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.