Evaluation of Expectations and Expectation Fulfillment in Patients Treated for Trapeziometacarpal Osteoarthritis

Frouzakis, Regula; Herren, Daniel; Marks, Miriam

doi:10.1016/j.jhsa.2014.10.066

Cited by 39 publications

(50 citation statements)

References 38 publications

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“…The MHQ pain subscale was used as primary outcome measure, because pain is the primary complaint and the main reason to seek treatment for CMC-1 OA patients [18]. To also see if there is an association between psychological effects and patient reported hand performance, we used the total MHQ score as secondary outcome measure.…”

Section: Michigan Hand Outcomes Questionnairementioning

confidence: 99%

“…Although there is evidence for the association between psychological factors and symptom severity in knee and hip OA, little is known regarding this association for patients treated non-invasively for CMC-1 OA [16,17]. In particular, the association between psychological factors and pain, which is the primary complaint of CMC-1 OA patients [18], is currently unknown. Moreover, while illness perceptions have been shown to be important factors in other conditions, like knee OA, no studies have investigated to what extent illness perceptions are associated with pain in this patient population [11].…”

Section: Introductionmentioning

confidence: 99%

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Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Hoogendam

Tsehaie

Wouters

et al. 2019

Disability and Rehabilitation

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Background: The aim of this study was to investigate to what extent psychological factors are related to pain levels prior to non-invasive treatment in patients with osteoarthritis of the first carpometacarpal joint. Methods: We included patients (n ¼ 255) at the start of non-invasive treatment for osteoarthritis of the first carpometacarpal joint who completed the Michigan Hand Outcome Questionnaire. Psychological distress, pain catastrophizing behavior and illness perception was measured. X-rays were scored on presence of scaphotrapeziotrapezoid osteoarthritis. We used hierarchical linear regression analysis to determine to what extent pain levels could be explained by patient characteristics, X-ray scores, and psychological factors. Results: Patient characteristics and X-ray scores accounted for only 6% of the variation in pre-treatment pain levels. After adding the psychological factors to our model, 47% of the variance could be explained. Conclusions: Our results show that psychological factors are more strongly related to pain levels prior to non-invasive treatment in patients with osteoarthritis of the first carpometacarpal joint than patient characteristics and X-ray scores, which implies the important role of these factors in the reporting of symptoms. More research is needed to determine whether psychological factors will also affect treatment outcomes for patients treated non-invasively for osteoarthritis of the first carpometacarpal joint. ä IMPLICATIONS FOR REHABILITATION Pain is the most important complaint for patients with osteoarthritis of the first carpometacarpal joint. Psychological factors are strongly associated with pain levels prior to treatment. Pain catastrophizing behavior appears to be a promising target for complementary treatment in patients with osteoarthritis of the first carpometacarpal joint.

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Section: Michigan Hand Outcomes Questionnairementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Hoogendam

Tsehaie

Wouters

et al. 2019

Disability and Rehabilitation

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“…Considerando-se o caráter crônico da OA e seu impacto sobre várias áreas de desempenho do paciente 10 , consensos emitidos por entidades internacionais e também pela Sociedade Brasileira de Reumatologia 11 preconizam de forma unânime o acompanhamento por equipe multiprofissional 9 , na qual o terapeuta ocupacional atua de forma a habilitar o engajamento do paciente em ocupações. Tal intervenção consiste na combinação de exercícios, técnicas de educação do paciente e uso de órteses para promover suporte e proteção articular 6 .…”

Section: Introductionunclassified

“…Tal intervenção consiste na combinação de exercícios, técnicas de educação do paciente e uso de órteses para promover suporte e proteção articular 6 . O uso de órteses para pacientes com OA objetiva o controle da dor e redução da rigidez matinal, o suporte mecânico para articulações favorecendo a movimentação 3 , sobretudo durante a realização de atividades em que a combinação entre alinhamento articular, imobilização e aplicação de forças de tração é necessária 12,13 , tais como costurar, tocar um instrumento musical, escrever, digitar no computador ou em telefones celulares 10 . Observa-se que, apesar da uniformidade de objetivos para o uso de órteses junto a pacientes com OA do polegar, o caráter único desta articulação constitui um desafio, uma vez que a órtese deverá promover estabilização articular sem impedir sua movimentação 3 .…”

