User perspectives on orthoses for thumb carpometacarpal osteoarthritis

Abstract

Study DesignQualitative and interpretive description. IntroductionOrthoses are often the first-choice treatment for thumb carpometacarpal osteoarthritis (CMCOA). It is unknown to what extent the orthoses are used in the way intended by health professionals and why patients continue using the orthoses despite minimal pain reduction. Purpose of the StudyThe purpose of this study is to investigate user perspectives and experiences with 2 types of CMCOA orthoses. MethodsSemistructured interviews were conducted with 16 individuals with CMCOA who used the Push-Ortho-Thumb-Brace-CMC (Nea International BV, Netherlands) and a custom-made orthosis. The data were analyzed using the phenomenological and the framework approach. ResultsFour men and 12 women participated (mean age, 57 years; half of whom were employed). Five central phenomena were identified, explaining the essence of the relation between user and orthosis: the orthosis as stabilizer, tool, healer, preventer, and nuisance. Users mentioned better appearance and the ability to do a variety of activities as advantages of the Push-Ortho-Thumb-Brace-CMC and better support and the ability to do strenuous activities as advantages of the custom-made orthosis. The central phenomena were related to the users' understanding of the disease process and the working mechanism of the orthoses and affected the patterns of usage and orthosis preference. DiscussionIt is recommended that the provider recognizes user perspectives and discusses the disease process of CMCOA along with the working mechanism of the orthosis to support therapy adherence. ConclusionsThere is a wide variety in usage patterns of the CMCOA orthoses, which are influenced by different user perspectives.