Occupational therapy and surgery
Project managers
Post doc
The project has ended.
Project title
Can occupational therapy delay or reduce the need for surgery in CMC osteoarthritis: A randomized controlled trial.
About the project
The most common treatment for arthrosis in the root joint of the thumb (CMC arthrosis) is no treatment, while those with severe complaints are referred to surgery. Recent studies show that occupational therapy for hand osteoarthritis reduces pain and improves hand function. The main aim of the study is to investigate whether occupational therapy before surgery can reduce the need for surgery in CMC arthrosis.
Who can join?
Recruitment has ended. Included patients were adults with hand osteoarthritis who were referred by a GP for assessment for surgery in the specialist health service.
What does the study entail?
We have recruited 180 patients who were referred for assessment for CMC surgery at St. Olav's Hospital, University Hospital in Trondheim, Haukeland University Hospital in Bergen and Rheumatism Hospital in Haugesund.
After measurements of pain and hand function, they were randomly allocated to a control group (no intervention while waiting for surgery) or an intervention group (adapted support splints for the CMC joint of the thumb, aids, ergonomic guidance and instruction in hand exercises while waiting).
Both groups received medical information and an offer of surgery as planned. Those who agreed were operated on and received the usual post-operative follow-up. All participants came for control 4, 18 and 24 months after baseline.
After two years, the main results show a non-significant tendency towards fewer operations among the participants in the occupational therapy group, where 22 (24%) of the patients underwent surgery, compared to 29 (32%) in the control group (OR 0.56, 95% CI 0.26 to 1.21; p =0.14). The median time to surgery was 350 days in the occupational therapy group and 296 days in the control group. Previously received non-drug treatment (OR 2.72) and high motivation for surgery (OR 1.25) were statistically significantly associated with CMC surgery (p<0.05).
We are now in the final phase of data analysis and dissemination.