Dynamic stabilization home exercise program for treatment of thumb carpometacarpal osteoarthritis: A prospective randomized control trial

McVeigh, Kimberly H.; Kannas, Stephanie; Ivy, Cynthia C.; Garner, Hillary W.; Barnes, Carolyn S.; Heckman, Michael G.; Brushaber, Danielle; Murray, Peter M.

doi:10.1016/j.jht.2021.06.002

Cited by 14 publications

(9 citation statements)

References 38 publications

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“…These exercises are commonly incorporated into hand therapies to improve the dynamic stability of the TMC joint. 16,17,18 However, there is no consensus on the design of the exercise or the intensity. 19 Our study shows that, for a muscle specific computationally modeled exercise, the maximum stress reduces despite an increase in the force applied to the joint surface, indicating that the stabilizing effect of stronger muscles outweighs the increased load.…”

Section: Discussionmentioning

confidence: 99%

“…Thenar muscles are of particular interest. 16,17,18 To better understand their individual contribution, each thenar eminence muscle was strengthened by 10%. Furthermore, four common hand exercises were simulated: an isometric-C exercise (OpP, EPB, APB), a thenar eminence exercise (Opp, APB, FPB), an abduction exercise (APB, APL), and a flexion exercise (FPB, FPL).…”

Section: Surgical and Hand Therapy Simulationmentioning

confidence: 99%

“…2 These exercises strengthen the thenar muscles intended to improve the joint stability. [16][17][18][19] FE analysis can reveal the effect of load redistribution, and therefore explore the role of exercises in delaying the progression of disease.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Using a finite element model of the thumb to study Trapeziometacarpal joint contact during lateral pinch

Dong¹,

Kerkhof²,

Deleu³

et al. 2023

Clinical Biomechanics

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Section: Discussionmentioning

confidence: 99%

Section: Surgical and Hand Therapy Simulationmentioning

confidence: 99%

See 1 more Smart Citation

Using a finite element model of the thumb to study Trapeziometacarpal joint contact during lateral pinch

Dong¹,

Kerkhof²,

Deleu³

et al. 2023

Clinical Biomechanics

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“…In most hand surgery departments, trapeziectomy combined with ligament reconstruction and tendon interposition is still the most commonly performed technique ( 20 ). Compared to trapeziectomy alone, partial resection partially maintained the height of the first metacarpal, and the use of ligamentoplasty adds stability and hence decreases articular irritation ( 21 ). Moreover, tendon interposition provides a good buffer while maintaining height, which also helps delay the progression of arthritis.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopy-assisted partial trapeziectomy combined with ligament reconstruction for thumb carpometacarpal joint osteoarthritis: A different technique

Zheng

Shen

et al. 2022

Front. Surg.

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BackgroundThere is no consensus on the best surgery option for thumb carpometacarpal osteoarthritis (CMC OA). The traditional method has the risk of large trauma, obvious metacarpal subsidence, and decreased stability. The aim of this study is to introduce a different technique to restore the function and stability of the first carpal metacarpal joint with minimal trauma, rapid pain relief, reduced complications, and the clinical outcomes in the long-term follow-up was evaluated and statistically analyzed.MethodsThis was a retrospective study of 10 patients with a mean age of 51.8 years. The surgery consisted of removing partial trapezium through arthroscopy, reconstructing the stability with flexor carpi radialis suspension and tendon interposition. The subjective assessment included visual analog scale (VAS) of pain, quick disabilities of the arm, shoulder, and hand (Quick-DASH) score, and patient satisfaction. The range of motion, grip strength, pinch strength, and radiographic assessment, which can reflect stability of the thumb, were objectively evaluated and statistically analyzed.ResultsTen patients were monitored at a mean follow-up of 6.8 years. The mean grip strength improved significantly from 16.64 to 22.57 kg after surgery. Pinch strength improved significantly from 3.72 to 5.71 kg on average. The Kapandji score improved signiﬁcantly from 5.7 to 8.6 on average. 80% (8/10) of the patients were satisfied with this surgery. On objective indicators, the VAS score decreased signiﬁcantly from 6.4 to 1.3 on average. The mean Quick-DASH score improved signiﬁcantly from 6.1 to 28.9. Postoperative x-ray showed slight subsidence and dislocation of the first metacarpal in two patients and did not affect the function by measurement.ConclusionArthroscopy-assisted partial trapezium resection combined with ligament reconstruction could be a workable and promising surgical technique in patients with thumb CMC OA. It can offer the advantages of minimizing surgical injury by preserving the first carpal metacarpal joint capsule to protect its stability, with a rapid pain relief, function improvement, and satisfactory results in patients’ clinical measurements.

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“…Subsequent screening of titles and abstracts resulted in 29 eligible publications for full-text assessment. Fifteen studies did not satisfy the inclusion criteria and fourteen RCTs were finally included [19][20][21][22][23][24][25][26][27][28][29][30][31][32]. The flow chart of the study selection is presented in Figure 1.…”

Section: Studies Selectionmentioning

confidence: 99%

Exercise-Based Interventions Are Effective in the Management of Patients with Thumb Carpometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Karanasios,

Mertyri,

Karydis

et al. 2024

Healthcare

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Exercise-based interventions are a common management strategy in patients with thumb carpometacarpal joint osteoarthritis (CMCJ OA); however, their exact effect on or the use of an optimal training programme for reducing pain and disability remains unclear. Our purpose was to evaluate the effectiveness of exercise-based interventions compared with other conservative interventions in patients with CMCJ OA. We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fourteen randomised clinical trials with 1280 patients were finally included. Exercise-based interventions present statistically and clinically better outcomes in reducing pain intensity (mean difference [MD]: −21.91; 95% confidence interval [CI]: −36.59, −7.24; p = 0.003) and wrist disability (MD: −8.1, 95% CI: −4.6, −11.5; p = 0.02) compared with no treatment at short-term follow-up. Proprioceptive exercises have statistically and clinically better outcomes compared with standard care only in pain intensity at very short-term (standardised mean difference [SMD]: −0.76; 95% CI: −1.30, −0.21; p = 0.007) and short-term (SMD: −0.93; 95% CI: −1.86, −0.01; p = 0.049) follow-up and statistically better results in wrist disability at very short-term (SMD: −0.94; 95% CI: −1.68, −0.21; p = 0.01) follow-up. No differences were found between the comparators at mid- and long-term follow-up. Low to moderate certainty of evidence suggests that exercise-based interventions can provide clinically better outcomes compared with no treatment in patients with thumb CMCJ OA, at least in the short term.

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Dynamic stabilization home exercise program for treatment of thumb carpometacarpal osteoarthritis: A prospective randomized control trial

Cited by 14 publications

References 38 publications

Using a finite element model of the thumb to study Trapeziometacarpal joint contact during lateral pinch

Using a finite element model of the thumb to study Trapeziometacarpal joint contact during lateral pinch

Arthroscopy-assisted partial trapeziectomy combined with ligament reconstruction for thumb carpometacarpal joint osteoarthritis: A different technique

Exercise-Based Interventions Are Effective in the Management of Patients with Thumb Carpometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

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