Occupational Therapy for Thumb Arthritis

Overseen By Bryce T Fletcher, BS, CCRP

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Julie Nuelle

Disqualifiers: Revision CMC arthroplasty, Traumatic dislocation, MCP hyperextension

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 6 weeks

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines the effectiveness of occupational therapy in aiding recovery after CMC arthroplasty, a surgery for thumb arthritis. Participants will either attend weekly occupational therapy sessions or follow a home exercise program provided by their doctor. It is ideal for individuals planning to undergo this thumb surgery who can read and write in English. As an unphased trial, this study provides a unique opportunity to contribute to understanding the benefits of occupational therapy post-surgery.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that occupational therapy is a safe and effective treatment for thumb arthritis. Studies have found that this therapy can improve hand function and reduce pain in the short term. Specifically, one study discovered that a combination of exercises and hands-on techniques significantly eased pain.

Another study found that exercise therapy for thumbs improved thumb movement and daily use for up to a year. These findings suggest that occupational therapy is generally well-tolerated and safe for treating thumb arthritis symptoms.

No major side effects were reported in the studies, supporting the conclusion that occupational therapy is a safe option for managing thumb arthritis. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the occupational therapy approach for thumb arthritis because it offers a hands-on, personalized way to manage symptoms without relying solely on medications like NSAIDs or corticosteroid injections. Unlike standard drug treatments, occupational therapy focuses on improving hand function and reducing pain through customized exercises and activities tailored to each individual's needs. This method empowers patients to actively participate in their own care, potentially leading to better long-term outcomes and quality of life.

What evidence suggests that occupational therapy is effective for thumb arthritis?

Research has shown that occupational therapy, which participants in this trial may receive, can significantly improve thumb function in people with arthritis. Studies have found that this therapy can reduce pain and facilitate thumb use in daily activities. One study noted short-term improvements in hand function after a specific type of occupational therapy. Meanwhile, participants in another arm of this trial will complete a home exercise program. Exercises and hands-on therapy, often included in occupational therapy, have been found to reduce pain more effectively than other methods. These findings suggest that occupational therapy could be a promising way to manage symptoms of thumb arthritis. ^{1 2 4 5 6}

Who Is on the Research Team?

Julia A.V. Nuelle, MD

Principal Investigator

University of Missouri-Columbia

Are You a Good Fit for This Trial?

This trial is for individuals with thumb carpometacarpal (CMC) arthritis who have undergone a trapeziectomy and suture suspensionplasty. The study aims to determine if in-clinic occupational therapy is necessary after the surgery.

Inclusion Criteria

Ability to read and write in English

I am undergoing or have undergone CMC joint surgery.

Ability to provide informed consent

Exclusion Criteria

I need surgery for a recent severe dislocation of my wrist joint.

I am having a second surgery on my thumb joint.

I am receiving treatment for MCP joint over-straightening.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to either in-clinic occupational therapy or at-home exercise therapy following trapeziectomy and suture suspensionplasty

6 weeks

1-2 visits per week (in-person) for OT group; weekly check-ins for HEP group

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments of key pinch strength, grip strength, Kapandji score, radial abduction, and PROMIS measures

1 year

Regular follow-up visits at 2 weeks, 6 weeks, 12 weeks, 6 months, and 1 year

What Are the Treatments Tested in This Trial?

Interventions

• Home Exercise Program
• Occupational Therapy

Trial Overview

The trial compares two post-surgery treatments: one group will follow a home exercise program, while another will receive formal occupational therapy. It's designed to see which method is more effective for recovery.

How Is the Trial Designed?

Group I: Occupational Therapy Experimental Treatment 1 Intervention

Participants in this arm will receive weekly occupational therapy for 6 weeks

Group II: Home Exercise Active Control 1 Intervention

Participants in this arm will complete an informal home exercise program provided by their treating physician

Who Is Running the Clinical Trial?

Julie Nuelle

Lead Sponsor

Trials

2

Recruited

430+

Arthrex, Inc.

Industry Sponsor

Trials

48

Recruited

30,200+

Published Research Related to This Trial

A systematic review of 20 articles found that most adverse events (AEs) from manual therapy to peripheral joints were benign and transient, with only a few serious AEs reported, primarily related to acupuncture or massage.

The study highlights the need for awareness of potential risks associated with various manual therapy techniques, but overall, serious adverse events are rare, suggesting that manual therapy is generally safe for treating peripheral joint issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events associated with manual therapy of peripheral joints: A scoping review. Sheldon, A., Karas, S.[2022]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4778382/

Effectiveness of physical and occupational therapy on pain ...

Trapeziometacarpal osteoarthritis is associated with more pain and restrictions than other hand osteoarthritis due to the functional importance of the thumb.

2.

sciencedirect.com

sciencedirect.com/science/article/pii/S1063458425011872

Effectiveness of Exercise Therapy in Patients with Thumb ...

There were two primary outcomes: pain at 3 months, measured using the pain subscale of the Michigan Hand outcomes Questionnaire (MHQ) [32], [33] ...

3.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10695337/

Long-Term Outcomes of Nonsurgical Treatment of Thumb ...

Exercise therapy can optimize thumb positioning and improve use in daily life, with a known treatment effect up to 1 year. Because of the ...

4.

acrjournals.onlinelibrary.wiley.com

acrjournals.onlinelibrary.wiley.com/doi/full/10.1002/acr.24543

Short‐Term Effects of Occupational Therapy on Hand Function ...

The results of our current study revealed that a multimodal occupational therapy intervention yielded significant beneficial short-term effects ...

5.

jospt.org

jospt.org/doi/10.2519/jospt.2013.4524

The Effectiveness of a Manual Therapy and Exercise ...

This clinical trial provides evidence that a combination of joint mobilization, neural mobilization, and exercise is more beneficial in treating pain than a ...

6.

oem.bmj.com

oem.bmj.com/content/82/1/14

a register-based study of construction workers

The results show an increased risk of developing CMC1 OA for work involving high grip force, pinch grip, repetitive wrist movements, hand-held tool use, heavy ...