A self-managed exercise therapy program for wrist osteoarthritis : study protocol for a randomized controlled trial
Larsson, Sara L. LU ; Ekstrand, Elisabeth LU
; Dahlin, Lars B.
LU
; Björkman, Anders
LU
and Brogren, Elisabeth
LU
(2023)
In Trials
24(1).
- Abstract
Background: Post-traumatic wrist osteoarthritis (OA) can eventually lead to pain, muscular weakness, and stiffness of the wrist, which can affect the function of the entire upper limb and reduce the quality of life. Although there is strong evidence that all patients with OA should be offered adequate education and exercises as a first-line treatment, an effective self-management program, including structured education and therapeutic exercises, has not yet been introduced for individuals with wrist OA. This trial aims to evaluate the effectiveness of an exercise therapy program with joint protective strategies to improve neuromuscular control (intervention group) compared to a training program with range of motion exercises (control... (More)
Background: Post-traumatic wrist osteoarthritis (OA) can eventually lead to pain, muscular weakness, and stiffness of the wrist, which can affect the function of the entire upper limb and reduce the quality of life. Although there is strong evidence that all patients with OA should be offered adequate education and exercises as a first-line treatment, an effective self-management program, including structured education and therapeutic exercises, has not yet been introduced for individuals with wrist OA. This trial aims to evaluate the effectiveness of an exercise therapy program with joint protective strategies to improve neuromuscular control (intervention group) compared to a training program with range of motion exercises (control group). Methods: This is a single-blinded randomized controlled trial (RCT) with two treatment arms in patients with symptomatic and radiographically confirmed wrist OA. The trial will be conducted at a hand surgery department. The participants will be randomly assigned either to a neuromuscular exercise therapy program or to a training program with range of motion exercises only. Participants in both groups will receive a wrist orthosis and structured education on wrist anatomy, pathophysiology, and joint protective self-management strategies. The programs consist of home exercises that will be performed twice a day for 12 weeks. The Patient-Rated Wrist Evaluation (PRWE) is the primary outcome measure of pain and function. Wrist range of motion (ROM), grip strength, the Numeric Pain Rating scale (NPRS), Disabilities of the Arm, Shoulder, and Hand (DASH), the General Self-Efficacy Scale (GSES), Global Rating of Change (GROC), and conversion to surgery are the secondary measures of outcome. Assessments will be performed at baseline and at 3, 6, and 12 months after baseline by a blinded assessor. Discussion: The upcoming results from this trial may add new knowledge about the effectiveness of a self-managed exercise therapy program on pain and function for individuals with wrist OA. If the present self-management program proves to be effective, it can redefine current treatment strategies and may be implemented in wrist OA treatment protocols. Trial registration: ClinicalTrials.gov, NCT05367817. Retrospectively registered on 27 April 2022. https://clinicaltrials.gov .
(Less)
- author
- Larsson, Sara L.
LU
; Ekstrand, Elisabeth
LU
; Dahlin, Lars B.
LU
; Björkman, Anders
LU
and Brogren, Elisabeth
LU
- organization
- publishing date
- 2023-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Exercise therapy, Neuromuscular control, Randomized controlled trial, Self-management, SLAC, SNAC, Wrist osteoarthritis
- in
- Trials
- volume
- 24
- issue
- 1
- article number
- 628
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:37784197
- scopus:85173017973
- ISSN
- 1745-6215
- DOI
- 10.1186/s13063-023-07668-4
- language
- English
- LU publication?
- yes
- id
- 4f4f8ef9-d62c-4eed-aa39-344586180e1b
- date added to LUP
- 2023-12-06 13:21:18
- date last changed
- 2024-04-19 07:55:56
@article{4f4f8ef9-d62c-4eed-aa39-344586180e1b,
abstract = {{<p>Background: Post-traumatic wrist osteoarthritis (OA) can eventually lead to pain, muscular weakness, and stiffness of the wrist, which can affect the function of the entire upper limb and reduce the quality of life. Although there is strong evidence that all patients with OA should be offered adequate education and exercises as a first-line treatment, an effective self-management program, including structured education and therapeutic exercises, has not yet been introduced for individuals with wrist OA. This trial aims to evaluate the effectiveness of an exercise therapy program with joint protective strategies to improve neuromuscular control (intervention group) compared to a training program with range of motion exercises (control group). Methods: This is a single-blinded randomized controlled trial (RCT) with two treatment arms in patients with symptomatic and radiographically confirmed wrist OA. The trial will be conducted at a hand surgery department. The participants will be randomly assigned either to a neuromuscular exercise therapy program or to a training program with range of motion exercises only. Participants in both groups will receive a wrist orthosis and structured education on wrist anatomy, pathophysiology, and joint protective self-management strategies. The programs consist of home exercises that will be performed twice a day for 12 weeks. The Patient-Rated Wrist Evaluation (PRWE) is the primary outcome measure of pain and function. Wrist range of motion (ROM), grip strength, the Numeric Pain Rating scale (NPRS), Disabilities of the Arm, Shoulder, and Hand (DASH), the General Self-Efficacy Scale (GSES), Global Rating of Change (GROC), and conversion to surgery are the secondary measures of outcome. Assessments will be performed at baseline and at 3, 6, and 12 months after baseline by a blinded assessor. Discussion: The upcoming results from this trial may add new knowledge about the effectiveness of a self-managed exercise therapy program on pain and function for individuals with wrist OA. If the present self-management program proves to be effective, it can redefine current treatment strategies and may be implemented in wrist OA treatment protocols. Trial registration: ClinicalTrials.gov, NCT05367817. Retrospectively registered on 27 April 2022. https://clinicaltrials.gov .</p>}},
author = {{Larsson, Sara L. and Ekstrand, Elisabeth and Dahlin, Lars B. and Björkman, Anders and Brogren, Elisabeth}},
issn = {{1745-6215}},
keywords = {{Exercise therapy; Neuromuscular control; Randomized controlled trial; Self-management; SLAC; SNAC; Wrist osteoarthritis}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Trials}},
title = {{A self-managed exercise therapy program for wrist osteoarthritis : study protocol for a randomized controlled trial}},
url = {{http://dx.doi.org/10.1186/s13063-023-07668-4}},
doi = {{10.1186/s13063-023-07668-4}},
volume = {{24}},
year = {{2023}},
}