Physical and occupational therapy for trapeziometacarpal osteoarthritis patients
The trapeziometacarpal osteoarthritis is associated with more pain and restrictions than other hand osteoarthritis. It is due to the functional prestige of the thumb. There is inadequate specific evidence about conservative non-pharmacological trapeziometacarpal osteoarthritis therapies, although the potency of surgical and pharmacological interventions has been widely examined.
This study was performed with an intention to provide evidence-based knowledge on the effectiveness of physiotherapy and occupational therapy on pain, function and quality of life.
The literature search of Medline, CINAHL, PEDro, OTseeker, EMB Dare Cochrane Database of Systematic Reviews and Cochrane CENTRAL was conducted which had the randomized and quasi-randomized controlled trials and corresponding systematic reviews, pragmatic studies, observational studies and case-control studies. Then the risk of bias was appraised.
Twenty seven studies were maintained out of total 218 studies. A series of meta-analyses and narrative summary was implemented. Meta-analysis showed consistency of pre-fabricated neoprene and custom-made thermoplastic splints: standardized mean difference (SMD) -0.01 (95%CI -0.43, 0.40) (p=0.95) related to pain reduction. The standardized mean difference was -3.16 (95%CI -5.56, -0.75) (p = 0.01) depicting multimodal interventions more convincing as compared to single interventions.
For the effective pain treatment in trapeziometacarpal osteoarthritis patients, physical and occupational therapy-related interventions, especially multimodal interventions were useful. There was neck to neck pain reduction in pre-fabricated neoprene splints and custom-made thermoplastic splints. Single interventions seem ineffective. Also, significant evidence for effectiveness on function and quality of life could not be established.