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404 Mechanisms of a Dynamic Stability Protocol for Persons with Thumb Osteoarthritis

Part of: JCTS_2024_ABSTRACT_COLLECTION

Published online by Cambridge University Press:  03 April 2024

Corey McGee ,
Halil Ibrahim Ergen ,
Paula Ludewig ,
Ann Brearley ,
Ann Van Heest  and
Erin Krebs
Corey McGee
Affiliation:
University of Minnesota
Halil Ibrahim Ergen
Affiliation:
Gaziantep University
Paula Ludewig
Affiliation:
University of Minnesota
Ann Brearley
Affiliation:
University of Minnesota
Ann Van Heest
Affiliation:
University of Minnesota
Erin Krebs
Affiliation:
Minneapolis VA Health Care System
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Abstract

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OBJECTIVES/GOALS: Our aims are to 1) describe changes in thumb Carpometacarpal (CMC1) joint stability following an 8-week clinic-based dynamic stability exercise program using computerized tomography (CAT) and 2) to evaluate the agreement between ultrasound and CAT (reference standard) when quantifying thumb CMC stability. METHODS/STUDY POPULATION: Aim 1: We have enrolled 13/49 participants in a prospective pre-post interventional study of an 8-week clinic-based occupational therapy dynamic stability program. The primary outcome will be change in stability (thumb metacarpal subluxation in mm) when forcefully loading the thumb as per CAT from pre-treatment to post-treatment at 9 weeks. Aim 2: Same 49 participants are undergoing a one-time ultrasound during baseline assessment. Agreement of ultrasound and CAT measurements (thumb metacarpal subluxation in mm) will be assessed by the Bland-Altman method. RESULTS/ANTICIPATED RESULTS: Exercise is a first-line treatment of CMC1 OA yet there is insufficient evidence to support this. Progression of CMC1 OA is characterized by altered joint mechanics. Joint replacement surgery may reduce pain but often worsens thumb mechanics and overall hand function. This study is the first to test the sustained biomechanical effects of non-invasive thumb exercises. Should these benefits exist, this will further support exercise as a first-tier intervention. Should ultrasound be a suitable proxy for CAT, therapists/physicians could monitor thumb CMC mechanics in response to treatment without risk of radiation exposure. We anticipate 1) a statistically significant reduction in thumb CMC subluxation at 9 weeks follow up and 2) high agreement between sonographic and CAT measures of thumb stability. DISCUSSION/SIGNIFICANCE: This study will lay the foundation for future work and may offer critical support for the use of a non-pharmacological and non-surgical approach as first-line treatment of a highly disabling disease. Future study should include controlled trials where hand function, activity limitation, disease progression, and costs are the outcomes in interest.

Type
Precision Medicine/Health
Information
Journal of Clinical and Translational Science , Volume 8 , Issue s1 , April 2024 , pp. 120
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2024. The Association for Clinical and Translational Science

Footnotes

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The online version of this abstract has been updated since original publication. A notice detailing the change has been published at https://doi.org/10.1017/cts.2024.528.