Effect of immobilization of metacarpophalangeal joint in thumb carpometacarpal osteoarthritis on pain and function. A quasi-experimental trial.

STUDY DESIGN: A quasi-experimental trial.

INTRODUCTION: Orthoses are effective to decrease pain and improve function in patients with carpometacarpal osteoarthritis (CMC OA). However, current research does not support one design of an orthosis as more effective and/or more favorable than another.

PURPOSE OF THE STUDY: The aim of this study was to compare the effectiveness of 2 different static orthosis on pain and functional abilities on CMC OA.

METHODS: Eighty-four patients, 91.7% females (mean ± standard deviation age, 60.1 ± 9.6 years), with thumb CMC OA were randomized into 1 of 2 groups. For group A, a Ballena orthotic was constructed, and for group B, a Colditz orthotic was constructed. Both static orthoses were worn for 3 months. The outcome measures included pain with activity measured with the visual analog scale and functional abilities assessed with the Disabilities of the Arm, Shoulder and Hand.

RESULTS: Both orthoses improved pain level and functional abilities (F[1.0]  = 413.327 and F[1.0]  = 211.742; both P < .001). There was no statistically significant difference between 2 groups regarding to pain recovery and functional improvement (F[1.0]  = 0.075 and F[1.0]  = 7.248; both P > .05).

DISCUSSION: The main purpose was to compare the effect of 2 different thermoplastic thumb orthoses. Previous studies support the use of CMC orthoses to decrease hand pain and improve hand function, but different orthoses have been described and in most cases, orthotic interventions were accompanied by other medical treatments.

CONCLUSIONS: A clinically significant reduction in pain intensity and improvement in functional abilities was achieved with both orthoses in patients with thumb CMC OA.

LEVEL OF EVIDENCE: 2.

TRIAL REGISTRATION: ClinicalTrials.gov registration number: NCT02780999.