Hand Therapy > Volume 14, Number 1 > Pp. 2-9

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An investigation into therapists' management of osteoarthritis of the carpometacarpal joint of the thumb in the UK

Barbara J Davenport 

Pulvertaft Hand Centre, Derby Hospitals NHS Trust, Derby, UK

Correspondence: Barbara J Davenport, Derbyshire County PCT, Physiotherapy Department, Cavendish Hospital, Manchester Road, Buxton SK17 6TE, UK. Email: davenport.barbara{at}gmail.com

Objective. Osteoarthritis (OA) of the first carpometacarpal (CMC) joint is common and causes pain and loss of function. Conservative management is widely used to manage this condition and this study aimed to investigate the current conservative management employed by therapists in the UK.

Methods. A survey design was selected using a self-completed questionnaire as the data collection tool. The questionnaire was designed by the author and distributed to therapists by post to a range of therapy departments and to delegates attending a hand therapy course.

Results. A total of 115 out of 330 therapists (35%) responded with a completed questionnaire and the majority of the sample (97%) treated OA of the first CMC joint. Therapists used a variety of treatments for OA of the first CMC joint and the severity of the OA influenced the treatments used. Advice on activities of daily living, ergonomic advice, splints and exercise were the most commonly used treatment modalities. Therapists varied greatly in how effective they felt the different treatment modalities were in treating OA of the first CMC joint and how strong they felt the evidence base was to support their use. Most therapists used outcome measures, but many different ones were in use. Few therapists were aware of a classification system to grade the severity of OA of the first CMC joint.

Conclusions. There is a need for further research into the conservative management of this condition in order to establish the most effective treatments for each stage of the disease process.

Key Words: Osteoarthritis • carpometacarpal joint • survey • hand therapy

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