Effects of a soft prefabricated thumb orthosis in carpometacarpal osteoarthritis.

AIMS: To explore the feasibility and assess the effect of a prefabricated soft thumb-base orthosis on pain, hand strength, and activity performance in persons with osteoarthritis of the CMC joint. METHODS: In this randomized controlled trial, 29 patients received hand exercises only (control group) and 30 patients received hand exercises and an orthosis (orthosis group). The primary outcome was pain, while secondary outcomes included grip and pinch strength, and self-reported symptoms and activity performance. Outcome assessments, and measures of grip strength and pain with and without orthosis in the orthosis group, were made after two months. RESULTS: 55 participants (mean age 70.5 years) completed all assessments. There were no significant differences between the groups in primary or secondary outcomes after two months. However, in the orthosis group, pain was significantly less when wearing the orthosis than when not wearing it. Participants reported that the orthosis felt uncomfortable during activities involving water and one-third wanted more support of the CMC joint. CONCLUSIONS: A soft prefabricated orthosis seems to have an immediate pain-relieving effect during use, but no effects in terms of less hand pain, or improved strength or activity performance when not worn.

Self-management strategies to support performance of daily activities in hand osteoarthritis.

AIMS: The main aim of this study was to explore self-management strategies in persons with hand osteoarthritis (HOA). METHODS: Self-management strategies were explored in semi-structured interviews, in which 125 participants described strategies, use of devices or equipment, and advice they would give to people with HOA concerning how to manage their daily life. RESULTS: The participants made a total of 483 statements, which were classified into 27 discrete strategies, and thereafter grouped into 13 broader strategies within three categories: general behavioural strategies, HOA-specific behavioural strategies, and cognitive strategies. The broad strategy "activity accommodations" specifically addressed performance of daily activities in people with HOA, comprising "use assistive devices", "adapt tools, materials or working techniques", "practise activity pacing" and "stop or avoid certain activities", of which the two first were the most frequently stated by participants. CONCLUSIONS: People with HOA use a wide variety of self-management strategies to support performance of daily activities, in which use of assistive devices and activity adaptation are the most frequently reported strategies. Patient-recommended self-management strategies should be included in written information material and patient education programmes, which should be developed in cooperation with patient representatives and made available for patients soon after they are diagnosed.

Grip force and pinch grip in an adult population: reference values and factors associated with grip force.

OBJECTIVES: To establish reference values of grip force and pinch grip in 10-year age-spans of an adult population, and to explore personal and activity factors associated with grip force. METHODS: The study has a cross-sectional design. A total of 566 participants, aged 20-94 years, were recruited from a variety of settings. Grip force and pinch grip in Newtons (N) were measured with the electronic instrument Grippit, while demographic data were obtained by a questionnaire. RESULTS: In general, males are stronger than females in all age groups, and females in their thirties are equally strong as males in their seventies. In both genders, grip force reaches its maximum in the third decade of life and decreases from the age of 40. Gender is the most important predictor of grip force, with a difference of 216 N (B = 216, p < 0.001) in force between females and males. In the gender-specific regression analyses, age, height, and exercise came out as independent significant predictors of grip force in both females and males. CONCLUSIONS: Grip force increases from the age of 20 and curves at the age of 40. Males are stronger than females in all age groups. Grip force is strongly associated with gender, age, height, and regular exercising.