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| Effect of physical therapy interventions in individuals with primary thumb carpometacarpal osteoarthritis: a systematic review and meta-analysis | 
| Tossini NB, de Sousa Melo C, Braz de Oliveira MP, de Fatima Carreira Moreira R, da Silva Serrao PRM | 
| Disability and Rehabilitation 2024;46(26):6251-6265 | 
| systematic review | 
| 
                     PURPOSE: This systematic review and meta-analysis aimed to investigate the effect of physiotherapeutic interventions in individuals with thumb primary CMC OA on the outcomes of pain, hand function, grip or pinch strength. METHODS: RCTs that used some type of physiotherapeutic intervention compared to a passive or active control group were included. The quality of the evidence was assessed using the GRADE approach and, for the calculation of the meta-analysis, the standardized difference of means (SMD) was used. RESULTS: Nineteen studies (n = 1477) were included and eight studies (n = 568) underwent meta-analysis. Orthosis intervention was superior to passive control group for pain improvement (SMD -1.02, p = 0.03, very low evidence), grip strength (SMD 0.45, p = 0.02, very low evidence) and pinch strength (SMD 1.78, p = 0.01, very low evidence), but there was no improvement in hand function (p = 0.54). The use of a neoprene orthosis was similar to the use of a thermoplastic orthosis in improving pain (p = 0.38), hand function (p = 0.50), grip strength (p = 0.42) and pinch strength (p = 0.14). The use of short thermoplastic orthosis was also similar to long thermoplastic orthosis in improving pain (p = 0.88) and hand function (p = 0.58). CONCLUSION: The use of orthoses is superior to no intervention in all outcomes, exception hand function.  
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