Table 1

Characteristics of studies of main non-pharmacological interventions (n=28 studies)

RoBStudyDesignInterventionFrequency, duration (instructions)NOA location, definitionWomen (%)Age (years)Primary outcome
Exercise
Østeras et al 20176SLR
(6 RCT,
1 CO)
Hand exercise vs no exercise (N=6); different CMC exercise programme (N=1)6–12 months534Hand (6) or CMC (1), ACR or clinical diagnosisMedian 90Mean 60–81
Joint protection
Dziedzic et al 20157 Factorial RCTGroup-based joint protection programme (including splints) (JP+, HEx–)4 sessions in 4 weeks62ACR6965.5 (8.6)OARSI-OMERACT responder
Group-based exercise programme(HEx+, JP–)656364.5 (9.0)
Group-based combination programme: education, joint protection (including splints), exercise (JP+, HEx+)657166.0 (9.3)
Education alone (JP–, HEx–)4 weeks656267.2 (9.5)
Splints
Adams et al 20148
(A)
RCTSplint+occupational therapy4 weeks (NR)9CMC, NR7861.2 (9.4)AUSCAN pain
Placebo splint+occupational therapy9
Occupational therapy only9
Arazpour et al 20169 RCTSplint (custom-made, thermoplast, CMC)4 weeks (use during ADLs, not at night)16CMC, clinical diagnosis and E-L stage I–II8750.2 (5.7)NR
No intervention98852.3 (6.4)
Bani et al 201316 CO (WA+)Splint (custom-made, thermoplast)4 weeks (use during ADLs, not at night)24CMC, clinical diagnosis and E-L stage I-II6753.4NR
Splint (prefabricated, neoprene, CMC/MCP)7554.9
No intervention4 weeks117358.6
Becker,et al 201313 RCTSplint (custom-made, thermoplast, CMC/MCP)8–10 weeks (use as needed during ADLs and at night)58CMC, clinical diagnosis8062.8 (7.7)DASH
Splint (prefabricated, neoprene, CMC)617563.3 (8.5)
Cantero-Tellez et al 201614 CCTSplint (custom-made, thermoplast, CMC/MCP)12 weeks (use during ADLs (3–4 hours/day) and at night)44CMC, clinical and Rx diagnosis9359.7 (9.6)NR
Splint (custom-made, thermoplast, CMC)409060.5 (9.8)
Gomes-Carreira 201010 RCTSplint (custom-made, CMC/MCP)12 weeks (NR)20CMC, clinical diagnosis and E-L stage II–III10062.8 (8.5)VAS pain
No intervention209065.1 (10.1)
Hermann et al 201311 RCTSplint+hand exercises (prefabricated, fabrifoam, CMC/MCP)8 weeks (use as needed)30CMC, ACR, thumb pain9770.7 (7.3)NRS pain
Hand exercises2910070.2 (6.2)
Rannou et al 200912 RCTSplint (custom-made, neoprene, CMC/MCP)1 year (use at night)57CMC, clinical and Rx diagnosis9363.0 (7.9)VAS pain
Usual care558563.5 (7.6)
Sillem et al 201117 CO (WA+)Splint (custom-made, neoprene, CMC/MCP)4 weeks (use when symptomatic, during heavy tasks and at night if preferred)56CMC, clinical diagnosis9164.1 (8.6)AUSCAN function
Splint (prefabricated, neoprene, IP to wrist)
Wajon et al 200515 RCTSplint (custom-made, thermoplast, CMC)+abduction exercise regimen2 weeks splint only, 4 weeks splint +exercise (use full-time)19CMC, clinical diagnosis and E-L stage I–III7459.7 (9.0)NR
Splint (custom-made, thermoplast, CMC/MCP)+pinch exercise regimen218161.2 (12.5)
Watt et al
201421
CCTSplint (custom-made, thermoplast, DIP)12 weeks (use at night)26DIP, ACR, Rx damage DIP8863 (51–78)NRS pain
No intervention26
Weiss et al
200019
CO
(WA–)
Splint (custom-made, thermoplast, CMC)1 week (use when symptomatic)26CMC, clinical and Rx diagnosis8157 (36–88)NR
Splint (custom-made, thermoplast, CMC to wrist)
Weiss et al
200420
CO
(WA–)
