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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
180
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).
Haukeland University Hospital
Bergen, Norway
Haugesund Rheumatism Hospital
Haugesund, Norway
National resource center for rehabilitation in rheumatology
Oslo, Norway
St Olavs Hospital
Trondheim, Norway
Number of participants in each group who have received surgery.
Time frame: Two years
Hand Pain at rest and in activity
Measured on Numeric Rating Scales, 0 - 10.
Time frame: Two years
Number of painful hand joints.
Examination.
Time frame: Two years
Joint mobility in 2-5 finger.
Flexion deficit in millimetre.
Time frame: Two years
Thumb flexion.
Goniometer
Time frame: Two years
Thumb abduction.
Pollexograph.
Time frame: Two years
Grip strength.
Grip-It, measured in Newton)
Time frame: Two years
Pinch strength
Grip-It, measured in Newton
Time frame: Two years
Activity performance.
MAP-Hand - a patient reported outcome/questionnaire.
Time frame: Two years
Hand and shoulder function
Quick-Dash, a patient reported outcome/questionnaire
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Time frame: Two Years
Satisfaction with care.
On Numeric Rating Scales, 0 - 10.
Time frame: Two years
Health related quality of life.
EQ5D, a patient reported outcome/questionnaire.
Time frame: Two years