How changes in pain and strength associate with meaningful change in activity and participation following a 6 week client-centered program for patients with thumb carpometacarpal joint osteoarthrtitis
Notice bibliographique
Résumé
Background: Osteoarthritis (OA) is a degenerative joint disease affecting an estimated 1 in 10 Canadians (1). The disease commonly presents at the carpometacarpal (CMC) joint of the thumb. Occupational therapists caring for patients with thumb CMC joint OA frequently use treatment strategies directed at impairment level outcomes. Patients, however, have been found to view themselves with respect to their activities and participation (2). Knowing the extent to which changes in impairment outcomes will impact activity and participation is important for therapists yet it has not been studied with respect to thumb CMC joint OA. Objective: This study answered the following question: “In patients with stage I to IV osteoarthritis of the thumb carpometacarpal joint, to what extent do changes in pain and strength that occur following a client-centered, 6 week program of orthosis use, joint protection education and exercises associate with meaningful change in activity and participation?”Design and Procedure: A pre-post design was utilized with assessment points at study entry and 6 weeks later. The study was conducted at the Centre Professionnel d’Ergothérapie in Montreal. At study entry, participants were provided with a client-centered, 6 week treatment program consisting of a thumb orthosis, home isometric strengthening exercises and joint protection education.Population: Patients with thumb CMC joint OA who were referred to the Centre Professionnel d’Ergothérapie and occupational therapy at Maisonneuve Rosemont Hospital were recruited for the study. All subjects provided informed consent. Measurement: Demographic information was collected for each participant. Exposure variables were measured with the visual analogue scale for pain and pinch strength. The primary outcome measure was the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Secondary outcome measures included joint goniometry for active range of motion, the Australian/Canadian Osteoarthritis Hand Index and the Canadian Occupational Performance Measure. Analysis: Two continuous explanatory variables and one continuous outcome variable were analyzed using a multiple regression model. All other data was analyzed using descriptive statistics and Pearson correlation coefficients.Sample Size: A total of 38 participants were recruited for the study. Ethics: Approval was obtained from the McGill Institutional Review Board and the Maisonneuve Rosemont Hospital Research Ethics Board. Recruitment was carried out by a research assistant. Informed consent was obtained. Results: The results demonstrated that pain and lateral pinch strength at 6 weeks had a statistically significant effect on change in activity and participation.1. The Canadian Arthritis Society. Types of Arthritis. Retrieved from www.arthritis.ca2. American Occupational Therapy Association Fact Sheet. Occupational-based hand therapy. The unique role of occupational therapy in rehabilitation of the hand. AOTA. Bethesda, Maryland.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».