PMID- 35927109 OWN - NLM STAT- MEDLINE DCOM- 20230109 LR - 20230221 IS - 1545-004X (Electronic) IS - 0894-1130 (Linking) VI - 35 IP - 3 DP - 2022 Jul-Sep TI - Characterizing response to a dynamic stability modeled approach for thumb carpometacarpal joint pain: A retrospective study. PG - 346-357 LID - S0894-1130(22)00075-8 [pii] LID - 10.1016/j.jht.2022.06.010 [doi] AB - STUDY DESIGN: Retrospective case series. INTRODUCTION: Literature trends indicate that thumb dynamic stabilization may benefit clients with thumb carpometacarpal (CMC) joint pain and arthritis. There is minimal research investigating whether client characteristics predict responsiveness to hand therapy for thumb dynamic stabilization. PURPOSE OF THE STUDY: 1) To investigate how adults with thumb CMC joint pain responded to a hand therapy dynamic stabilization modeled intervention. 2) To determine if various client factors influenced responsiveness and to what extent. METHODS: An electronic medical record search identified adults treated from August 2009 through December 2015 for thumb CMC joint pain. Radiographs were retrospectively staged. Outcome measures were 1) Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) total disability score and 2) Numerical Pain Rating Scale (NPRS). Paired t-tests were performed to compare pre and post treatment measures. Multivariate analyses were used to investigate predictive factors. RESULTS: A total of 249 charts were analyzed. Large overall significant effects were noted for disability score (QuickDASH P <.001, X = 12.1, Cohen's d = 0.9). The average improvement of 2.1 (SD = 2.6) points exceeded the minimal clinically important difference (MCID) of 1.7 points on the NPRS pain scale. Significant predictors of QuickDASH Scores were radiographic staging, bilateral hand involvement and initial pain ratings. Significant predictors for change in pain scores (meeting or exceeding the minimal clinically important difference for the NPRS) were bilateral thumb involvement and initial "pain at worst" rating. CONCLUSION: After completing hand therapy with a dynamic stabilization approach, clients had less pain and disability. Those who had unilateral thumb pain, or those who started with higher pain levels were most likely to have clinically meaningful improvements in pain. Clients in early CMC osteoarthritis (OA) stages responded better than those in later stages, indicating that early referral to therapy is important. CI - Copyright (c) 2022. Published by Elsevier Inc. FAU - Johnson, Jennifer AU - Johnson J AD - M Health Fairview Hand Therapy, M Health Fairview Clinics and Surgery Center, Minneapolis, MN, USA. Electronic address: Jennifer.Johnson1@Fairview.org. FAU - Tranchida, Geneva AU - Tranchida G AD - Department of Orthopaedic Surgery, Raymond G. Murphy VA Medical Center, Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA. FAU - Mathiason, Michelle A AU - Mathiason MA AD - School of Nursing, University of Minnesota, Minneapolis, MN, USA. FAU - O'Brien, Virginia H AU - O'Brien VH AD - University of Wisconsin Hospitals and Clinics, Hand and Upper Extremity Program, Department of Rehabilitation and Orthopedics, Madison, WI, USA. FAU - McGee, Corey AU - McGee C AD - Programs in Occupational Therapy and Rehabilitation Science, University of Minnesota, Program in Occupational Therapy, University of Minnesota, Minneapolis, MN, USA. LA - eng PT - Journal Article DEP - 20220801 PL - United States TA - J Hand Ther JT - Journal of hand therapy : official journal of the American Society of Hand Therapists JID - 8806591 SB - IM MH - Adult MH - Humans MH - Retrospective Studies MH - *Carpometacarpal Joints MH - Thumb MH - Arm MH - Pain MH - Arthralgia/diagnosis/etiology OTO - NOTNLM OT - arthritis OT - carpometacarpal OT - conservative OT - stability OT - therapy OT - thumb EDAT- 2022/08/05 06:00 MHDA- 2023/01/10 06:00 CRDT- 2022/08/04 22:04 PHST- 2022/01/21 00:00 [received] PHST- 2022/06/03 00:00 [revised] PHST- 2022/06/20 00:00 [accepted] PHST- 2022/08/05 06:00 [pubmed] PHST- 2023/01/10 06:00 [medline] PHST- 2022/08/04 22:04 [entrez] AID - S0894-1130(22)00075-8 [pii] AID - 10.1016/j.jht.2022.06.010 [doi] PST - ppublish SO - J Hand Ther. 2022 Jul-Sep;35(3):346-357. doi: 10.1016/j.jht.2022.06.010. Epub 2022 Aug 1.