Article

The purpose of this study was to conduct a current review of randomized
controlled trials regarding the effect of conservative interventions on pain and
function in people with thumb carpometacarpal (CMC) osteoarthritis (OA), perform
a meta-analysis of the findings and summarize current knowledge. METHOD: Data
were obtained from MEDLINE, CINAHL, Embase, PEDro and CENTRAL databases from
their inception to May 2014. Reference lists of relevant literature reviews were
also searched. All published randomized trials without restrictions to time of
publication or language were considered for inclusion. Study subjects were
symptomatic adults with thumb CMC OA. Two reviewers independently selected
studies, conducted quality assessment and extracted results. Data were pooled in
a meta-analysis, when possible, using a random-effects model. Quality of the body
evidence was assessed using GRADE approach. RESULTS: Sixteen RCTs involving 1145
participants met the inclusion criteria. Twelve were of high quality (PEDro score
> 6). We found moderate quality evidence that manual therapy and therapeutic
exercise combined with manual therapy improve pain in thumb CMC OA at short- and
intermediate-term follow-up, and from low to moderate quality evidences that
magneto therapy improves pain and function at short-term follow-up. Orthoses
(splints) were found to improve function at long-term follow-up and pinch
strength at short-term follow-up. Finally, we found from very low to low-quality
evidence that other conservative interventions provide no significant improvement
in pain and in function at short- and long-term follow-up. CONCLUSIONS: Some of
the commonly performed conservative interventions performed in therapy have
evidence to support their use to improve hand function and decrease hand pain.
Additional research is required to determine the efficacy of other therapeutic
interventions that are performed with patients with thumb CMC OA. IMPLICATIONS
FOR REHABILITATION: Manual therapy and exercise are an effective means of
improving pain and function at short-term follow-up by patients with thumb CMC
OA. Magneto therapy, manual therapy, manual therapy and exercise and Orthoses
(splints) were found to have clinically significant results. Very few of the
included studies showed a clinically significant effect size in favor of
treatment.

Langue : ANGLAIS