Rheumatology Division, Department of Medicine, Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.
Department of Diagnostic Imaging, Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.
Arch Phys Med Rehabil. 2024 Oct;105(10):1837-1845. doi: 10.1016/j.apmr.2024.06.013. Epub 2024 Jul 4.
To compare the functional (daytime) use to the nightly use of an orthosis for patients affected by trapeziometacarpal osteoarthritis (OA).
Randomized, controlled single-blind trial.
The rheumatology outpatient clinic of the University.
Sixty participants diagnosed with trapeziometacarpal OA.
Participants were randomly assigned into 2 groups: a functional group that used a functional hand-based thumb immobilization orthosis during activities of daily living and a night-time group that used the same orthosis at night.
The patients were evaluated at baseline and after 45, 90, 180, and 360 days considering: pain at the base of the thumb and in the hand, range of motion of the thumb, grip, and pinch strength, manual dexterity, and hand function.
The groups were homogeneous at the beginning of the trial. No statistically significant difference was observed between groups over time for trapeziometacarpal pain (P=.646). For general hand pain, no statistically significant difference was found between groups over time (P=.594). Although both groups improved from baseline, there were no statistically significant differences between the groups in the vast majority of the assessed parameters. Statistically significant differences between the groups were found only in the following outcomes: thumb palmar abduction of the right hand (P=.023), pick-up test with closed eyes of the right hand (P=.048), and tripod grip strength of the right hand (P=.006).
Both groups showed improvement in pain and function from baseline to the end of the intervention. However, there were no reported differences in these outcomes after a 1-year follow-up between the functional (daytime) and night-time use of orthosis in patients with trapeziometacarpal OA. This suggests that both types of usage can be offered to patients.
比较腕掌关节炎（OA）患者使用支具的日间功能使用与夜间使用的效果。
随机、对照、单盲试验。
大学风湿病门诊。
60 名被诊断为腕掌 OA 的患者。
参与者被随机分配到 2 组：功能组在日常生活活动中使用基于手部的功能性拇指固定支具，夜间组在夜间使用相同的支具。
在基线和 45、90、180 和 360 天时评估患者：拇指根部和手部疼痛、拇指活动度、握力、捏力、手灵活性和手部功能。
试验开始时，两组患者具有同质性。在整个试验过程中，两组之间在腕掌疼痛方面没有统计学上的显著差异（P=.646）。对于手部一般疼痛，两组之间在整个试验过程中没有统计学上的显著差异（P=.594）。尽管两组患者的基线均有改善，但在大多数评估参数中，两组之间没有统计学上的显著差异。仅在以下几个方面，两组之间存在统计学显著差异：右手拇指掌侧外展（P=.023）、右手闭眼拾物试验（P=.048）和右手三指握力（P=.006）。
两组患者从基线到干预结束，疼痛和功能均有改善。然而，在 1 年随访后，在腕掌 OA 患者中，支具的日间（功能）与夜间使用在这些结果方面没有报告差异。这表明这两种使用类型都可以提供给患者。
