title: Stabilization effectiveness and functionality of different thumb orthoses in female patients with first carpometacarpal joint osteoarthritis.
abstract: BACKGROUND
  Thumb orthoses have to reconcile and satisfy competing goals: stability and mobility. The purpose of the study was to characterize the stabilization effectiveness and functionality of different thumb carpometacarpal osteoarthritis orthoses.
  
  
  METHODS
  Eighteen female carpometacarpal osteoarthritis subjects were included. Four orthoses were compared: BSN medical (BSN); Push braces (PUSH); Sporlastic (SPOR); and medi (MEDI). Three-dimensional thumb kinematics during active opposition-reposition with and without orthosis was quantified. Ranges-of-motion of the carpometacarpal and metacarpophalangeal joint in x- (flexion-extension), y- (adduction-abduction) and z-direction (pronation-supination) were determined. Hand functionality was examined by Sollerman test.
  
  
  RESULTS
  All orthoses restricted carpometacarpal range-of-motion in all directions. In x-direction carpometacarpal range-of-motion was smallest with MEDI and BSN, in y-direction largest with PUSH compared to all other orthoses, in z-direction smaller with BSN and MEDI compared to PUSH, but similar to SPOR. All orthoses restricted metacarpophalangeal range-of-motion in x-direction, except PUSH. In x-direction metacarpophalangeal range-of-motion was smallest with MEDI compared to all other orthoses. In y-direction and z-direction only BSN and MEDI restricted metacarpophalangeal range-of-motion. Sollerman score was highest with PUSH, lowest with MEDI and both differed from other orthoses. Values for BSN and SPOR were similar and lay between PUSH and MEDI.
  
  
  CONCLUSIONS
  Stabilization is borne by functionality. The high stabilization effectiveness provided by MEDI resulted in lowest hand functionality. PUSH, which partially stabilized the CMC joint and allowed large motions in the MCP joint, afforded largest hand functionality. Best compromise of stability and functionality could be reached with BSN. Long-term studies are needed to monitor clinical efficacy.
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany. Electronic address: hamann@dshs-koeln.de.
authors.forename: Nina
authors.initials: N
authors.lastname: Hamann
authors.affiliation: Joint Centre Brühl, Franziskanerhof 3a, 50321 Brühl, Germany.
authors.forename: Jörn
authors.initials: J
authors.lastname: Heidemann
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Heinrich
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
authors.forename: Han
authors.initials: H
authors.lastname: Wu
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Bleuel
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Gonska
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
authors.forename: Gert-Peter
authors.initials: GP
authors.lastname: Brüggemann
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D001915:Braces; D052737:Carpometacarpal Joints / Q000503:physiopathology*; D005081:Exercise Therapy; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009989:Orthotic Devices / Q000592:standards*; D010003:Osteoarthritis / Q000503:physiopathology / Q000534:rehabilitation*; D016059:Range of Motion, Articular / Q000502:physiology; D013933:Thumb / Q000503:physiopathology*
keywords: CMC; Immobilization; Kinematics; OA; Orthosis; Splinting; TMC