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Effect of physical therapy interventions in individuals with primary thumb carpometacarpal osteoarthritis: a
Natália Barbosa Tossini1, Cristiane de Sousa Melo1, Marcos Paulo Braz de Oliveira1
1Departament of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
Purpose:
This systematic review and meta-analysis aimed to investigate the effect of physiotherapeutic interventions in individuals with thumb primary CMC OA on the outcomes of pain, hand function, grip or pinch strength.
Methods:
RCTs that used some type of physiotherapeutic intervention compared to a passive or active control group were included. The quality of the evidence was assessed using the GRADE approach and, for the calculation of the meta-analysis, the standardized difference of means (SMD) was used.
Results:
Nineteen studies (n = 1477) were included and eight studies (n = 568) underwent meta-analysis. Orthosis intervention was superior to passive control group for pain improvement (SMD = -1.02, p = 0.03, very low evidence), grip strength (SMD = 0.45, p = 0.02, very low evidence) and pinch strength (SMD = 1.78, p = 0.01, very low evidence), but there was no improvement in hand function (p = 0.54). The use of a neoprene orthosis was similar to the use of a thermoplastic orthosis in improving pain (p = 0.38), hand function (p = 0.50), grip strength (p = 0.42) and pinch strength (p = 0.14). The use of short thermoplastic orthosis was also similar to long thermoplastic orthosis in improving pain (p = 0.88) and hand function (p = 0.58).
Conclusion:
The use of orthoses is superior to no intervention in all outcomes, exception hand function.
