Clinical Aspects of Hand Osteoarthritis: Non-pharmacological management, clinical assessment and disease impact
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AbstractBackground: To be able to treat the patient with hand osteoarthritis (HOA) efficiently health professionals are dependent on information regarding patient experiences, clinical experience and research- based evidence. Overviews of existing scientific knowledge about nonpharmacological and non-surgical treatments for hip and knee OA are available, but not for HOA. There are outcome measures available for assessing functioning in hip and knee OA, but no outcome measures for HOA are available free of charge in Norwegian. Knowledge about disease impact in HOA compared to OA in other localizations is also limited.
Objectives: The overall objective of this thesis was to improve understanding about management, clinical assessment and disease impact in HOA. This included the following objectives I) To perform an overview of systematic reviews on the effect of non-pharmacological treatments in HOA, II) To validate patient reported outcomes (PROs) for functioning in HOA and III) To describe disease impact in patients with HOA compared to hip, knee and generalized OA.
Methods: Methods used were I) a systematic literature review, II) concurrent evaluation of two outcome measures for assessing hand function, and III) a cross-sectional study.
Results: I) There is insufficient high-quality evidence regarding non-pharmacological and nonsurgical interventions for HOA. II) The Australian/Canadian Osteoarthritis Hand Index (AUSCAN) and the Functional Index for Hand Osteoarthritis (FIHOA) are reliable and valid instruments suitable for measuring physical functioning in HOA. III) OA patients reported considerable levels of disease impact across localizations. Regardless of functional impairments related to the primary OA localization, patients generally reported high levels of impaired disease-specific functioning at other sites.
List of papers. The papers are removed from the thesis due to publisher restrictions.
Paper I: Moe RH, Kjeken I, Uhlig T, Hagen KB. There is inadequate evidence to determine the effectiveness of non-pharmacological and non-surgical interventions for hand osteoarthritis: an overview of high-quality systematic reviews. Phys Ther 2009; 89(12): 1363-70. doi:10.2522/ptj.20080398
Paper II: Moe RH, Garratt A, Slatkowsky-Christensen B, Maheu E, Mowinckel P, Kvien TK, Kjeken I, Hagen KB, Uhlig T. Concurrent evaluation of data quality, reliability and validity of the Australian/Canadian Osteoarthritis Hand Index (AUSCAN) and the Functional Index for Hand Osteoarthritis (FIHOA). Rheumatology (Oxford) 2010; 49(12): 2327-36. doi:10.1093/rheumatology/keq219
Paper III: Moe RH, Grotle M, Kjeken I, Hagen KB, Kvien TK, Uhlig T. Disease impact of hand osteoarthritis compared to hip, knee and generalized disease in specialist rheumatology health care. Rheumatology (Oxford), 2013; 52(1): 189-196. doi:10.1093/rheumatology/kes215