The Effect of Proprioception Training on Pain Intensity in Thumb Basal Joint Osteoarthritis: A Randomized Controlled Trial

Raquel Cantero-Téllez, David Pérez-Cruzado, Jorge Hugo Villafañe, Santiago García-Orza, Nancy Naughton, Kristin Valdes, Raquel Cantero-Téllez, David Pérez-Cruzado, Jorge Hugo Villafañe, Santiago García-Orza, Nancy Naughton, Kristin Valdes

Abstract

A randomized controlled trial of forty-five females over 18 years of age with diagnosis of thumb basal osteoarthritis in their dominant hand and with a minimum pain rating of 4/10 on the Visual Analogue Scale (VAS) during activities of daily living (ADLs) were recruited from March to June 2021. The group receiving proprioception training was compared to routine conservative physiotherapy treatment. The main purpose of this clinical trial is to test the effect of proprioception training on pain intensity in subjects with thumb osteoarthritis. Primary outcome was joint position sense (JPS) for the assessment of CMC proprioception and secondary outcomes were Visual Analogue Scale (VAS) and Canadian Occupational Performance Measure (COPM) for the assessment of patient satisfaction and the Quick-DASH which assessed upper limb function. A block randomization was carried out for the control group (n = 22) and experimental group (n = 23). Participants and evaluator were blinded to the group assignment. Proprioception training produced a statistically significant reduction in pain post intervention, but this reduction was small (d = 0.1) at the 3-month follow-up. JPS accuracy demonstrated statistically significant differences between the groups (p = 0.001) post-intervention and at the 3-month follow-up (p < 0.003). Statistically significant differences between means were found in both the Quick-Dash and COPM post intervention (both, p < 0.001), as well as at the 3-month follow-up (both, p < 0.001). There was a significant time factor for the reduction of pain intensity over time but effect sizes between groups was small at the 3-month follow-up period. Proprioceptive training improves thumb JPS accuracy; however, it does not contribute to a reduction in pain intensity in the long term. The inclusion of a proprioceptive program may be beneficial for improving individuals with thumb CMC OA sensorimotor performance. The study was registered at ClinicalTrials.gov NCT04738201. No funding was provided for this study.

Keywords: carpometacarpal joint; joint position sense; proprioception; thumb osteoarthritis; thumb pain.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Short thumb orthosis.
Figure 2
Figure 2
Movement to be reproduced by patients. (a) manual distraction of the CMC joint; (b) massage of the adductor thumb muscle; (c) resistive exercises for the first dorsal interosseous; (d) move their thumb to the position as had been previously demonstrated; (e) movements of the thumb in different degrees and/or stop at the numbers indicated by the therapist on a stick; (f) pass a marble along the radial side of the index finger.
Figure 3
Figure 3
Flow chart of the study.

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