Effectiveness of exercise therapy in patients with thumb carpometacarpal osteoarthritis: A multicenter, randomized controlled trial

IF 9.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage Pub Date : 2026-05-01 Epub Date: 2025-10-23 DOI:10.1016/j.joca.2025.10.005

Robbert M. Wouters , Lisa MJ Esteban Lopez , Stella CM Heemskerk , Sita MA Bierma-Zeinstra , Gerald A. Kraan , Joost Colaris , J.Michiel Zuidam , Guus M. Vermeulen , Ruud W. Selles , the THETA Study Group Collaborators

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引用次数: 0

Abstract

Objective

To compare the effectiveness and costs of an orthosis + exercise therapy with only an orthosis on pain at 3 months and conversion to surgery <1 year in patients with thumb carpometacarpal (CMC-1) osteoarthritis (OA).

Design

Multicenter, single-blinded, randomized controlled trial.

Setting

Eighteen outpatient hand surgery and therapy clinics in the Netherlands.

Participants

Adult patients with CMC-1 OA.

Interventions

Orthosis + exercise therapy versus orthosis-only.

Primary outcome measures

Pain at 3 months (Michigan Hand Outcomes Questionnaire pain subscale) and conversion to surgery <1 year.

Results

We included 166 patients (81 orthosis + exercise, 85 orthosis-only). There was no difference between the orthosis + exercise group and the orthosis-only group in pain at three months (least mean square difference 3.7 [95% CI −1.0–8.3]). Conversion to surgery was 4.9% (n=4) in the orthosis + exercise group and 9.4% (n=8) in the orthosis-only group, which was not significantly different (risk difference 4.7% [-3.3–12.2%) due to the low conversion to surgery rates. The total societal costs for orthosis + exercise were 37% (-€825 [-2072–421]) lower per patient than orthosis-only. The orthosis + exercise group had favorable outcomes in MHQ subscale activities of daily living scores (6mo), work ability (all time points), satisfaction with hand (3mo), the MHQ total score (3mo, 6mo), satisfaction with treatment results (all except 6mo), grip strength (6w), and illness perceptions (3mo).

Conclusions

In patients with CMC-1 OA, an orthosis + exercise therapy is preferred over orthosis-only because of the favorable secondary outcomes.

Trial registration

ClinicalTrials.gov: NCT05772715.

查看原文本刊更多论文

运动疗法对拇指手掌骨关节炎患者的疗效：一项多中心随机对照试验。

目的比较矫形器+运动治疗与单纯矫形器治疗拇指腕掌骨关节炎（CMC-1）患者疼痛3个月后转手术治疗<1年的疗效和成本。设计：多中心、单盲、随机对照试验。在荷兰有18家门诊手部手术和治疗诊所。参与者：成年CMC-1 OA患者。干预：矫形+运动治疗vs单纯矫形。主要结局测量：疼痛3个月（密歇根手部结局问卷疼痛亚量表），转行手术<1年。结果共纳入166例患者，其中矫形+运动81例，单纯矫形85例。矫形器+运动组与仅矫形器组在3个月时疼痛无差异（最小均方差3.7 [95% CI -1.0 ~ 8.3]）。矫形器+运动组转手术率为4.9% (n=4)，单纯矫形器组为9.4% (n=8)，由于转手术率较低，两者差异无统计学意义（风险差4.7%[-3.3% ~ 12.2%]）。与单纯矫形相比，矫形+运动的社会总成本每位患者低37%（- 825欧元[-2072至421]）。矫形器+运动组在日常生活活动分（6mo）、工作能力（所有时间点）、手部满意度（3mo）、MHQ总分（3mo、6mo）、治疗效果满意度（除6mo外）、握力（6w）、疾病感知（3mo）方面均有较好的结果。结论在CMC-1型OA患者中，矫形器+运动治疗优于单纯矫形器治疗，因为其次要结果较好。临床试验注册网站：NCT05772715。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoarthritis and Cartilage 医学-风湿病学

CiteScore

11.70

自引率

7.10%

发文量

802

审稿时长

52 days

期刊介绍： Osteoarthritis and Cartilage is the official journal of the Osteoarthritis Research Society International. It is an international, multidisciplinary journal that disseminates information for the many kinds of specialists and practitioners concerned with osteoarthritis.