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
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".