and evaluator were blinded to the group assignment. Proprioception training produced a statistically significant reduction in pain post intervention, but this reduction was small (d = 0.1) at the 3-month follow-up. JPS accuracy demonstrated statistically significant differences between the groups (p = 0.001) post-intervention and at the 3-month follow-up (p < 0.003). Statistically significant differences between means were found in both the Quick-Dash and COPM post intervention (both, p < 0.001), as well as at the 3-month follow-up (both, p < 0.001). There was a significant time factor for the reduction of pain intensity over time but effect sizes between groups was small at the 3-month follow-up period. Proprioceptive training improves thumb JPS accuracy; however, it does not contribute to a reduction in pain intensity in the long term. The inclusion of a proprioceptive program may be beneficial for improving individuals with thumb CMC OA sensorimotor performance. The study was registered at ClinicalTrials.gov NCT04738201. No funding was provided for this study.
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  • 文章类型: Journal Article
    This is a longitudinal, observational, multicenter, cohort study.
    Thumb carpometacarpal (CMC) osteoarthritis (OA) is associated with more pain and restrictions than other hand OA. The use of patient-identified occupational performance goals to guide hand therapy treatment and to measure clinical outcomes is fundamental for a patient-centered intervention. The COPM enables subjects to identify goals for hand therapy and engage in a subject-specific therapeutic process.
    The purpose of this study is to evaluate the convergent validity and responsiveness of the COPM to evaluate the relationship between the patient\'s self-perception and satisfaction of performance in everyday living and pain intensity, upper limb function, and manual ability.
    Eligible participants to multiple hand therapy centers were recruited. Outcomes measures (VAS scale, QuickDASH, MAM-36, and the COPM questionnaire) were measured at the baseline and 3 months after.
    One hundred forty-five (n = 145) consecutive patients for five different hand rehabilitation centers with symptomatic thumb CMC OA were screened for eligibility criteria. COPM-P and COPM-S were the most responsive instruments, with an area under the curve of 0.88 (95% CI 0.79-0.96) and 0.88 (95% CI 0.80-0.96), respectively.
    Although more investigation in this area is necessary to conclude that the COPM is the best option to evaluate the effectiveness of hand therapy interventions for thumb OA. The COPM focuses on function and occupation and, in comparison with others upper limb scales, does not require the use of another complementary scale for addressing both satisfaction and ADL status. COPM is an instrument with a good convergent validity and responsiveness to evaluate the relationship between the patient\'s self-perception and satisfaction in thumb CMC OA.
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  • 文章类型: Journal Article
    Conservative treatment for carpometacarpal (CMC) joint osteoarthritis (OA) may include orthotic fabrication to decrease pain. Different types of orthoses have been used as conservative interventions to improve symptoms, but there are no guidelines specifying if inclusion of the thumb metacarpophalangeal (MCP) in an orthosis is required in the treatment of thumb CMC joint OA. The main objective of this study is to determine the effectiveness of 2 different thumb CMC joint orthotic designs on pain reduction and improved hand function: one design immobilizes both the MCP joint and the CMC joint and the other design immobilizes only the CMC joint.
    A total of 66 patients were included in the study. One group of 33 patients received a short thumb orthosis with the MCP joint excluded, and the other group of 33 patients received a short thumb orthosis with the MCP joint included. Outcomes measures included the visual analog scale for pain and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH; Spanish version) for function.
    In both patient groups, the orthoses contributed to decreased pain levels and improved functional abilities ( F1.0 = 315.467 and F1.0 = 72.419; both, P < .001). There was no significant difference between the 2 groups regarding pain or improvement in daily activities ( F1.0 = 0.553 and F1.0 = 2.539; both, P > .05).
    There are benefits of either thumb orthotic design on pain reduction and functional improvement even after 1 week of using the orthoses as the sole conservative treatment.
