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Due to positive effects of exercises on pain; exercise programs are suggested along with orthotics for the treatment of patients with first carpometacarpal joint osteoarthritis.
In Thumb Base OAA propensity score matching study by Wouters RM et al. published in the 'Archives of Physical Medicine and Rehabilitation' portraying that the non-surgical treatment of patients with first carpometacarpal joint (CMC-1) osteoarthritis (OA) should incorporate exercises, as there is a relatively large treatment effect compared to using orthosis alone.
This prospective
cohort study highlighted the effect of exercises plus orthotics as compared to
orthotics alone on the pain and hand function in patients with CMC-1 OA and to
predict the outcomes on the pain and hand function of exercises and orthotics
in these patients. The data collection took place in 13 outpatient clinics for
hand surgery and hand therapy in The Netherlands, comprising a consecutive,
population-based sample of patients with CMC-1 OA (N=173). Out of which, 84
patients were matched on baseline demographics and primary baseline outcomes.
The primary outcomes comprised of pain and hand function at 3 months,
calculated using a visual analog scale (VAS, 0-100) and Michigan Hand Outcomes
Questionnaire (MHQ, 0-100).This study resulted in superior and clinically
relevant outcomes for the exercise þ orthotic group as opposed to the orthotic
group on VAS pain (at rest and during the physical load) and the MHQ subscales
pain, work performance, aesthetics, and patient satisfaction. There were no
differences found on MHQ total score, its subscales, and a patient satisfaction
questionnaire. The primary outcomes for the total exercise + orthotic group
(N=131) were predicted using the baseline scores of metacarpophalangeal
flexion, the presence of scaphotrapeziotrapezoid OA, VAS pain at rest, heavy
physical labor, and MHQ.
"To
verify the findings of this study, future research should study exercises and
predictors in a more standardized setting", noted the study authors.
Archieves of Physical Medicine and Rehabilitatin
Exercise therapy in addition to an orthosis reduces pain more than an orthosis alone in patients with thumb base osteoarthritis: a propensity score matching study
Wouters RM et al.
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