Abstract
Study Design
Cross-sectional descriptive study.
Introduction
Osteoarthritis (OA) is the most prevalent musculoskeletal disease in the adult and
older adult populations. The use of orthoses to stabilize the thumb's articular complex
is one of the most common conservative management strategies. Despite substantial
research about this topic, there is insufficient evidence about the optimal use of
orthoses to inform clinical practice, contributing to practice variations within and
across health professionals.
Purpose of the Study
To identify the prescription patterns, design preferences, and barriers for the use
of orthotic devices among Brazilian health care professionals involved in the treatment
of patients with OA of the basal thumb joint.
Methods
An electronic questionnaire was sent to occupational therapists, physiotherapists,
and rheumatologists across Brazil through professional association mailing lists.
Survey included questions about orthosis design, materials, and barriers to the use
of orthotic interventions. Respondents indicated their use based on photographs of
25 orthoses models that were selected through bibliographic review and expert consultation.
Descriptive statistics, the chi-square test for independence, and the Fisher exact
test were used to compare differences among orthotic prescription preferences, barriers,
and challenges observed amidst the 3 participants' professional classes.
Results
There was no consensus about orthotic prescription among 275 professionals who answered
the survey. About 69% of participants reported the use of multiple orthosis during
treatment of patients with thumb OA. Results suggest significant variations in the
number of joints included and stabilization strategies adopted, with a preference
for orthotics made in rigid materials and involving the wrist, carpometacarpal, and
metacarpophalangeal joints (P < .001). The lack of knowledge about orthotic options, institutional regulations,
and policies were the major barriers reported by respondents (P < .01).
Conclusion
A plentiful variety of different orthoses designs were observed in this study, and
the prescriptions made by 3 professional classes showed differences regarding types
of stabilization, joint involvement, and positioning. Despite the existence of clinical
trials suggesting benefits for specific custom-made design models, our results indicated
widespread clinical variation in practices and preferences.
Level of Evidence
Not applicable.
Keywords
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JHT Read for Credit
Quiz: #441
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The study design is
- a.RCTs
- b.cross sectional descriptive
- c.case series
- d.case study
- a.
- #2.According to the authors _________________ is the most common intervention for thumb CMC arthritis
- a.joint protection
- b.surgery
- c.cast immobilization
- d.static orthotic immobilization
- a.
- #3.Data was collected using
- a.chart reviews
- b.patient interviews
- c.an electronic questionnaire
- d.a meta analysis
- a.
- #4.The authors site only one guideline with specific instructions. It is attributed to the
- a.ASHT
- b.EULAR
- c.AOTA
- d.IFSHT
- a.
- #5.The authors were unable to identify the one most effective orthosis
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: October 19, 2016
Accepted:
July 20,
2016
Received in revised form:
May 20,
2016
Received:
August 18,
2015
Identification
Copyright
© 2016 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
