ABSTRACT

 

Purpose: We hypothesized that Kaltenborn manual therapy induces hypoalgesia and increases strength in secondary carpometacarpal osteoarthritis (CMC OA).

Method: Twenty-nine patients with secondary CMC OA (70–90 years old) were randomized into Kaltenborn manual therapy and sham groups. All patients were females. This study was designed as a double-blind, randomized controlled trial (RCT). Therapy consisted of Kaltenborn mobilization of posterior-anterior gliding with distraction in Grade 3 of the CMC joint of the dominant hand during six sessions over two weeks. Pain was measured by algometry, as the pressure pain threshold (PPT) at the carpometacarpal (CMC) joint and tubercle of the scaphoid bone. The tip and tripod pinch strength was also measured. Grip strength was measured by a grip dynamometer. Measurements were taken before treatment and after one week (1st Follow-up [FU]) and two weeks (2nd FU).

Results: All values in the sham group remained unchanged during the treatment period. In the treated group, the PPT in the CMC joint was 2.98 ± 0.30 kg/cm2, which increased after treatment to 4.07 ± 0.53 and was maintained at the same level during the 1st FU (3.46 ± 0.31) and 2nd FU (3.84 ± 0.36). Similarly, the PPT in the scaphoid bone was 3.61 ± 0.29 kg/cm2, which increased after treatment to 4.87 ± 0.37 and was maintained at the same level during the 1st FU (4.44 ± 0.43) and  2nd FU (4.22 ± 0.32). In contrast, we found no differences in the tip, tripod pinch and grip strength between the treatment and sham groups.

Conclusions: Kaltenborn manual therapy decreases pain in the CMC joint and scaphoid bone; however, it does not confer an increase in motor function in patients with CMC OA and therefore could be used as an alternative therapy to decrease pain in these patients.

Trial registration: Current Controlled Trials ISRCTN06361999.