Section: Introductionunclassified

“…Estudos conduzidos junto a terapeutas e pacientes norte americanos 4 demonstraram variações significativas tanto para a escolha da órtese, quanto para as estratégias de raciocínio clínico utilizadas durante o tratamento da OA do polegar. Tais práticas resultaram em abordagens terapêuticas que, muitas vezes diferiam dos objetivos e expectativas dos pacientes, ocasionando abandono do tratamento e dos dispositivos prescritos 10 . Tendo em vista a escassez de estudos sobre práticas profissionais de terapeutas ocupacionais atuando junto a pacientes reumatológicos no Brasil e as diferenças dos contextos sociais e políticos envolvendo a prescrição de dispositivos de tecnologia assistiva em países em desenvolvimento 16,17 , o presente estudo buscou estabelecer o perfil do uso de órteses na clínica de terapia ocupacional junto a pacientes com OA do polegar em nosso país, identificando preferências dos tipos de órteses, materiais, modelos e articulações envolvidas, assim como barreiras e dificuldades enfrentadas para seu uso junto a esta população.…”

Section: Introductionunclassified

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Órteses para o paciente com osteoartrite do polegar: o que os terapeutas ocupacionais no Brasil indicam?

Almeida

Pontes

Rossi

et al. 2016

Rev. Ter. Ocup. Univ. São Paulo (Online)

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Órteses são consideradas a primeira linha de atuação para o tratamento de disfunções causadas pela osteoartrite (OA) da articulação carpometacárpica do polegar. Entretanto, não existem estudos que investiguem as preferências e indicações de órteses por profissionais brasileiros. Objetivo: Identificar os modelos de órteses indicados por terapeutas ocupacionais para pacientes com OA do polegar, bem como as barreiras encontradas para o uso deste recurso. Métodos: Estudo exploratório transversal, realizado através de questionário eletrônico com terapeutas ocupacionais brasileiros. Os dados obtidos foram analisados por meio da distribuição, frequência e porcentagem das respostas. Resultados: Participaram da pesquisa 52 terapeutas ocupacionais de todo o Brasil, atuando junto a pacientes reumáticos. A maioria das indicações foi de órteses sob medida (81%), envolvendo mais de uma articulação (83,7%). Políticas institucionais e ausência de materiais foram as principais dificuldades para 48,1% dos participantes. Conclusão: A indicação de órteses para pacientes com OA se faz presente na prática clínica de terapeutas ocupacionais e torna-se importante o incentivo a estratégias que permitam o aperfeiçoamento e difusão de ações de reabilitação junto a esta população.

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Patients With Higher Treatment Outcome Expectations Are More Satisfied With the Results of Nonoperative Treatment for Thumb Base Osteoarthritis: A Cohort Study

Hoogendam

Wouters

Andrinopoulou

et al. 2021

Archives of Physical Medicine and Rehabilitation

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To investigate how satisfaction with treatment outcome is associated with patient mindset and Michigan Hand Outcome Questionnaire (MHQ) scores at baseline and 3 months in patients receiving nonoperative treatment for first carpometacarpal joint (CMC-1) osteoarthritis (OA). Design: Cohort study Setting: A total of 20 outpatient locations of a clinic for hand surgery and hand therapy in the Netherlands. Participants: Patients (NZ308) receiving nonoperative treatment for CMC-1 OA, including exercise therapy, an orthosis, or both, between September 2017 and February 2019. Interventions: Nonoperative treatment (ie, exercise therapy, an orthosis, or both) Main Outcome Measures: Satisfaction with treatment outcomes was measured after 3 months of treatment. We measured total MHQ score at baseline and at 3 months. As baseline mindset factors, patients completed questionnaires on treatment outcome expectations, illness perceptions, pain catastrophizing, and psychological distress. We used multivariable logistic regression analysis and mediation analysis to identify factors associated with satisfaction with treatment outcomes. Results: More positive pretreatment outcome expectations were associated with a higher probability of being satisfied with treatment outcomes at 3 months (odds ratio, 1.15; 95% confidence interval, 1.07-1.25). Only a relatively small part (33%) of this association was because of a higher total MHQ score at 3 months. None of the other mindset and hand function variables at baseline were associated with satisfaction with treatment outcomes. Conclusions: This study demonstrates that patients with higher pretreatment outcome expectations are more likely to be satisfied with treatment outcomes after 3 months of nonoperative treatment for CMC-1 OA. This association could only partially be explained by a better functional outcome at 3 months for patients who were satisfied. Health care providers treating patients nonoperatively for CMC-1 OA should be aware of the importance of expectations and may take this into account in pretreatment counseling.

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Evaluation of Expectations and Expectation Fulfillment in Patients Treated for Trapeziometacarpal Osteoarthritis

Cited by 39 publications

References 38 publications

Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Órteses para o paciente com osteoartrite do polegar: o que os terapeutas ocupacionais no Brasil indicam?

Patients With Higher Treatment Outcome Expectations Are More Satisfied With the Results of Nonoperative Treatment for Thumb Base Osteoarthritis: A Cohort Study

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