Effectiveness of physical treatment at De Quervain᾽s disease

Abstract

Introduction: De Quervain᾽s disease is a stenosing tenosynovitis of common tendon sheath of abducktor policis longus and extensor policis brevis muscles. Due to the superficial positions it can easily lead tomechanical injuries of tendons and their sheaths. The disease more often affects women over 40 years old and people with certain professions who intensively use hand and fingers in their daily work. Pathologicalchanges consist of sheath᾽s fibrous layer thickening. The clinical condition develops gradually with the pain of varying intensity. It is localized above the radial styloid process and radiates from the back side of thethumb. The aim is to determine the efficacy of physical therapy at De Quervain᾽s disease.Methods: The study was conducted on 50 patients with De Quervain's disease who were reported to the CBR "Praxis" Sarajevo. With retrospective analysis the data was processed for the period from 01.01.2001. to 31.12.2011. year. Before the initiation of physical therapy assessment of functional status scored from 0 to 6 was performed. In the chronic phase physical therapy was performed, after which it underwent assessment of therapy success scores of 0-5. Criteria for inclusion in the study were patients with confirmed De Quervain's disease, patients of both sex and of all ages, and criterion for exclusion was non-compliance withtreatment protocols.Results: In the CBR "Praxis" with De Quervain᾽s disease total of 50 patients were treated in that period, of which 34 women and 16 men. 38% of respondents received a score of 4, while 56% of patients at the end oftreatment received a score of 5.Conslusion: Physical therapy and kinesiotherapeutical procedures have greatly contributed to the elimination of symptoms and consequences of De Quervainove disease.

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“…30 Keluhan pada ibu jari tangan diakibatkan karena adanya peradangan pada struktur jaringan pergelangan tangan. 31 Keluhan yang biasa ditemukan adalah keluhan nyeri. 30 Keluhan nyeri tersebut berkaitan dengan hubungan antara resistensi gerakan otot extensor pollicis brevis dan abductor pollicis longus dengan posisi pergelangan tangan ditemukan bahwa resistensi geser (sliding) maksimum diperoleh ketika pergelangan tangan berada pada posisi dorsifleksi maksimum.…”

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“…The clinician may consider serologic testing for rheumatoid arthritis (ie, checking serum rheumatoid factor) if the patients has no history of either acute or repetitive trauma or other risk factors [6]. Radiographically, there is usually no changes, although it sometimes can be spotted periosteal reaction [1]. On occasionally evidence of calcification in the tendon or tendon sheath can be noted on x-ray examinations [11].…”

“…de Quervain's disease is a stenosing tenosynovitis of common tendon sheath of abductor pollicis longus and extensor pollicis brevis muscles [1]. These musculotendinous units control the position and orientation, force application and joint stability of the thumb.…”