Effectiveness of splinting for pain and function in people with thumb carpometacarpal osteoarthritis: a systematic review with meta-analysis
Buhler, Miranda
Cite this item:
Buhler M, Chapple CM, Stebbings S, Sangelaji B, David Baxter G, Effectiveness of splinting for pain and function in people with thumb carpometacarpal osteoarthritis: a systematic review with meta-analysis, Osteoarthritis and Cartilage (2018), doi: https://doi.org/10.1016/j.joca.2018.09.012
Permanent link to OUR Archive version:
http://hdl.handle.net/10523/8465
Abstract:
Objective: To examine the effectiveness of splinting for reducing pain and improving function and health-related quality of life (HR-QoL) in people with thumb base osteoarthritis (OA).
Design: The Cochrane Library, MEDLINE, Embase, CINAHL, ISI Web of Science, Scopus and Google Scholar, 3 trial registries and 2 conference proceedings were systematically searched for randomised and non-randomised controlled trials up to March 17th, 2018. Two reviewers independently applied the inclusion criteria to select potential studies and assess risk of methodologic bias using the Cochrane Collaboration’s Risk of Bias Tool. Studies were pooled using the inverse variance method to calculate standardised mean difference (SMD). Sensitivity analyses were conducted and the quality of evidence for each outcome was judged following the GRADE approach.
Results: Twelve studies were retrieved (n=1353), 4 comparing a splint to control and 8 to another splint. In the medium-term (3-12 months), low quality evidence showed that splints cause a moderate to large reduction in pain (SMD 0.7 [95% CI 1.04, 0.35], P < 0.0001) and small to moderate improvement in function (SMD 0.42 [95% CI 0.77, 0.08], P = 0.02). No significant effect was found at short-term or for different types of splints. No studies reported HR-QoL.
Conclusions: Splinting demonstrated a moderate to large effect for pain and small to moderate effect for function in the medium-term but not in the short term. Quality of the evidence is low. Major challenges are the lack of diagnostic criteria for thumb base OA and of a gold-standard outcome measure.
Date:
2018
Contributor:
Chapple, Cathy M.; Stebbings, Simon; Sangelaji, Bahram; Baxter, G. David
Publisher:
Elsevier
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Keywords:
Thumb; Trapeziometacarpal; Osteoarthritis; Splints; Systematic Review; Meta-Analysis
Research Type:
Journal Article
Languages:
English
Notes:
This is a PDF file of an unedited post-print version of a manuscript that has been accepted for publication. The final version of the accepted manuscript is now available online at: https://doi.org/10.1016/j.joca.2018.09.012 Please note access to the full text of the final manuscript version will depend on your personal or institutional entitlements. This early version of the manuscript is made available to you here to provide fast access to the article and is not intended to be the final version of the article. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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