Psychosocial Factors a Prognostic Study of Pain in Patients With CMC Osteoarthritis

Study Overview
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Brief Summary
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In this clinical trial, females with a diagnosis of thumb CMC OA, will be recruited. The primary outcome of potential risk factors of osteoarthritis, pain and function will be measured using the demographic data, visual analog scale (VAS) and Disabilities of the Arm, Shoulder and Hand (QuickDASH). Secondary out-comes will include the Pain Self-Efficacy Questionnaire (PSEQ), Tampa Scale of Kinesiophobia (TSK), Fear Avoidance Beliefs Questionnaire (FABQ), Hospital Anxiety and Depression Scale (HADS) and Impairment and Functioning Inventory (IFI). Measurements will be taken at the baseline, three, six and 12 months follow up.

Detailed Description
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The study will start recruitment in April 2019.In this clinical trial, 50-100 females, aged 50 to 90 years of age, with a diagnosis of thumb CMC OA, will be recruited. The primary outcome of potential risk factors of osteoarthritis, pain and function will be measured using the demographic data, visual analog scale (VAS) and Disabilities of the Arm, Shoulder and Hand (QuickDASH). Secondary out-comes will include the Pain Self-Efficacy Questionnaire (PSEQ), Tampa Scale of Kinesiophobia (TSK), Fear Avoidance Beliefs Questionnaire (FABQ), Hospital Anxiety and Depression Scale (HADS) and Impairment and Functioning Inventory (IFI). Measurements will be tak-en at the baseline, three, six and 12 months follow up.

Official Title
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Psychosocial Factors a Prognostic Study of Pain Persistence in Patients With Thumb Carpometacarpal Osteoarthritis

Conditions
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Pain, Osteoarthritis

Intervention / Treatment
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* Other: Standard of Care Hand Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: women older than 18 years diagnosed with bilateral thumb CMC OA a reported pain intensity during activities of daily living (ADLs) of up to 4 of 10 on the visual analog scale (VAS) The referring hand surgeon will made the diagnosis of CMC OA based on radiographs and clinical exploration. Exclusion Criteria: neurologic disorder affecting the upper limb had received previous treatment for their hand problem in the last 6 months including an intra-articular joint injection to wrist, fingers, or thumb had fractures or a significant hand injury or previous surgery to the wrist or hand had hand or finger tenosynovitis and/or Dupuytren disease patients who did not complete any questionnaire or if they did not sign the informed consent.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Cohort Study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Standard of Care<br>short thumb orthoses during ADL, joint reeducation for hand used, radial nerve gliding exercises and thumb proprioception exercises | Other: Standard of Care Hand Therapy<br>* 8 sessions 2 times a week for 4 weeks<br>* Other names: Proprioception exercises;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline to 12 months Visual Analog Scale (VAS) | Pain scale VAS; 0: no pain, 100: maximum pain | baseline, three, six and 12 months follow up | 
| Change from baseline to 12 months Quick Disabilities of the Arm, Shoulder and Hand | Self Report Function,QuickDash scores range from 0 to 100, higher scores means more dysfunction | baseline, three, six and 12 months follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline to 12 months using the Pain Self-Efficacy Questionnaire | Confidence in performing activities of daily living,They answer by circling a number on a 7-point Likert scale under each item, where 0 = not at all confident and 6= completely confident. A total score, ranging from 0 to 60, is calculated by adding the scores for each item. Higher scores reflect stronger self- efficacy beliefs. | baseline, three, six and 12 months follow up | 
| Change from baseline to 12 months using the Tampa Scale of Kinesiophobia | measure of fear of movement, the total score ranges between 17 and 68. A high value on the TSK indicates a high degree of kinesiophobia, and a cutoff score was developed by Vlaeyen (1995), where a score of 37or over is considered as a high score, while scores below that are considered as low scores. Use of a total score (including all 17 items) is recommended, although practitioners may wish to interpret results using two subscales | baseline, three, six and 12 months follow up | 
| Change from baseline to 12 months using the Fear Avoidance Beliefs Questionnaire | self report measure of avoidance of activities of daily livin, The questionnaire consists of 16 items in which a patient rates their agreement with each statement on a 7-point Likert scale. Where 0= completely disagree, 6=completely agree. There is a maximum score of 96. A higher score indicates more strongly held fear avoidance belief | baseline, three, six and 12 months follow up | 
| Change from baseline to 12 months using the Hospital Anxiety and Depression Scale | Measure Depression and Anxiety,Each item on the questionnaire is scored from 0-3 and this means that a person can score between 0 and 21 for either anxiety or depression. The higher the score indicates heightened anxiety or depression | baseline, three, six and 12 months follow up | 
| Change in from baseline to 12 months using the Impairment and Functioning Inventory | Function, . It consists of 30 items with two related subscales: Daily Functioning and Impairment (perceived current level of functioning compared with the level of functioning before pain onset). 30 questions scored 0-4. Higher score indicates increased ability to perform activities of daily living | baseline, three, six and 12 months follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain, osteoarthritis, function