Splint (custom-made, thermoplast, CMC)1 week (use when symptomatic)25CMC, clinical diagnosis and E-L stage I–II84NRNR
Splint (prefabricated, neoprene, CMC/MCP)
Van der Vegt et al
201718
CO (WA+)Splint (custom-made, thermoplast, CMC/MCP)2 weeks (NR)63CMC, clinical and Rx diagnosis7060.1 (8.2)VAS pain
Splint (prefabricated, semirigid, CMC)
Assistive devices
Kjeken et al
201122
RCTProvision of assistive devices+information12 weeks (NR)35ACR9761.1 (6.0)COPM
Information alone359759.9 (7.5)
Combination programme
Boustedt
200923
RCTGroup-based combination programme: education, joint protection, exercise, splints10 sessions in 5 weeks22CMC, clinical and Rx diagnosis10061 (40–76)NR
Group-based joint protection programme2061 (50–76)
Dziedzic,et al
20157
Factorial RCTGroup-based joint protection programme (including splints) (JP+, HEx–)4 sessions in 4 weeks62ACR6965.5 (8.6)OARSI-OMERACT responder
Group-based exercise programme (HEx+, JP–)656364.5 (9.0)
Group-based combination programme: education, joint protection (including splints), exercise (JP+, HEx+)657166.0 (9.3)
Education alone (JP–, HEx–)4 weeks656267.2 (9.5)
Perez-Marmol et al
201724
RCTFine motor skills occupational therapy24 sessions in 8 weeks25Clinical diagnosis8482.8 (8.3)DASH
Conventional occupational therapy237479.2 (10)
Stamm et al
200225
CCTIndividual combination programme: education, joint protection, exerciseSingle session, 3 months20ACR8560.5 (8.3)Grip strength
Education alone3 months209060.4 (6.4)
Stukstette et al 201326 RCTGroup-based combination programme: education, joint protection (including splints), exercise4 sessions in 12 weeks76ACR8260 (7)AUSCAN function, OARSI-OMERACT responder
Education alone12 weeks758458 (9)
Stukstette et al 201427(A)RCTGroup-based booster session after combination programme26 Single session, 1 year147ACR8459 (8)AUSCAN function, OARSI-OMERACT responder
No booster session after combination programme26 1 year
Villafane 201328 RCTIndividual combination programme: manual therapy, exercise12 sessions in 4 weeks30CMC, clinical diagnosis and Rx damage9082 (2)VAS pain
Sham intervention (non-therapeutic ultrasound of the thumb region)308083 (1)
Wajon 200515 RCTSplint (custom-made, thermoplast, CMC)+abduction exercise regimen2 weeks splint only, 4 weeks splint+excercise; use full-time19CMC, clinical diagnosis and E-L stage I–III7459.7 (9.0)NR
Splint (custom-made, thermoplast, CMC/MCP)+pinch exercise regimen218161.2 (12.5)
  • Values are mean (SD) or median (min–max). Colours denote RoB (green: low, yellow: unclear, red: high). (A) indicates conference abstract.

  • ACR, American College of Rheumatology; ADLs, activities of daily living; AUSCAN, Australian/Canadian Hand Osteoarthritis Index; CMC, first carpometacarpal joint; CO, cross-over trial; COPM, Canadian Occupational Performance Measure; DASH, Disabilities of the Arm, Shoulder and Hand; DIP, distal interphalangeal joint; E-L, Eaton-Litter; FIHOA, Functional Index for Hand OsteoArthritis; IP, interphalangeal joint; MCP,metacarpophalangeal; N, number; NR, not reported; NRS, numerical rating scale; OA, osteoarthritis; RCT, randomised controlled trial; RoB, risk of bias; Rx, radiography; SLR, systematic literature review; VAS, visual analogue scale; WA, wash-out period.