Abstract
Objective: This study was carried to determine the effect of eccentric exercises in treatment of De Quervian’s disease
Methods: Thirty female patients diagnosed as De Quervian’s tenosynovitis was randomly distributed into two equal experimental groups. Each patient was treated for twelve sessions each other day for a total period of four weeks. Patients in the experimental group (A) received phonophoresis, while patients in the experimental group (B) received a combined program of phonophoresis identical to those applied to group (A) in addition to eccentric exercises then visual analogue scale (VAS) was used to assess pain severity. The disability of arm, shoulder and hand outcome questionnaire (DASH) was used to assess hand functions. Jamar’s dynamometer and pinch gauge were used to assess hand grip and pinch strength.
Results: Patients of both groups showed significant improvement in all the measured variables. In between group difference, the second group showed a significant improvement than the first group in all the measured variables.
Conclusion: Both of phonophoresis and the combination of phonophoresis with eccentric exercise were effective on decreasing pain severity, functional disability as well as improving grip and pinch strength. However, the combination of phonophoresis with eccentric exercise was more effective than phonophoresis alone in treatment of De Quervian’s disease.
Keywords: De Quervian’s disease, Phonophoresis, Eccentric exercises.
References
1. Huang TH., Feng CK., Gung YW., Tsai, MW., Chen, CS., Liu, CL.: Optimization design of thumb spica splint using finite element method. Med Bio Eng Comput. 2006; 44(12):1105–1111.
2. Pagonis T., Ditsios K., Toli P., Givissis P., Christodoulou A.:Improved Corticosteroid treatment of Recalcitrant de Quervain Tenosynovitis With a Novel 4-Point Injection Technique. The American journal of sports medicine. 2011;39(2): 398-403.
3. Avci S., Yilmaz C., Sayli U.: Comparison of nonsurgical treatment measures for de Quervain’s disease of pregnancy and lactation. Journal of Hand Surgery. 2002; 27(2):322–324.
4. Retig AC.: Athletic injuries of the wrist and hand. Part II: overuse injuries of the wrist and traumatic injuries to the hand. American Journal of Sports Medicine. 2004; 32(1): 262–273.
5. Dawson C and Mudgal CS.: Staged description of the Finkelstein test. Journal of hand surgery. 2010; 35(9):1513–1515.
6. El-Hadidy S., Badran D., Yousef S., Ababneh M., El-Hadidy M., Doar H.: De Quervain’s Tendovaginitis Stenosans in Jordanians. JMJ. 2010; 40(3).
7. Suresh SS., Zaki H., Ali A.: Does Radial Styloid Abnormality in de Quervain’s Disease Affect the Outcome of Management? American Association for Hand Surgery. 2010; 5:374–377.
8. Clarke MT., Lyall HA., Grant JW., Matthewson MH.: The histopathology of de Quervain’s disease. J H S Br. 1998; 23(6):732–742.
9. Stanish WD., Rubinovich RM., Curwin S.: Eccentric exercise in chronic tendinitis. Clin Orthop. 1986; 208: 65–68.
10. Stanish WD., Curwin S., Mandel S.: Tendinitis: Its Etiology and Treatment. Oxford: Oxford University Press. 2000.
11. Rees J.D., Lichtwark G.A., Wolman R.L., Wilson A.M.: The mechanism for efficacy of eccentric loading in Achilles tendon injury; An in vivo study in humans. Rheumatology. 2008; 47(10):1493–1497.
12. Knobloch K .,Gohritz A., Spies M., Peter M.: Neovascularisation in de Quervain’s disease of the wrist: novel combined therapy using sclerosing therapy with polidocanol and eccentric training of the forearms and wrists—a pilot report: Knee Surg Sports Traumatol Arthrosc. 2008; 16:803–805.
13. Papa J.A, FCCPOR(C).: Conservative management of De Quervain’s stenosing tenosynovitis: a case report J Can Chiropr Assoc. 2012; 56(2): 112-120.
14. Hiral S., Bhakti D.: A Study to determine the effect of Ultrasound and Phonophoresis in De Quervain's Diseases. Indian Journal of Physiotherapy and Occupational Therapy - An International Journal. 2014; 8(2):224-229.
15. Tabinda H and Mahmood F.: De Quervain's Tenosynovitis and Phonophoresis: A Randomised Control Trial in Pregnant Females De Quervain. journal of Orthopaedics, Trauma and Rehabilitation. 2014; 19(1), 2-6.
16. Rabin A., Israeli T., Kozol Z.: Physiotherapy Management of People Diagnosed with de Quervain's Disease: A Case Series. Physiotherapy Canada. 2015; 67(3): 263-267.
17. Shah, F. A., Khan H., Kifayatullah W. A., Khan Z., Durrani Z. A., Alam W.: Efficacy of local corticosteroid injections in de Quervain’s tenosynovitis. Pak J Surg. 2012; 28(2): 118-121.
18. Hadianfard M., Ashraf A., Fakheri M., Nasiri A.: Efficacy of acupuncture versus local methylprednisolone acetate injection in de Quervain's tenosynovitis: a randomized controlled trial. Journal of acupuncture and meridian studies. 2014; 7(3): 115-121.
19. Rowland P., Phelan N., Gardiner S., Linton K. N., Galvin R.: The Effectiveness of Corticosteroid Injection for De Quervain’s Stenosing Tenosynovitis (DQST): A Systematic Review and Meta-Analysis. O O J l. 2015; 9: 437-444.
DOI: http://dx.doi.org/10.18535/jmscr/v4i5.12
