Effectiveness of exercise therapy in patients with thumb carpometacarpal osteoarthritis: A multicenter, randomized controlled trial
Authors' conclusion
In patients with CMC-1 OA, an orthosis + exercise therapy is preferred over orthosis-only because of the favorable secondary outcomes.
Study context
- Population
- Adult patients with thumb carpometacarpal (CMC-1) osteoarthritis (OA), 18 outpatient hand surgery and therapy clinics in the Netherlands
- Participants
- 166 patients
- Comparison
- Orthosis + exercise therapy vs orthosis-only
- Orthosis + exercisen = 81
- Orthosis-onlyn = 85reference
- Primary endpoint
- Co-primary: pain (Michigan Hand Outcomes Questionnaire pain subscale) at 3 months and conversion to surgery <1 year
- Follow-up
- 3 months; <1 year
Methodological detailsmulticentre, single-blinded
- Multicentre
- Single-blinded
Primary result
Pain (MHQ pain subscale) · 3 months
Least mean square difference
3.7
95% CI −1.0-8.3
Between Orthosis + exercise and Orthosis-only
least mean square difference 3.7 (95% CI −1.0-8.3)
As reported in the abstract
Secondary outcomes
| Outcome | Orthosis + exercise | Orthosis-only | Risk difference (CI) | |
|---|---|---|---|---|
| Co-primary: conversion to surgery · <1 yearNot significantly different, due to low conversion rates | 4.9% | 9.4% | 4.7% (−3.3-12.2%) | |
| −5051015Difference (linear scale) |
| Outcome | Difference (CI) |
|---|---|
| Total societal costs per patient37% lower | -€825 (−2072-421) |
Other secondary outcomes
- Orthosis + exercise had favorable outcomes in MHQ ADL (6mo), work ability (all time points), satisfaction with hand (3mo), MHQ total (3mo, 6mo), satisfaction with treatment results (all except 6mo), grip strength (6w), illness perceptions (3mo)
Original publication
Effectiveness of exercise therapy in patients with thumb carpometacarpal osteoarthritis: A multicenter, randomized controlled trial. Osteoarthritis Cartilage. Published 23 October 2025. doi:10.
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