Primerjava učinkovitosti ortoze za palec in običajnih terapij pri osteoartritisu palca : diplomsko delo

Flajs, Jerneja (author), Lampe, Tomaž (mentor), Pavlović, Monika (comentor), Levec, Tina (reviewer)

Uvod: Razširjenost osteoartritisa se je povečala s podaljšanjem življenjske dobe in je najpogostejše artritično obolenje, pri tem je najpogosteje prizadeto mesto roka, natančneje karpometakarpalni sklep palca. Posamezniki, ki trpijo zaradi osteoartritisa v karpometakarpalnem sklepu palca, se soočajo z oteklino in bolečino vzdolž baze palce in palčeve kepe (tenar), hkrati pa imajo zaradi zmanjšanih funkcionalnih sposobnosti težave med opravili, kjer je potrebno stiskanje z roko. Namen: Namen diplomskega dela je primerjati učinkovitosti ortoz za palec in običajne terapije pri osteoartritisu karpometakarpalnega sklepa palca na podlagi pregleda znanstvene in strokovne literature. Metode dela: Strokovno literaturo smo iskali v angleškem jeziku v podatkovnih bazah PubMed in Google Učenjak in jo zbirali od konca oktobra 2022 do sredine julija 2023. Ključne besede, ki smo jih pri tem uporabili, so bile: osteoarthritis in cmc joint; orthotic treatment for osteoarthritis in cmc, effectiveness of conservative treatment in cmc osteoarthritis. Rezultati: V diplomsko delo smo vključili 22 člankov. Vseh šest vključenih raziskav za zdravljenje z ortozo poroča o učinkovitosti na zmanjšanje bolečine in povečanje moči oprijema in lateralnega prijema. Ostalih šestnajst člankov opisuje ostale pristope zdravljenja (intraartikularna aplikacija kortikosteroidov, manualna terapija in nesteroidna protivnetna zdravila), ki so se izkazala kot zmerno učinkovita na kratki rok. Razprava in zaključek: Na podlagi pregleda literature smo ugotovili, da ni enovitega pristopa za zdravljenje osteoartritisa. Z injiciranjem kortikosteroidov in nesteroidnimi protivnetnimi zdravili lahko vplivamo na zmanjšanje bolečine, vendar so pri tem bolj opazni tudi stranski učinki in kratkoročna učinkovitost. Manualna terapija ima zmerne pozitivne učinke na zmanjšanje bolečine. Z uporabo ortoz lahko izboljšamo moč oprijema in moč lateralnega prijema in zmanjšamo bolečino, a se pojavi težava pri izboru ustrezne ortoze. Ortoze so se izkazale za najbolj učinkovite pri zmanjšanju bolečine in izboljšanju oziroma ohranjanju funkcije roke, najbolje v kombinaciji z drugim pristopom. V prihodnjih študijah bi se bilo potrebno osredotočiti na pristope, ki so učinkoviti na dolgi rok, pri tem pa tudi določiti enovit pristop za zdravljenje osteoartritisa karpometakarpalnega sklepa palca.

• Language: Slovenian
• Keywords: diplomska dela, ortotika in protetika, artritis, opornica za prst, konzervativno zdravljenje, ortotična oskrba
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [J. Flajs]
• Year: 2023
• Number of pages: 31 str., [3] str. pril.
• PID: 20.500.12556/RUL-150788
• UDC: 617.3
• COBISS.SI-ID: 165508099
• Publication date in RUL: 23.09.2023

Secondary language

• Language: English
• Title: Comparison of the effectiveness of a thumb orthosis and common therapies in osteoarthritis of the thumb : diploma work

Abstract

Introduction: The prevalence of osteoarthritis has increased with higher life expectancy and is the most common arthritic disease. Most commonly affected body part is the hand, specifically the carpometacarpal joint of the thumb. Individuals who suffer from osteoarthritis of the carpometacarpal joint of the thumb experience swelling and pain along the base of the thumb and the ball of the thumb and have difficulty during tasks that require a hand grip due to reduced functional abilities. Purpose: The purpose of the thesis is to compare the effectiveness of a thumb orthosis and conventional therapy in osteoarthritis of the carpometacarpal joint of the thumb based on a review of scientific and professional literature. Methods: We searched for professional literature in the English language in the PubMed and Google Scholar databases from the end of October 2022 to the middle of July 2023. The used keywords were: osteoarthritis and cmc joint; orthotic treatment of osteoarthritis in cmc, effectiveness of conservative treatment in osteoarthritis of cmc. Results: We included 22 articles in the thesis. All six included orthotic treatment studies reported efficacy in reducing pain, increasing hand grip and lateral grip strength. The other sixteen articles describe other treatment approaches (intra-articular application of corticosteroids, manual therapy, nonsteroidal anti-inflammatory drugs) that have been shown to be moderately effective in the short term. Discussion and conclusion: Based on the review of the literature, we found that there is no single approach to the treatment of osteoarthritis. By injecting corticosteroids and non-steroidal anti-inflammatory drugs, we can influence the reduction of pain, but side effects and short-term effectiveness are more noticeable. Manual therapy has moderate positive effects on pain reduction. The use of an orthosis can improve grip strength, lateral grip strength and reduce pain, but problem is choosing the appropriate orthosis. Orthosis have been shown as most effective for pain relief while improving or maintaining hand function, best when combined with other methods. Future studies should focus on approaches that are effective in the long term, while also defining a unified approach for the treatment of osteoarthritis of the carpometacarpal joint of the thumb.

• Keywords: diploma theses, orthotics and prosthetics, arthritis, finger splint, conservative treatment, orthotic care