Proprioceptive Thumb Exercises Program in Patients With Carpometacarpal Joint Osteoarthritis
Proprioceptive Thumb Exercises Program in Patients With Carpometacarpal Joint Osteoarthritis
Osteoarthritis (OA) is a chronic and prevalent joint disorder with great impact on quality of
 life and high economic burden. Although a number of conservative therapies have proven to be
 effective for the management of hand OA, only modest treatment effects were reported for most
 individual interventions. The aim of the proposed study is to assess the effect of
 proprioceptive training on pain, function and sense perception in patients with
 carpometacarpal osteoarthritis (CMC OA).
A randomized, controlled, single-center, double-blind, clinical trial, with 1:1 allocation
 ratio, will be carried out involving patients diagnosis of CMC joint OA grade 1-2 (aged 18
 years and above). Both assessor and statistician will remained blinded. The research
 diagnostic criteria for carpometacarpal joint osteoarthritis will be used to assess all
 individuals who agree to participate. Based on the clinical and radiological findings, the
 participants will be classified by a rheumatology. Those with CMC OA grade 2-3 will be
 included in the study.

 Standard conservative thumb CMC joint OA treatments will received for both the control and
 experimental groups for a period of 12 weeks. The experimental group will received a
 proprioceptive training program during the same intervention period, which will be conducted
 twice weekly (24 sessions).

 The severity of pain with activity will be measured according to the visual analog scale
 (VAS). QuickDASH questionnaire will be used to measure upper extremity function. Patient's
 occupational performance will be measured with the Canadian Occupational Performance Measure
 (COPM) and proprioception with Joint position sense (JPS) testing. All outcome measures will
 be collected at baseline, immediately following the intervention at 4 weeks and at 12 weeks
 following the end of the intervention.

 Participation in the study will be voluntary and patients will be included if they satisfied
 specific inclusion criteria.

 All procedures will be follow in accordance with the ethical standards of the responsible
 committee on human experimentation (institutional and national) and with the Helsinki
 Declaration. All participants will sign a written informed consent in accordance with
 guidelines approved by the local ethics committee.
Inclusion Criteria:

 -  Diagnosis of grade I, II or III thumb CMC joint OA in their dominant hand according to
 the Eaton Classification Stage

 -  Pain rating of 4/10 on the Visual Analogue Scale (VAS) during activities of daily
 living (ADLs) at the time of the therapy initial evaluation.

 -  The ability to read and understand the patient information sheets and exercises

 Exclusion Criteria:

 -  Neurological disorder affecting the upper limb.

 -  Had received specific treatment for hand or thumb pain in the same limb in the last 6
 months including an intra-articular joint injection to wrist, fingers, or thumb; -
 Fractures or a significant hand injury or previous surgery to the wrist or hand;

 -  Tenosynovitis and/or Dupuytren disease