Article

Previous research regarding the
non-surgical treatment of thumb carpometacarpal joint osteoarthritis has been
based on protocol driven research designs that primarily examined impairment
level changes. Exploration is therefore needed to determine the benefits of
individually prescribed orthoses, joint protection and assistive device education
programs that are based on the activities the person needs to regularly perform.
PURPOSE OF THE STUDY:
The primary objective of this study was to examine the
effect of client-centered multimodal treatment on activity, participation,
impairment, and satisfaction of people with thumb carpometacarpal joint
osteoarthritis. METHODS: A total of 60 participants completed the study that used
a prepost design. The Canadian Occupational Performance Measure (COPM) was used
to identify the participants' performance and satisfaction concerning their
self-identified occupational performance issues. Additional outcome measures that
were used included the Disabilities of the Arm, Shoulder and Hand (DASH)
questionnaire, total active range of motion (TAROM), lateral pinch strength, and
the visual analog scale for pain. All participants completed a client-centered
6-week program that consisted of the use of an orthosis, joint protection, and
assistive device education as well as exercises. RESULTS: At 6 weeks after
initiation of treatment, pain, pinch strength, TAROM, the DASH questionnaire and
the performance and satisfaction scales of the COPM had significantly improved.
The changes in pain, TAROM, and the performance and satisfaction scales of the
COPM were all greater than the minimal clinically important difference. The
changes in pain and lateral pinch strength were significantly associated with
changes in activity and participation. DISCUSSION: This study demonstrated that a
multimodal, client-centered treatment approach resulted in statistically and
clinically significant improvement in pain, TAROM and performance and
satisfaction as measured by the COPM. The improvement in pain was associated with
the participants' improved ability to engage in activities assessed by the DASH.
CONCLUSIONS: Our results support the use of client-centered treatment strategies
that are targeted to control pain during meaningful activity when working with
patients with thumb carpometacarpal joint osteoarthritis therapists. LEVEL OF
EVIDENCE: 4.
CI - Copyright (c) 2017 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS