Short‐Term Effects of Occupational Therapy on Hand Function and Pain in Patients With Carpometacarpal Osteoarthritis: Secondary Analyses From a Randomized Controlled Trial. Issue 6 (5th April 2022)

• Record Type: Journal Article
• Authors: Tveter, Anne Therese; Østerås, Nina; Nossum, Randi; Eide, Ruth Else Mehl; Klokkeide, Åse; Matre, Karin Hoegh; Olsen, Monika; Kjeken, Ingvild
• Is Part Of: Arthritis care & research. Volume 74:Issue 6(2022)
• Page Start: 955
• Page End: 964
• Publication Date: 2022-04-05
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.24543
• Languages: English
• ISSNs: 2151-464X

Abstract

Abstract : 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.