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Short‐Term Effects of Occupational Therapy on Hand Function and Pain in Patients With Carpometacarpal Osteoarthritis: Secondary Analyses From a Randomized Controlled Trial
Author(s) -
Tveter Anne Therese,
Østerås Nina,
Nossum Randi,
Eide Ruth Else Mehl,
Klokkeide Åse,
Matre Karin Hoegh,
Olsen Monika,
Kjeken Ingvild
Publication year - 2022
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24543
Subject(s) - medicine , physical therapy , grip strength , randomized controlled trial , occupational therapy , range of motion , osteoarthritis , rheumatology , confidence interval , carpometacarpal joint , physical medicine and rehabilitation , sports medicine , manual therapy , hand strength , alternative medicine , pathology
Objective To assess the short‐term effects of multimodal occupational therapy on pain and hand function in patients referred for surgical consultation due to first carpometacarpal (CMC1) joint osteoarthritis (OA). Methods In this randomized controlled trial, patients with CMC1 joint OA referred for surgical consultation at 3 rheumatology departments were randomized to 3 months multimodal occupational therapy (including patient education, hand exercises, orthoses, and assistive devices) or usual treatment (OA information). Pain was measured on a numeric rating scale from 0 to 10 (0 = no pain). Function included grip and pinch strength (Newtons), range‐of‐motion (palmar and CMC1 joint abduction [°]; flexion deficit in digits 2–5 [mm]), and self‐reported Measure of Activity Performance of the Hand (MAP‐Hand; range 1–4, 1 = no activity limitation) and short version of the Disability of the Arm, Shoulder, and Hand (QuickDASH; range 0–100, 0 = no disability). Between‐group difference was assessed with follow‐up values as dependent variables and group as an independent variable, adjusted for baseline values and time to follow‐up. Results Among 180 patients (mean ± SD age 63 ± 8 years; 81% women), 170 completed the short‐term follow‐up assessment (3–4 months after baseline). Compared to usual treatment, occupational therapy yielded significantly improved pain at rest (−1.4 [95% confidence interval (95% CI) −0.7, −2.0]; P < 0.001), pain following grip strength (−1.1 [−0.5, −1.7]; P = 0.001), grip strength (23.4 [95% CI 7.5, 39.3]; P = 0.004), MAP‐Hand score (−0.18 [95% CI −0.09, −0.28]; P = 0.001), and QuickDASH score (−8.1 [95% CI −4.6, −11.5]; P < 0.001). Conclusion The multimodal occupational therapy intervention had significant short‐term effects on pain, grip strength, and hand function in patients with CMC1 joint OA.