The effectiveness of physical therapies for patients with base of thumb osteoarthritis: systematic review and meta-analysis

Malene Ahern, Jason Skyllas, Anne Wajon, Julia Hush

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Trapeziometacarpal osteoarthritis (known as base of thumb OA) is a common condition causing pain and disability worldwide.
Objective: The purpose of this review was to evaluate the effectiveness of multimodal and unimodal physical therapies for base of thumb osteoarthritis (OA) compared with usual care, placebo or sham interventions.
Design: Systematic review and meta-analysis.
Method: We searched MEDLINE (PubMed), CINAHL, Embase, AMED, PEDro, Cochrane Database of Systematic Review, Cochrane Register of Controlled Trials (CENTRAL) from inception to May 2017. Randomized controlled trials involving adults comparing physical therapy treatment for base of thumb OA with an inactive control (placebo or sham treatment) and reported pain, strength or functional outcomes were included. Meta-analyses were performed where possible. Methodological risk of bias was assessed with the Cochrane Risk of Bias tool.
Results: Five papers with low risk of bias were included. Meta-analyses of mean differences (MD) with 95% confidence intervals (95% CI), were calculated for between-group differences in point estimates at 4 weeks post-intervention. Multimodal and unimodal physical therapies resulted in clinically worthwhile improvements in pain intensity (MD 2.9 [95% CI 2.8 to 3.0]; MD 3.1 [95% CI 2.5 to 3.8] on a 0–10 scale, respectively). Hand function improved following unimodal treatments (MD 6.8 points [95% CI 1.7 to 11.9)] on a 0–100 scale) and after a multimodal treatment (MD 20.5 (95%CI -0.7 to 41.7).
Conclusions: High quality evidence shows unimodal and multimodal physical therapy treatments can result in clinically worthwhile improvements in pain and function for patients with base of thumb OA.
LanguageEnglish
Pages46-54
Number of pages9
JournalMusculoskeletal Science and Practice
Volume35
DOIs
Publication statusPublished - Jun 2018

Fingerprint

Thumb
Osteoarthritis
Meta-Analysis
Confidence Intervals
Pain
Placebos
Therapeutics
Combined Modality Therapy
PubMed
MEDLINE
Randomized Controlled Trials
Hand
Databases

Keywords

  • Osteoarthritis
  • Physical therapy
  • Trapeziometacarpal
  • Thumb

Cite this

@article{b43cce3dbff0461997582fde74071b27,
title = "The effectiveness of physical therapies for patients with base of thumb osteoarthritis: systematic review and meta-analysis",
abstract = "Background: Trapeziometacarpal osteoarthritis (known as base of thumb OA) is a common condition causing pain and disability worldwide.Objective: The purpose of this review was to evaluate the effectiveness of multimodal and unimodal physical therapies for base of thumb osteoarthritis (OA) compared with usual care, placebo or sham interventions.Design: Systematic review and meta-analysis.Method: We searched MEDLINE (PubMed), CINAHL, Embase, AMED, PEDro, Cochrane Database of Systematic Review, Cochrane Register of Controlled Trials (CENTRAL) from inception to May 2017. Randomized controlled trials involving adults comparing physical therapy treatment for base of thumb OA with an inactive control (placebo or sham treatment) and reported pain, strength or functional outcomes were included. Meta-analyses were performed where possible. Methodological risk of bias was assessed with the Cochrane Risk of Bias tool.Results: Five papers with low risk of bias were included. Meta-analyses of mean differences (MD) with 95{\%} confidence intervals (95{\%} CI), were calculated for between-group differences in point estimates at 4 weeks post-intervention. Multimodal and unimodal physical therapies resulted in clinically worthwhile improvements in pain intensity (MD 2.9 [95{\%} CI 2.8 to 3.0]; MD 3.1 [95{\%} CI 2.5 to 3.8] on a 0–10 scale, respectively). Hand function improved following unimodal treatments (MD 6.8 points [95{\%} CI 1.7 to 11.9)] on a 0–100 scale) and after a multimodal treatment (MD 20.5 (95{\%}CI -0.7 to 41.7).Conclusions: High quality evidence shows unimodal and multimodal physical therapy treatments can result in clinically worthwhile improvements in pain and function for patients with base of thumb OA.",
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The effectiveness of physical therapies for patients with base of thumb osteoarthritis : systematic review and meta-analysis. / Ahern, Malene; Skyllas, Jason; Wajon, Anne; Hush, Julia.

