Abstract
Objective
To provide an overview of rehabilitation for patients who underwent first carpometacarpal
joint (CMC-1) arthroplasty, with emphasis on early active mobilization.
Data Sources
PubMed/MEDLINE, Embase, CINAHL, and Cochrane were searched.
Study Selection
Articles written in English that described the postoperative regimen (including immobilization
period/method and/or description of exercises/physical therapy, follow-up 6wk) on
CMC-1 arthroplasty were included.
Data Extraction
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was
used as guidance in this review, and methodological quality was assessed using the
Effective Public Health Practice Project quality assessment tool. Randomized studies
were additionally scored using the Physiotherapy Evidence Database scale.
Data Synthesis
Twenty-seven studies were included consisting of 1015 participants, in whom 1118 surgical
procedures were performed. A summary of the components of postoperative rehabilitation
used in the included studies of CMC-1 osteoarthritis is presented for different surgical
interventions. We found that early active recovery (including short immobilization,
early initiation of range of motion and strength exercises) provides positive outcomes
for pain, limitations in activities of daily living, and grip and pinch strength,
but comparative studies are lacking. Furthermore, 3 postoperative exercises/therapy
phases were identified in the literature—the acute phase, the unloaded phase, and
the functional phase—but again comparative studies are lacking.
Conclusions
Early active recovery is used more often in the literature and does not lead to worse
outcomes or more complications. This systematic review provides guidance for clinicians
in the content of postoperative rehabilitation for CMC-1 arthroplasty. The review
also clearly identifies the almost complete lack of high-quality comparative studies
on postoperative rehabilitation after CMC-1 arthroplasty.
Keywords
List of abbreviations:
ADL (activities of daily living), CMC-1 (first carpometacarpal joint), MCP-1 (first metacarpophalangeal joint), OA (osteoarthritis), ROM (range of motion), SMD (scaphometacarpal distance)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 10, 2017
Footnotes
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
