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A self-managed exercise therapy program for wrist osteoarthritis: study protocol for a randomized controlled trial
Skane Univ Hosp, Sweden; Lund Univ, Sweden.
Skane Univ Hosp, Sweden; Lund Univ, Sweden.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Skane Univ Hosp, Sweden; Lund Univ, Sweden.ORCID iD: 0000-0003-1334-3099
Univ Gothenburg, Sweden.
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2023 (English)In: Trials, E-ISSN 1745-6215, Vol. 24, no 1, article id 628Article in journal (Refereed) Published
Abstract [en]

BackgroundPost-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).MethodsThis 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.DiscussionThe 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 registrationClinicalTrials.gov, NCT05367817. Retrospectively registered on 27 April 2022. https://clinicaltrials.gov.

Place, publisher, year, edition, pages
BMC , 2023. Vol. 24, no 1, article id 628
Keywords [en]
Wrist osteoarthritis; SLAC; SNAC; Exercise therapy; Neuromuscular control; Self-management; Randomized controlled trial
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-198836DOI: 10.1186/s13063-023-07668-4ISI: 001081888600004PubMedID: 37784197OAI: oai:DiVA.org:liu-198836DiVA, id: diva2:1808752
Note

Funding Agencies|Not applicable.

Available from: 2023-11-01 Created: 2023-11-01 Last updated: 2024-04-15

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