In: Musculoskeletal Science and Practice, Vol. 35, 06.2018, p. 46-54.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - The effectiveness of physical therapies for patients with base of thumb osteoarthritis

T2 - Musculoskeletal Science and Practice

AU - Ahern,Malene

AU - Skyllas,Jason

AU - Wajon,Anne

AU - Hush,Julia

PY - 2018/6

Y1 - 2018/6

N2 - Background: Trapeziometacarpal osteoarthritis (known as base of thumb OA) is a common condition causing pain and disability worldwide.Objective: The purpose of this review was to evaluate the effectiveness of multimodal and unimodal physical therapies for base of thumb osteoarthritis (OA) compared with usual care, placebo or sham interventions.Design: Systematic review and meta-analysis.Method: We searched MEDLINE (PubMed), CINAHL, Embase, AMED, PEDro, Cochrane Database of Systematic Review, Cochrane Register of Controlled Trials (CENTRAL) from inception to May 2017. Randomized controlled trials involving adults comparing physical therapy treatment for base of thumb OA with an inactive control (placebo or sham treatment) and reported pain, strength or functional outcomes were included. Meta-analyses were performed where possible. Methodological risk of bias was assessed with the Cochrane Risk of Bias tool.Results: Five papers with low risk of bias were included. Meta-analyses of mean differences (MD) with 95% confidence intervals (95% CI), were calculated for between-group differences in point estimates at 4 weeks post-intervention. Multimodal and unimodal physical therapies resulted in clinically worthwhile improvements in pain intensity (MD 2.9 [95% CI 2.8 to 3.0]; MD 3.1 [95% CI 2.5 to 3.8] on a 0–10 scale, respectively). Hand function improved following unimodal treatments (MD 6.8 points [95% CI 1.7 to 11.9)] on a 0–100 scale) and after a multimodal treatment (MD 20.5 (95%CI -0.7 to 41.7).Conclusions: High quality evidence shows unimodal and multimodal physical therapy treatments can result in clinically worthwhile improvements in pain and function for patients with base of thumb OA.

AB - Background: Trapeziometacarpal osteoarthritis (known as base of thumb OA) is a common condition causing pain and disability worldwide.Objective: The purpose of this review was to evaluate the effectiveness of multimodal and unimodal physical therapies for base of thumb osteoarthritis (OA) compared with usual care, placebo or sham interventions.Design: Systematic review and meta-analysis.Method: We searched MEDLINE (PubMed), CINAHL, Embase, AMED, PEDro, Cochrane Database of Systematic Review, Cochrane Register of Controlled Trials (CENTRAL) from inception to May 2017. Randomized controlled trials involving adults comparing physical therapy treatment for base of thumb OA with an inactive control (placebo or sham treatment) and reported pain, strength or functional outcomes were included. Meta-analyses were performed where possible. Methodological risk of bias was assessed with the Cochrane Risk of Bias tool.Results: Five papers with low risk of bias were included. Meta-analyses of mean differences (MD) with 95% confidence intervals (95% CI), were calculated for between-group differences in point estimates at 4 weeks post-intervention. Multimodal and unimodal physical therapies resulted in clinically worthwhile improvements in pain intensity (MD 2.9 [95% CI 2.8 to 3.0]; MD 3.1 [95% CI 2.5 to 3.8] on a 0–10 scale, respectively). Hand function improved following unimodal treatments (MD 6.8 points [95% CI 1.7 to 11.9)] on a 0–100 scale) and after a multimodal treatment (MD 20.5 (95%CI -0.7 to 41.7).Conclusions: High quality evidence shows unimodal and multimodal physical therapy treatments can result in clinically worthwhile improvements in pain and function for patients with base of thumb OA.

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KW - Trapeziometacarpal

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