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Comparative Effectiveness of Orthoses for thumb osteoarthritis: A Systematic Review and Network Meta-Analysis.
Archives of Physical Medicine and Rehabilitation ( IF 4.3 ) Pub Date : 2020-07-01 , DOI: 10.1016/j.apmr.2020.06.012
Nicola Marotta 1 , Andrea Demeco 1 , Cinzia Marinaro 1 , Lucrezia Moggio 1 , Ilaria Pino 1 , Marianna Barletta 1 , Annalisa Petraroli 1 , Antonio Ammendolia 1
Affiliation  

OBJECTIVE To evaluate the best option among orthoses for carpometacarpal osteoarthritis of the thumb, using a network meta-analysis. DATA SOURCES Medline, Embase, Cochrane, and ClinicalTrials.gov registry databases were used PubMed, Embase, Cochrane Controlled Trials Register, Cochrane and other databases were used without language restrictions. STUDY SELECTION We searched randomized controlled trials (RCTs) on adults with osteoarthritis of the thumb by studying any orthosis in from the beginning to March 10, 2020 DATA EXTRACTION: Data were extracted and checked for accuracy and completeness by pairs of reviewers. Outcomes were pain and function. Comparative treatment effects were analysed by random-effects model for direct pair-wise comparisons and Bayesian network meta-analyses to integrate direct and indirect. DATA SYNTHESIS 11 RCTs involving 619 patients were included. We evaluated five groups, for 4 different orthoses: short thermoplastic carpometacarpal splint (Rigid CMC) (n=5), long thermoplastic carpometacarpal-metacarpophalangeal splint (Rigid CMC-MCP) (n=7), short neoprene carpometacarpal splint (Soft CMC) (n=1), long neoprene carpometacarpal-metacarpophalangeal splint (Soft CMC-MCP) (n=5), and one as a control group (n=5). Our results show that all splints were superior to placebo to reduce pain intensity and the top-ranked intervention was the Rigid CMC-MCP (surface under the cumulative ranking curve analysis, SUCRA score: 65.4). In function evaluation, we report a 71.6 SUCRA for Rigid CMC. CONCLUSIONS Although the current evidence is unclear on the use of the splint in osteoarthritis of the thumb, it is not known which orthosis is more effective and whether the orthosis is more effective than other interventions, the network Meta-analysis shows that a long thermoplastic splint it is the best choice for pain relief and the short thermoplastic carpometacarpal splint is the best treatment to increase function. These results may suggest initial treatment with a long rigid orthosis and then a short rigid orthosis.

中文翻译:

拇指骨关节炎矫形器的比较有效性:系统评价和网络荟萃分析。

目的 使用网络荟萃分析评估拇指腕掌骨关节炎矫形器的最佳选择。数据来源 使用 Medline、Embase、Cochrane 和 ClinicalTrials.gov 注册数据库 PubMed、Embase、Cochrane Controlled Trials Register、Cochrane 和其他数据库,没有语言限制。研究选择 我们通过研究从 2020 年 3 月 10 日开始到 2020 年 3 月 10 日期间的任何矫形器,检索了关于成人拇指骨关节炎的随机对照试验 (RCT)。结果是疼痛和功能。通过用于直接成对比较的随机效应模型和整合直接和间接的贝叶斯网络元分析来分析比较治疗效果。数据综合 包括 11 项 RCT,涉及 619 名患者。我们针对 4 种不同的矫形器评估了 5 组:短热塑性腕掌骨夹板(刚性 CMC)(n=5)、长热塑性腕掌骨-掌指骨夹板(刚性 CMC-MCP)(n=7)、短氯丁橡胶腕掌骨夹板(软 CMC) (n=1), 长氯丁橡胶腕掌-掌指夹板 (Soft CMC-MCP) (n=5), 1 个作为对照组 (n=5)。我们的结果表明,所有夹板在减轻疼痛强度方面都优于安慰剂,排名最高的干预措施是刚性 CMC-MCP(累积排名曲线分析下的表面,SUCRA 评分:65.4)。在功能评估中,我们报告了刚性 CMC 的 71.6 SUCRA。结论 尽管目前关于夹板在拇指骨关节炎中的使用的证据尚不清楚,目前尚不清楚哪种矫形器更有效,该矫形器是否比其他干预措施更有效,网络荟萃分析表明,长热塑性夹板是缓解疼痛的最佳选择,短热塑性腕掌夹板是最佳治疗方法增加功能。这些结果可能表明使用长刚性矫形器进行初始治疗,然后使用短刚性矫形器。
更新日期:2020-07-01
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