目的:本研究旨在比较受梯形掌骨骨关节炎影响的患者的矫形器的功能性(白天)使用与夜间使用。
方法:随机化,对照单盲试验。
方法:大学风湿病门诊。
方法:60名被诊断为梯形掌骨关节炎的参与者。
方法:参与者被随机分为2组:在日常生活活动中使用功能性手固定拇指矫形器的功能组和在夜间使用相同矫形器的夜间组。
方法:在基线和45、90、180和360天后对患者进行评估,考虑到:拇指基部和手部疼痛,拇指的运动范围,握把,和捏合强度,手动灵巧,手的功能。
结果:试验开始时,各组是同质的。随着时间的推移,两组之间的梯形掌骨疼痛没有统计学上的显着差异(p=0.646)。对于一般的手部疼痛,随着时间的推移,组间无统计学差异(p=0.594).尽管两组均较基线有所改善,在绝大多数评估参数方面,组间无统计学显著差异.两组之间的统计学差异仅在以下结果中发现:右手拇指手掌外展(p=0.023),右手闭眼拾取试验(p=0.048),和右手的三脚架握力(p=0.006)。
结论:两组均显示从基线到干预结束的疼痛和功能改善。然而,对于梯形掌骨骨关节炎患者,在功能性(日间)和夜间使用矫形器之间进行1年随访后,这些结局没有报告差异.这表明两种类型的使用都可以提供给患者。
OBJECTIVE: To compare the functional (daytime) use to the nightly use of an orthosis for patients affected by trapeziometacarpal osteoarthritis (OA).
METHODS: Randomized, controlled single-blind trial.
METHODS: The rheumatology outpatient clinic of the University.
METHODS: Sixty participants diagnosed with trapeziometacarpal OA.
METHODS: Participants were randomly assigned into 2 groups: a functional group that used a functional hand-based
thumb immobilization orthosis during activities of daily living and a night-time group that used the same orthosis at night.
METHODS: The patients were evaluated at baseline and after 45, 90, 180, and 360 days considering: pain at the base of the
thumb and in the hand, range of motion of the
thumb, grip, and pinch strength, manual dexterity, and hand function.
RESULTS: The groups were homogeneous at the beginning of the trial. No statistically significant difference was observed between groups over time for trapeziometacarpal pain (P=.646). For general hand pain, no statistically significant difference was found between groups over time (P=.594). Although both groups improved from baseline, there were no statistically significant differences between the groups in the vast majority of the assessed parameters. Statistically significant differences between the groups were found only in the following outcomes:
thumb palmar abduction of the right hand (P=.023), pick-up test with closed eyes of the right hand (P=.048), and tripod grip strength of the right hand (P=.006).
CONCLUSIONS: Both groups showed improvement in pain and function from baseline to the end of the intervention. However, there were no reported differences in these outcomes after a 1-year follow-up between the functional (daytime) and night-time use of orthosis in patients with trapeziometacarpal OA. This suggests that both types of usage can be offered to patients.