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掌指关节固定术治疗拇指腕掌关节骨关节炎的疼痛和功能效果。一项准实验研究。

Effect of immobilization of metacarpophalangeal joint in thumb carpometacarpal osteoarthritis on pain and function. A quasi-experimental trial.

机构信息

Physical Therapy Section, Faculty of Health Sciences, University of Malaga, Tecan Hand Rehabilitation Center, Málaga, Spain.

IRCCS Don Gnocchi Foundation, Milan, Italy.

出版信息

J Hand Ther. 2018 Jan-Mar;31(1):68-73. doi: 10.1016/j.jht.2016.11.005. Epub 2017 Feb 22.

Abstract

STUDY DESIGN

A quasi-experimental trial.

INTRODUCTION

Orthoses are effective to decrease pain and improve function in patients with carpometacarpal osteoarthritis (CMC OA). However, current research does not support one design of an orthosis as more effective and/or more favorable than another.

PURPOSE OF THE STUDY

The aim of this study was to compare the effectiveness of 2 different static orthosis on pain and functional abilities on CMC OA.

METHODS

Eighty-four patients, 91.7% females (mean ± standard deviation age, 60.1 ± 9.6 years), with thumb CMC OA were randomized into 1 of 2 groups. For group A, a Ballena orthotic was constructed, and for group B, a Colditz orthotic was constructed. Both static orthoses were worn for 3 months. The outcome measures included pain with activity measured with the visual analog scale and functional abilities assessed with the Disabilities of the Arm, Shoulder and Hand.

RESULTS

Both orthoses improved pain level and functional abilities (F = 413.327 and F = 211.742; both P < .001). There was no statistically significant difference between 2 groups regarding to pain recovery and functional improvement (F = 0.075 and F = 7.248; both P > .05).

DISCUSSION

The main purpose was to compare the effect of 2 different thermoplastic thumb orthoses. Previous studies support the use of CMC orthoses to decrease hand pain and improve hand function, but different orthoses have been described and in most cases, orthotic interventions were accompanied by other medical treatments.

CONCLUSIONS

A clinically significant reduction in pain intensity and improvement in functional abilities was achieved with both orthoses in patients with thumb CMC OA.

LEVEL OF EVIDENCE

TRIAL REGISTRATION

ClinicalTrials.gov registration number: NCT02780999.

摘要

研究设计

准实验性试验。

引言

矫形器对于减轻掌腕关节(CMC)骨关节炎(OA)患者的疼痛和改善功能是有效的。然而,目前的研究并不支持一种矫形器设计比另一种更有效和/或更有利。

研究目的

本研究旨在比较两种不同的静态矫形器对 CMC OA 的疼痛和功能能力的治疗效果。

方法

84 名患者(91.7%为女性,平均年龄±标准差为 60.1±9.6 岁),患有拇指 CMC OA,随机分为两组。A 组使用 Ballena 矫形器,B 组使用 Colditz 矫形器。两组患者均佩戴矫形器 3 个月。评估指标包括活动时的疼痛程度(用视觉模拟评分法测量)和功能能力(用手臂、肩部和手功能障碍问卷测量)。

结果

两种矫形器均能改善疼痛程度和功能能力(F=413.327 和 F=211.742;均 P<.001)。两组在疼痛恢复和功能改善方面没有统计学上的显著差异(F=0.075 和 F=7.248;均 P>.05)。

讨论

本研究的主要目的是比较两种不同的热塑拇指矫形器的效果。先前的研究支持使用 CMC 矫形器来减轻手部疼痛和改善手部功能,但已经描述了不同的矫形器,在大多数情况下,矫形器干预都伴随着其他医疗治疗。

结论

两种矫形器均能显著减轻拇指 CMC OA 患者的疼痛强度,改善功能能力。

证据水平

2。

临床试验注册

ClinicalTrials.gov 注册号:NCT02780999。

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