Efectos de la imaginería motora realizada durante periodo posquirúrgico en mujeres con artrosis trapeciometacarpianaun ensayo clínico aleatorizado

Abstract

Background Trapeziometacarpal Osteoarthritis is the second most frequent degenerative hand disease and is the most functionally debilitating. The condition presents in 66% of women over 55. After surgery, immobilization for three weeks results in functional losses that could be attenuated by motor imagery training, but the literature is sparse and the effects of its implementation need to be investigated. Objectives The aim of this study was to analyse whether motor imagery training performed during the post-surgical immobilization period led to a recovery in functional and rest pain, joint balance, strength, oedema, functionality for activities of daily living and quality of life related to upper limb function compared to the conventional protocol and to verify whether there were differences between the imaging group and the control group in the recovery and/or attenuation of functional losses following surgery. Method Experimental, prospective, longitudinal, parallel arm randomized clinical trial. Participants: 40 women diagnosed with trapeziometacarpal osteoarthritis and over 50 years of age on the surgical waiting list at the University Hospital of León were selected, excluding from the study women with cognitive impairment, arthritis, trigger finger, Quervain's tenosynovitis, previous fractures and carpal tunnel syndrome. Motor imagery was applied to the experimental group during the 3 weeks of immobilization and to the control group, the conventional protocol. Measurement: outcomes will be assessed four times throughout the study using the Disabilities of the Arm, Shoulder and Hand questionnaire, the Cochin Hand Function Scale questionnaire, the Visual Analogue Scale, goniometry, baseline pinch gauge, circumferential measurement (cm), and the Modified Kapandji Index. Results The results showed a significant reduction (p < .05) in functional and rest pain (VAS scale), significant improvement in quality of life related to upper limb function problems (DASH scale), hand mobility (Kapandji test), range of motion in thumb abduction (goniometer) and wrist edema (centimetry), in post-motor imaging, pre- and post-rehabilitation measurements. There were significant improvements in hand functionality (Cochín scale) in the post-rehabilitation measurement, in finger-to-finger pinch strength (Baseline pinch gauge) after motor imagery. There were no statistically significant differences in tridigital strength, lateral strength and metacarpophalangeal edema. There were clinically significant improvements in functional and rest pain, quality of life related to upper limb function problems and in hand functionality. Conclusions Early intervention with motor imagery could be effective for resting and functional pain, quality of life related to upper limb problems, functional capacity, mobility, range of motion, strength and edema, mitigating the negative effects of upper limb disuse when physical practice is not possible and promoting recovery and autonomy in activities of daily living. These findings highlight the potential of motor imagery as a valuable tool to improve post-surgical recovery in women with trapeziometacarpal osteoarthritis.