The effectiveness of orthoses in the conservative management of thumb CMC joint osteoarthritis: An analysis of functional pinch strength.

STUDY DESIGN: The study was a retrospective cohort analysis for a 19-month period from May 2013 to December 2014.

INTRODUCTION: Although the use of orthoses has long been a staple of conservative treatment measures for individuals with osteoarthritis of the thumb carpometacarpal (CMC) joint, there remains little evidence exploring its effectiveness in improving functional outcomes for this client population.

PURPOSE OF THE STUDY: The purpose of this study was to assess the effectiveness of 3 frequently used orthoses in improving the functional pinch strength of adults with a diagnosis of thumb CMC joint osteoarthritis.

METHODS: A retrospective cohort analysis was conducted to determine whether pinch strength improved after orthotic fabrication, and fitting in patients referred to a hand therapy clinic.

RESULTS: Patients who received a Colditz design orthosis had a mean increase of 2.64 lb with regard to functional pinch strength after orthotic fabrication and fitting. Patients who received a Comfort Cool orthosis (North Coast Medical, Morgan Hill, CA) had a mean increase of 2.47 lb, whereas patients who received a Thumb Spica orthosis had a mean increase of 3.25 lb. There was no evidence of any statistically significant difference in the average improvements in pinch strength between the Colditz design orthosis and the Comfort Cool orthosis.

CONCLUSIONS: Results from this study demonstrate that orthosis wear consistently increases the functional pinch strength of individuals with thumb CMC joint osteoarthritis. Large-scale multisite research studies comparing various orthotic designs are necessary to help therapists determine best practice interventions for the conservative management of thumb CMC joint osteoarthritis.

LEVEL OF EVIDENCE: 2(c).