Journal
JOURNAL OF HAND THERAPY
Volume 26, Issue 1, Pages 44-52Publisher
HANLEY & BELFUS-ELSEVIER INC
DOI: 10.1016/j.jht.2012.10.005
Keywords
Thumb pain; CMC joint; Conservative intervention; Exercise; Orthosis; Orthoses; Neuromuscular re-education; joint protection education; 1st dorsal interosseous
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Study design: Retrospective cohort. Introduction: Conservative intervention of carpometacarpal joint (CMC) thumb pain, caused by osteoarthritis and ligament laxity, is frequently seen in hand therapy. Traditional intervention for pain and disability reduction includes orthoses, exercises, and joint protection education. The literature on conservative management is unclear which design or program of exercises create an effective result. Results of a conservative dynamic stability interventional model for thumb pain are presented as a design which positively effects pain and disability. Purpose of the study: The purposes were to primarily investigate change in pain and disability in persons with CMC pain in a dynamic stability modeled approach to intervention, and secondarily, to assess the average number of visits and the duration of total visits in this model. Methods: A retrospective chart review was completed on 35 charts of those seen at a multicenter hand therapy clinic. The pain and disability scores from the QuickDASH were used as outcome measures. Results: The average group pain and disability scores improved by 17.9% (p < .01) and 19.3% (p < .01) respectively, with average individual disability improvement of 15.7%, which is greater than the accepted MCID. The average patient visits were 2.37 over an average range of 44.5 days. The group demographics match current literature: 31 females to 4 males, with average age of 58 years (range of 30-82 years). Conclusion: Significant reduction in pain and disability is noted with a conservative dynamic stability modeled approach to intervention, with information on average visits and duration in this model of care for individuals with thumb pain at the CMC joint.
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