Occupational therapy and surgery - completed project
Project managers
Post doc
The project is completed.
Can occupational therapy delay or reduce the need for surgery in CMC osteoarthritis: A randomized, controlled trial.
ABOUT THE PROJECT, WHICH IS COMPLETED
The most common treatment for osteoarthritis of the thumb's metacarpophalangeal joint (CMC osteoarthritis) is no treatment, while those with severe symptoms are referred to surgery. Recent studies show that occupational therapy for hand osteoarthritis reduces pain and improves hand function. The main goal of the study is to investigate whether occupational therapy before surgery can reduce the need for surgery for CMC osteoarthritis.
Read the results brochure by opening this PDF!
Who can join?
Recruitment has closed. Included patients were adults with hand osteoarthritis who were referred by their 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. Olavs Hospital, Trondheim University Hospital, Haukeland University Hospital in Bergen, and the Rheumatism Hospital in Haugesund.
After measurements of pain and hand function, they were randomly assigned to a control group (no intervention while waiting for surgery) or an intervention group (customized support splints for the thumb CMC joint, assistive devices, ergonomic guidance, and instruction in hand exercises while waiting).
Both groups received medical information and an offer of surgery as planned. Those who agreed underwent surgery and received standard postoperative follow-up. All participants were followed up 4, 18, and 24 months after baseline.
After two years, the main results show a non-significant trend towards fewer surgeries among participants in the occupational therapy group, with 22 (24%) of patients undergoing surgery compared with 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. Prior non-pharmacological 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.