Effects of a soft prefabricated thumb orthosis in carpometacarpal osteoarthritis

Abstract

Aims: To explore the feasibility and assess the effect of a prefabricated soft thumb-base orthosis on pain, hand strength, and activity performance in persons with osteoarthritis of the CMC joint. Methods: In this randomized controlled trial, 29 patients received hand exercises only (control group) and 30 patients received hand exercises and an orthosis (orthosis group). The primary outcome was pain, while secondary outcomes included grip and pinch strength, and self-reported symptoms and activity performance. Outcome assessments, and measures of grip strength and pain with and without orthosis in the orthosis group, were made after two months. Results: 55 participants (mean age 70.5 years) completed all assessments. There were no significant differences between the groups in primary or secondary outcomes after two months. However, in the orthosis group, pain was significantly less when wearing the orthosis than when not wearing it. Participants reported that the orthosis felt uncomfortable during activities involving water and one-third wanted more support of the CMC joint. Conclusions: A soft prefabricated orthosis seems to have an immediate pain-relieving effect during use, but no effects in terms of less hand pain, or improved strength or activity performance when not worn.

Key words::

• randomized controlled trial
• pain
• occupational therapy

Acknowledgements

The authors would like to thank the patient research partners Greta Møller and Wenche Irene Rambøl for giving valuable input in the process of planning the study and the trial participants for their time and effort, Cathrine Østvik and Aleksander Mathiessen for helping with data collection and Hilde Iren Flaatten for library assistance.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Financial support for the study was provided by the Norwegian Occupational Therapy Association, by the Norwegian Rheumatism Association, and by the Norwegian Women's Public Health Association.