The effect of proprioceptive training on functional recovery in thumb base osteoarthritis: A case study

Abstract

The dorsal thumb ligament complex is the structure with the highest concentration of mechanoreceptors, especially Ruffini corpuscles. All the afferents originating from the thumb's mechanoreceptors constitute its proprioception, which is essential for well-adapted sensorimotor control (Suetterlin and Sayer, 2014). Diseases that have implications on the thumb, such as trapeziometacarpal (TM) osteoarthritis (OA), impact its function and consequently, the occupational performance of individuals.

A 50-year-old woman with TM OA was referred for conservative Occupational Therapy (OT) treatment, diagnosed four months prior, with a medical report indicating stage II according to Eaton et al. in the right, dominant hand. She worked as an administrative employee for 28 years and is currently a homemaker. In the initial assessment, she expressed concern and frustration while performing her daily activities, reported pain, and showed deterioration in manual function.

A traditional conservative treatment combined with proprioceptive exercises was applied for three months. Outcome measures indicated an improvement in thumb proprioception and a significant enhancement in occupational performance. Pain decreased. These measures included the Joint Position Sense Test, the Canadian Occupational Performance Measure, the Functional Subscale of the Australian Canadian Osteoarthritis Hand Index, and the Visual Analog Scale. Follow-ups were conducted at 1 month and 3 months.

The treatment significantly improved the occupational performance and proprioceptive sensitivity of a patient with functional impairment related to TM OA in her dominant hand.