Osteoarthritis in the Carpometacarpal (CMC) Joint
Conditions
Keywords
Hand osteoarthritis, CMC1-joint, surgery, occupational therapy, hand exercises, assistive devices, orthoses
Brief summary
The purpose of the study is to investigate if occupational therapy may delay or prevent the need for surgery in patients with carpometacarpal(CMC) osteoarthritis (OA) who are scheduled for surgery in the CMC-joint. Our study hypothesis is that compared to participants in the intervention group, significantly more participants in the control group have received CMC-surgery after two years.
Detailed description
Hand osteoarthritis (OA) is one of the most prevalent musculoskeletal diseases in an adult population, and approximately 68% of people between the ages of 71 and 80 years have radiographic OA in the carpometacarpal (CMC) joint. Currently, there is no cure for hand OA. However, several studies have demonstrated that hand exercises and CMC-orthoses may reduce pain and improve grip strength, and in a recent study, assistive devices improved activity performance and satisfaction with performance in people with hand-OA. Still, most people do not receive any such treatment, but those with severe CMC-OA are often referred for surgery in this joint. The effect of occupational therapy to prevent or delay need for surgery CMC-OA has been investigated in a small study with 33 participants, but randomised controlled trails (RCT) of good quality are needed.
Interventions
OTHERCare as usual
OTHEROccupational therapy
Occupational therapy in the waiting period before surgery. Occupational therapy comprises orthoses for the CMC-joint, hand exercises, and use of alternative working methods and assistive devices. The participants are encouraged to perform hand exercises three times a week for the first 12 weeks, and to use orthosis as much as possible, both during daytime (day orthosis) and night time (night orthosis).
Sponsors
St. Olavs Hospital
Haukeland University Hospital
Haugesund Rheumatism Hospital
National Resource Center for Rehabilitation in Rheumatology
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Patients with CMC-OA who are referred for review for the need for surgery in the CMC joint.
Exclusion criteria
* Persons with cognitive dysfunction * Persons who do not understand the Norwegian language * Persons with other diseases or injuries that may negatively impact hand function
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of participants in each group who have received surgery. | Two years |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Activity performance. | Two years | MAP-Hand - a patient reported outcome/questionnaire. |
| Hand and shoulder function | Two Years | Quick-Dash, a patient reported outcome/questionnaire |
| Satisfaction with care. | Two years | On Numeric Rating Scales, 0 - 10. |
| Health related quality of life. | Two years | EQ5D, a patient reported outcome/questionnaire. |
| Hand Pain at rest and in activity | Two years | Measured on Numeric Rating Scales, 0 - 10. |
| Pinch strength | Two years | Grip-It, measured in Newton |
| Joint mobility in 2-5 finger. | Two years | Flexion deficit in millimetre. |
| Thumb flexion. | Two years | Goniometer |
| Thumb abduction. | Two years | Pollexograph. |
| Grip strength. | Two years | Grip-It, measured in Newton) |
| Number of painful hand joints. | Two years | Examination. |
Countries
Norway
Outcome results
None listed