Article

Hand therapists are often called upon to
provide treatment for thumb carpometacarpal joint osteoarthritis. PURPOSE:
These 2 case studies present a client-centered approach in the selection of orthoses
and joint protection strategies for patients with thumb carpometacarpal joint
osteoarthritis. At baseline, the participants presented with pain, decreased
active range of motion, decreased pinch strength, and limitations in activity and
participation. METHODS: The outcome measures utilized at study entry and 6 weeks
included the pain Visual Analog Scale, the Australian Canadian Osteoarthritis
Hand Index, the Disabilities of the Arm, Shoulder and Hand questionnaire, the
Canadian Occupational Performance Measure, active range of motion measured with
goniometry, and pinch strength measured with a pinch gauge. The Canadian
Occupational Performance Measure facilitated the client-centered approach by
identifying occupational performance issues and rating the participant's
performance and satisfaction for each. Each participant was prescribed a
different orthotic design, received client-centered joint protection instruction,
and evidence-based exercises. RESULTS: After 6 weeks, both clients had decreased
pain and improvement in their activities, participation, and satisfaction.
DISCUSSION: Using a client-centered approach can help therapists to carefully
consider a patient's occupational needs when designing and fabricating orthoses
and customizing their joint protection education for carpometacarpal joint
osteoarthritis. CONCLUSION: Focusing rehabilitation strategies on that which is
most important to the client should be considered to optimize their occupational
performance.
CI - Copyright (c) 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
- Orthèse

Langue : ANGLAIS