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  • 文章类型: Journal Article
    We present the results of a prospective study of 31 thumbs in 30 patients affected by primary osteoarthritis at the thumb carpometacarpal (CMC1) joint who were treated with denervation of the involved joint. For every operated hand, the Kapandji score, key-pinch strength, grip strength and pain on a visual analogue scale were evaluated preoperatively and postoperatively at 2 weeks, 6 weeks, 3 months, 6 months and 1 year. The patients\' satisfaction was determined. The Kapandji score and key-pinch strength improved significantly in all patients. Grip strength improved significantly in 10 hands. Pain was reduced in all cases. Nevertheless, 6 patients were dissatisfied with the operation. Of these 6 patients, 4 had stage IV arthritis in the TMC and scaphotrapeziotrapezoid joints of the thumb. Thumb CMC denervation appears to reduce pain at 1 year with an overall improvement in key-pinch strength. However, patients with stage IV CMC arthritis were not satisfied with the outcome of the procedure.
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  • 文章类型: Case Reports
    [目的]探讨逐步应用矫形器和运动学带对拇指掌指关节过伸损伤患者的影响。[主题]患者是一名43岁的男性,具有严重的拇指MCP疼痛和极其有限的拇指运动。[方法]连续3周和4周逐步应用矫形器和运动学贴膜,分别。[结果]经过逐步治疗,病人能够握力,精密捏合,转动一把钥匙,拿着笔没有痛苦。[结论]逐步应用拇指矫形器和运动学胶带治疗拇指MCP关节过伸损伤是一种安全有效的治疗方法。
    [Purpose] The purpose of this study was to investigate on the effects of the stepwise application of orthosis and kinesiology tape on a patient with thumb metacarpophalangeal joint hyperextension injury. [Subject] The patient was a 43-year-old man with severe thumb MCP pain and extremely limited thumb movement. [Methods] Stepwise application of orthosis and kinesiology taping were performed for 3 weeks and 4 weeks, respectively. [Results] After stepwise treatment, the patient was able to power grip, precision pinch, turn a key, and hold a pen without pain. [Conclusion] Stepwise application of thumb orthosis and kinesiology tape is a safe and effective treatment for thumb MCP joint hyperextension injury.
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  • 文章类型: Journal Article
    目的:通过短信对拇指疼痛患者进行临床和超声评估。
    背景:拇指通常用于短信,它们不是为精细的操作或灵巧的工作而设计的。在文本消息中重复使用会导致拇指肌腱受伤。
    方法:从一项调查中选择了98名具有重复劳损症状的拇指损伤类型的学生,并通过临床和超声分析拇指的肌肉肌腱单元来进行评估,以注意由于过度使用手机引起的变化。年龄和性别匹配的对照也进行超声评估。
    结果:临床检查显示,40%的病例的Finkelstein试验呈阳性,在这些情况下,横向和尖端捏合强度显著降低。在19%的病例中,超声检测到第一和第三隔室的变化。
    结论:已经报道了拇指疼痛的孤立病例,但是这项研究注意到拇指肌腱的临床和超声改变。这些变化应被视为警告信号,表明由于重复使用手机,这些受试者的拇指软组织可能发生亚临床变化,使他们容易患上痛苦的肌肉骨骼疾病。
    结论:重复使用手机进行短信发送会导致除腕部第一腔肌腱外,拇指长肌的损伤。
    OBJECTIVE: To do a clinical and ultrasonic evaluation of subjects with thumb pain with text messaging.
    BACKGROUND: Thumbs are commonly used for text messaging, which are not as well designed for fine manipulative or dexterous work. Repetitive use as in text messaging can lead to the injury to the tendons of the thumb.
    METHODS: Ninety eight students with symptoms of Repetitive Strain Type of injuries of the thumb were selected from a survey and evaluated both clinically and by ultrasound analysis of the musculotendinous unit of the thumb to note changes due to excessive use of the mobile phone. Age and sex matched controls were also subjected to ultrasound evaluation.
    RESULTS: Clinical examination showed positive Finkelstein test in 40% of the cases, significant reduction in the lateral and tip pinch strengths in the cases. Ultrasound detected changes in the first and the third compartments in 19% of the cases.
    CONCLUSIONS: Isolated cases of pain in the thumb have been reported but this study noted changes both clinically and by ultrasound in the tendons of the thumb. These changes should be taken as warning signs of possible subclinical changes taking place in the soft tissues of the thumb in these subjects due to repetitive use of mobile phones and thus, making them prone for developing painful Musculoskeletal Disorders.
    CONCLUSIONS: Repetitive use of mobile phones for text messaging can lead to the damage of Extensor pollicis longus of the thumb in addition to the tendons of the first compartment of the wrist.
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