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This randomized controlled trial aims to assesses the combined effects of MWM and tendon gliding exercises on hand function in smartphone users with De Quervain's Tenosynovitis, considering hand anthropometric variations.
De Quervain's Tenosynovitis (DQT) is a painful musculoskeletal condition characterized by inflammation of the abductor pollicis longus and extensor pollicis brevis tendons within the first dorsal compartment of the wrist. It is commonly associated with repetitive thumb and wrist movements, with smartphone overuse emerging as a significant contributing factor among young adults.
Mulligan's Mobilization with Movement (MWM) has been shown to correct minor joint malalignments and reduce compressive forces on inflamed tendons, thereby improving wrist kinematics and reducing pain. Tendon gliding exercises enhance tendon excursion, minimize adhesions, and improve synovial fluid circulation, which supports recovery of thumb and wrist function. When combined, these interventions address both mechanical and functional impairments associated with DQT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mulligan's Mobilization with Movement (MWM) + Tendon Gliding Exercises (combined effect) | Experimental | MWM: Radial glide of 1st MCP with active thumb extension (10 reps × 3 sets, progressed with resistance in weeks 3-4). 2- Tendon Gliding Exercises: Straight hand, hook fist, tabletop, full fist, straight fist (10 reps × 2 sets in weeks 1-2; 3 sets × 15 with resistance band in weeks 3 |
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| Conventional Treatment | Other | Wrist ROM (flexion, extension, radial/ulnar deviation, pronation/supination). 2-Thumb ROM (abduction/adduction, flexion/extension, opposition/circumduction). 3-Isometric wrist/thumb strengthening. 4-Strengthening with soft ball, thumb abduction/adduction against resistance. 5-Postural and ergonomic education for smartphone usage. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MWM + Tendon Gliding Exercises | Other | MWM: Radial glide of 1st MCP with active thumb extension (10 reps × 3 sets, progressed with resistance in weeks 3-4). 2- Tendon Gliding Exercises: Straight hand, hook fist, tabletop, full fist, straight fist (10 reps × 2 sets in weeks 1-2; 3 sets × 15 with resistance band in weeks 3-4). |
| Measure | Description | Time Frame |
|---|---|---|
| Grip Strength Dynamometer | It is a valid and reliable tool used for measuring isometric hand grip strength. This objective tool will be used to assess hand muscular performance and functional status in patients with De Quervain's Tenosynovitis. The NOD digital dynamometer has been shown to provide consistent and reproducible readings. Reliability: 0.97 and Validity: 0.94. | 4 weeks |
| Patient-Rated Wrist Evaluation (PRWE) Questionnaire | It is a valid and reliable patient-reported outcome measure for assessing wrist pain and functional disability. This tool will be used to evaluate wrist-related limitations in activities of daily living in DQT patients. It includes two subscales: pain and function, making it responsive to clinical changes. Reliability: 0.96 and Validity: 0.88. | 4 weeks |
| Hand Anthropometry (Caliper & Measuring Tape) | These are reliable and valid tools used to measure various hand dimensions, including palm width, thumb length, and wrist circumference. These measurements help understand the influence of hand morphology on grip strength and functional ability in smartphone users with DQT. Reliability: 0.88 and Validity: 0.71. | Baseline |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| maria Khalid, MSOMPT | Contact | 03315369768 | maria.khalid@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Maria khalid, MSOMPT | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Begum Akhtar Rukhsana Hospital (stroke and rehab centre) | Recruiting | Rawalpindi | Punjab Province | Pakistan |
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| Conventional Treatment | Other | 1- Wrist ROM (flexion, extension, radial/ulnar deviation, pronation/supination). 2-Thumb ROM (abduction/adduction, flexion/extension, opposition/circumduction). 3-Isometric wrist/thumb strengthening. 4-Strengthening with soft ball, thumb abduction/adduction against resistance. 5-Postural and ergonomic education for smartphone usage |
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