FRI0695 NEURAL MANUAL MOBILIZATION VS ROBOTIC ASSISTED MOBILIZATION TO REDUCE PAIN HYPERSENSITIVITY IN HANDOSTEOARTHRITIS: A RANDOMISED CONTROLLED PILOT TRIAL

Abstract

Background Recent studies suggest that osteoarthritis (OA) is a mixed pain state and that in some patients’ central nervous system factors can play an important role. Objectives In this study, we showed some preliminary dataon the effectiveness of neural manual mobilization vs robotic assisted mobilization, on reduce pain sensitivity in subjects with dominant hand OA. Methods A pilot randomized controlled trial was conducted. 50 patients (50 to 90 years old) with a diagnosis of dominant hand OA were randomized into two groups of 25 participants. The experimental group received an intervention of neurodynamic mobilization of median, radial and ulnar nerves plus exercise, the control one received a robotic assisted passive mobilization treatment (Gloreha Workstation, Idrogenet srl, Brescia, Italy) plus exercise. Both groups received 12 treatment sessions over 4 weeks. Pressure pain thresholds (PPTs) were assessed bilaterally over the Radial, Median and Ulnar nerves, first Carpometacarpal (CMC) joint, Hamate bone and in the C5-C6 zygapophyseal joint. Intensity of pain (Visual analogue scale, VAS), Quick-DASH scale, grip and pinch strength were also measured bilaterally. Patients were assessed at beginning, at the end of therapy and after a period of 1 and 3 months. Results In comparison with pre-treatment values, the experimental treatment increased the PPTs in the first CMC joint, radial and median nerves (P Conclusion Neurodynamic mobilization by sliding technique decreases pain in the hand joints in patients with hand OA, suggesting alternative therapies to surgery or to the use of analgesic. This research suggests alternative therapies to surgery or the use of analgesic therapy.