Abstract
Forty-two women with thumb base osteoarthritis referred to a joint protection programme (JP) were distributed into groups: one with only JP (Control group) and one with addition of splints day/night, hot pack/home exercise (SE group). Assessments of pain, stiffness, grip force, disabilities of daily activities were performed before treatment, 1 week and 1 year after treatment. The SE group had a significant decrease in pain, stiffness and an improvement in daily activities directly after the intervention and at 1-year follow-up compared to the Control group. In the SE group pain at night, pain on motion, and stiffness decreased. Grip force increased and daily activities improved. The Control group decreased in pain on motion and showed improvement in daily activities just after the intervention but not at 1-year follow up. This comparative study shows that when splinting and exercise regimen are added to a JP programme it gives a greater improvement of pain, stiffness, grip force and daily activities than the JP programme alone.
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References
Creamer P, Hochberg MC (1997) Osteoarthritis. Lancet 350(9076):503–508
Dennison E, Cooper C (2007) Osteoarthritis: epidemiology and classification. In: Hochberg MC, Silman A, Smolen J, Weinblatt M, Weisman M (eds) Rheumatology. Elsevier, St. Louis, Mo
Van Heest AE, Kallemeier P (2008) Thumb carpal metacarpal arthritis. J Am Acad Orthop Surg 16(3):140–151
Poole JU, Pellegrini VD Jr (2000) Arthritis of the thumb basal joint complex. J Hand Ther 13(2):91–107
Brandt KD (1998) The importance of nonpharmacologic approaches in management of osteoarthritis. Am J Med 105(1B):39S–44S
Cordery JC (1965) Joint protection; a responsibility of the occupational therapist. Am J Occup Ther 19(5):285–294
Nordenskiold U (1997) Daily activities in women with rheumatoid arthritis. Aspects of patient education, assistive devices and methods for disability and impairment assessment. Scand J Rehabil Med Suppl 37:1–72
Pellegrini VD Jr (2001) Pathomechanics of the thumb trapeziometacarpal joint. Hand Clin 17(2):175–184 vii-viii
Glickel SZ (2001) Clinical assessment of the thumb trapeziometacarpal joint. Hand Clin 17(2):185–195
Lozada C, Altman R (2005) Management of osteoarthritis. In: Koopman W, Moreland L (eds) Arthritis and allied conditions: a textbook of rheumatology. Lippincott Williams & Wilkins, Philadelphia, Pa. ; London, pp 2246–2263
Stamm TA, Machold KP, Smolen JS, Fischer S, Redlich K, Graninger W, Ebner W, Erlacher L (2002) Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: a randomized controlled trial. Arthritis Rheum 47(1):44–49
Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, Dincer F, Dziedzic K, Hauselmann HJ, Kaklamanis P et al: EULAR evidence based recommendations for the diagnosis of hand osteoarthritis - report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2008
Swigart CR, Eaton RG, Glickel SZ, Johnson C (1999) Splinting in the treatment of arthritis of the first carpometacarpal joint. J Hand Surg [Am] 24(1):86–91
Eaton RG, Littler JW (1969) A study of the basal joint of the thumb. Treatment of its disabilities by fusion. J Bone Joint Surg Am 51(4):661–668
Weiss S, LaStayo P, Mills A, Bramlet D (2000) Prospective analysis of splinting the first carpometacarpal joint: an objective, subjective, and radiographic assessment. J Hand Ther 13(3):218–226
Berggren M, Joost-Davidsson A, Lindstrand J, Nylander G, Povlsen B (2001) Reduction in the need for operation after conservative treatment of osteoarthritis of the first carpometacarpal joint: a seven year prospective study. Scand J Plast Reconstr Surg Hand Surg 35(4):415–417
Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, Dincer F, Dziedzic K, Hauselmann HJ, Herrero-Beaumont G et al (2007) EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 66(3):377–388
Nordenskiöld U, Althoff B, Hansen AM (1994) Joint protection for active living—guide. The Swedish Rheumatism Association, Stockholm, Sweden
Wajon A, Ada L (2005) No difference between two splint and exercise regimens for people with osteoarthritis of the thumb: a randomised controlled trial. Aust J Physiother 51(4):245–249
Dellhag B, Wollersjo I, Bjelle A (1992) Effect of active hand exercise and wax bath treatment in rheumatoid arthritis patients. Arthritis Care Res 5(2):87–92
Huskisson EC (1974) Measurement of pain. Lancet 2(7889):1127–1131
Nordenskiold UM, Grimby G (1993) Grip force in patients with rheumatoid arthritis and fibromyalgia and in healthy subjects. A study with the Grippit instrument. Scand J Rheumatol 22(1):14–19
Gummesson C, Atroshi I, Ekdahl C (2003) The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord 4:11
Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 29(6):602–608
Sandqvist G, Akesson A, Eklund M (2004) Evaluation of paraffin bath treatment in patients with systemic sclerosis. Disabil Rehabil 26(16):981–987
Spacek E, Poiraudeau S, Fayad F, Lefevre-Colau MM, Beaudreuil J, Rannou F, Fermanian J, Revel M (2004) Disability induced by hand osteoarthritis: are patients with more symptoms at digits 2–5 interphalangeal joints different from those with more symptoms at the base of the thumb? Osteoarthritis Cartilage 12(5):366–373
Weiss S, Lastayo P, Mills A, Bramlet D (2004) Splinting the degenerative basal joint: custom-made or prefabricated neoprene? J Hand Ther 17(4):401–406
Egan MY, Brousseau L (2007) Splinting for osteoarthritis of the carpometacarpal joint: a review of the evidence. Am J Occup Ther 61(1):70–78
Colditz JC (2000) The biomechanics of a thumb carpometacarpal immobilization splint: design and fitting. J Hand Ther 13(3):228–235
Acknowledgements
Supported by grants from the Västra Götaland’s Research Found VGFOUGSB-6397, VGFOUREG-1857 and Göteborg's Found for Rheumatism (GSFR), The Swedish Research Council (VR K2002-27-VX-14318-01A).
Many thanks go to Birgitta Rosèn, occupational therapist, Associated Professor at Lund University, for fruitful discussions and to statistician Anna Ekman at Göteborg University for helpful analysis.
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Boustedt, C., Nordenskiöld, U. & Lundgren Nilsson, Å. Effects of a hand-joint protection programme with an addition of splinting and exercise. Clin Rheumatol 28, 793–799 (2009). https://doi.org/10.1007/s10067-009-1150-y
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DOI: https://doi.org/10.1007/s10067-009-1150-y