Characterizing response to a dynamic stability modeled approach for thumb carpometacarpal joint pain: A retrospective study

Jennifer Johnson, Geneva V Tranchida, Michelle A. Mathiason, Virginia H. O'Brien, Corey McGee

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

STUDY DESIGN: Retrospective case series.

INTRODUCTION: Literature trends indicate that thumb dynamic stabilization may benefit clients with thumb carpometacarpal (CMC) joint pain and arthritis. There is minimal research investigating whether client characteristics predict responsiveness to hand therapy for thumb dynamic stabilization.

PURPOSE OF THE STUDY: 1) To investigate how adults with thumb CMC joint pain responded to a hand therapy dynamic stabilization modeled intervention. 2) To determine if various client factors influenced responsiveness and to what extent.

METHODS: An electronic medical record search identified adults treated from August 2009 through December 2015 for thumb CMC joint pain. Radiographs were retrospectively staged. Outcome measures were 1) Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) total disability score and 2) Numerical Pain Rating Scale (NPRS). Paired t-tests were performed to compare pre and post treatment measures. Multivariate analyses were used to investigate predictive factors.

RESULTS: A total of 249 charts were analyzed. Large overall significant effects were noted for disability score (QuickDASH P <.001, X = 12.1, Cohen's d = 0.9). The average improvement of 2.1 (SD = 2.6) points exceeded the minimal clinically important difference (MCID) of 1.7 points on the NPRS pain scale. Significant predictors of QuickDASH Scores were radiographic staging, bilateral hand involvement and initial pain ratings. Significant predictors for change in pain scores (meeting or exceeding the minimal clinically important difference for the NPRS) were bilateral thumb involvement and initial "pain at worst" rating.

CONCLUSION: After completing hand therapy with a dynamic stabilization approach, clients had less pain and disability. Those who had unilateral thumb pain, or those who started with higher pain levels were most likely to have clinically meaningful improvements in pain. Clients in early CMC osteoarthritis (OA) stages responded better than those in later stages, indicating that early referral to therapy is important.

Original languageEnglish (US)
Pages (from-to)346-357
Number of pages12
JournalJournal of Hand Therapy
Volume35
Issue number3
DOIs
StatePublished - Jul 1 2022

Bibliographical note

Funding Information:
Funding: This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences , grant UL1TR002494 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences. This research was approved by the University of Minnesota Institutional Review Board (study number 1702M07481).

Funding Information:
Funding: This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences. This research was approved by the University of Minnesota Institutional Review Board (study number 1702M07481).

Publisher Copyright:
© 2022

Keywords

  • arthritis
  • carpometacarpal
  • conservative
  • stability
  • therapy
  • thumb

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