Two recent randomised trials of Kaltenborn

Two recent randomised trials of Kaltenborn Apoptosis inhibitor mobilisation (Villafañe et al 2011a) and radial nerve gliding (Villafañe et al 2012a) in people with thumb carpometacarpal osteoarthritis found that these interventions applied over the symptomatic hand exerted unilateral hypoalgesic effects. However,

hypoalgesia induced by manual therapies may be bilateral (Mansilla-Ferragut et al 2009). Given this emerging evidence of widespread hyperalgesia in osteoarthritis related-pain, we hypothesised that a neurodynamic radial nerve slider intervention applied to the affected hand in people with carpometacarpal osteoarthritis would induce bilateral mechanical hypoalgesia. Therefore, PLX4032 mw we conducted a secondary analysis of our randomised trial of nerve

sliding in people with thumb carpometacarpal osteoarthritis, which has already shown ipsilateral hypoalgesic effects (Villafañe et al 2012a), to examine contralateral hypoalgesic effects. Therefore, the specific research question for this study was: In people with thumb carpometacarpal osteoarthritis, does radial nerve mobilisation on the affected side reduce pressure pain sensitivity on the contralateral side? Full details of the trial design and primary analysis are available elsewhere (Villafañe et al 2012a), with relevant parts of the design summarised here. Participants with thumb carpometacarpal osteoarthritis of the dominant hand were randomly

assigned to an experimental or control group using simple randomisation with a random number generator. Allocation was concealed by generating each allocation after enrolment. The experimental group received a radial nerve slider technique and the control group received a sham intervention of sub-therapeutic ultrasound. Both interventions were applied only to the symptomatic hand. Pressure pain sensitivity was measured contralaterally at the carpometacarpal joint, the lateral epicondyle, and through the hamate and scaphoid bones. Measurements were made at baseline, immediately after the 4-week treatment period, and at one month and two months after the treatment by an assessor blinded to the participants’ allocated group. People with a diagnosis of carpometacarpal osteoarthritis of the dominant hand referred to a physiotherapy outpatient clinic at ‘Residenze Sanitarie Assistenziali’ (Avigliana and Sangano), Azienda Sanitaria Locale 3, Collegno, Italy were screened consecutively for eligibility.

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