AzTrials
AzTrials

Trapeziometacarpal OsteoarthritisNCT07421089

FDI and APL Muscle Activation During Thumb Exercises in CMC Osteoarthritis

An observational study of Trapeziometacarpal Osteoarthritis, run by University of Malaga at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The aim of this study is to investigate whether there are differences in muscle activation of the First Dorsal Interosseous (FDI) and the Abductor Pollicis Longus (APL) between individuals with and without trapeziometacarpal osteoarthritis (TMC OA) of the thumb. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Trapeziometacarpal Osteoarthritis
How many people
30 participants
Where
1 siteSpain
Study dates
28 Feb 2026to 28 Aug 2026
How long will I take part?
1 Day
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Participants were adults with a clinical diagnosis of thumb carpometacarpal osteoarthritis, recruited from the Universidad de Málaga.

Who may be able to join

  • Over 18 years of age
  • Agreed to participate in the study, signing informed consent
  • Ability to read and understand the patient information sheets and exercises
  • Clinical diagnosis of thumb carpometacarpal osteoarthritis on the dominant hand grade 1-4 according to the Eaton-Littler Classification

Who cannot join

  • Received treatment for hand or thumb pain in the same limb in the last 6 months
  • Presence of upper limb sensory disturbances
  • Upper limb entrapment neuropathy or cervical radiculopathy
  • Systemic conditions known to cause peripheral neuropathy
  • Rheumatoid arthritis
  • Previous surgery to the wrist or hand
  • Fracture or significant hand/thumb injury in the last 6 months
  • Cognitive impairment that inhibited understanding of the informed consent or exercise program

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Universidad de Málaga

    Málaga, Málaga, 29071

Other trials in Spain

About this study

Official title: First Dorsal Interosseous Exercises Reveal Altered Recruitment for the FDI and APL in Thumb Carpometacarpal Osteoarthritis. A Cross-Sectional EMG Study

The aim of this study is to investigate whether there are differences in muscle activation of the First Dorsal Interosseous (FDI) and the Abductor Pollicis Longus (APL) between individuals with and without trapeziometacarpal osteoarthritis (TMC OA) of the thumb. The study also seeks to identify which exercises are most effective for activating these muscles, in order to inform rehabilitation strategies for patients.

The FDI has been defined as a key stabilizer of the thumb TMC joint. However, the literature reports various protocols for FDI activation and limited information on APL behavior during these exercises. OA TMC of the thumb can cause pain, decreased thumb strength, impaired hand function, and difficulty performing activities of daily living (ADLs). Appropriate rehabilitation is essential to maintain muscle function, limit joint degeneration, and improve hand performance; however, the exercises that optimally activate the FDI and APL muscles are not yet established.

Read more

Participants will perform a series of standardized exercises and functional tasks designed to activate the FDI and APL muscles. Exercises include FDI strengthening with elastic bands in different hand positions (palmar and ulnar support), as well as exercises with the thumb in greater abduction. Functional tasks simulating everyday activities (e.g., turning a key, picking up a coin, writing, squeezing a tube of toothpaste, and holding a glass of water) will also be performed. Muscle activity will be recorded using surface electromyography (sEMG) during all tasks.

Adults aged 40 years and older, both men and women, with TMC osteoarthritis and healthy controls without osteoarthritis will be invited to participate.

Researchers will measure the activation patterns of the FDI and APL muscles during FDI activation exercises . The study aims to identify exercises that optimally activate these muscles, providing evidence to guide the rehabilitation of patients with thumb base osteoarthritis.

Read the detailed description

Thumb carpometacarpal (CMC) osteoarthritis is a chronic, progressive, and degenerative condition of the thumb base characterized by articular cartilage degeneration, subchondral bone changes, and capsuloligamentous laxity, causing progressive alteration of joint congruence and thumb force during activities of daily living requiring pinch execution. It is one of the most common and symptomatic forms of hand osteoarthritis, representing a major source of hand pain, weakness, and disability, particularly in postmenopausal women.

Thumb CMC joint congruence depends on a fine balance between capsuloligamentous support, articular congruity, and the force vectors generated by the surrounding intrinsic and extrinsic muscles. Cadaveric studies suggest that individual thumb muscles may have stabilizing or destabilizing effects on CMC joint alignment: the first dorsal interosseous (FDI) has been identified as the primary stabilizing muscle, reducing radiographic subluxation upon contraction, whereas the abductor pollicis longus (APL) has been described as a primary destabilizing force, increasing dorso-radial misalignment.

Although FDI activation exercises have been incorporated into conservative management of thumb CMC osteoarthritis, the actual effect of these exercises on the specific activation of the FDI and APL has yet to be determined. Surface electromyography (sEMG) offers a non-invasive method to examine muscle activation during functional or therapeutic tasks. The purpose of this study is to compare muscle activation patterns in individuals with thumb CMC osteoarthritis during selected FDI exercises, with particular attention to the concurrent behavior of the APL.

This is a cross-sectional observational comparative study with a between-group analysis. The study includes two groups: adults aged 40 years and older, both men and women, with a clinical diagnosis of thumb TMC osteoarthritis and healthy controls without musculoskeletal or neurological disorders affecting the hand.

Exclusion criteria include sensory disturbances such as numbness or tingling, cardiac pacemaker implantation, upper limb entrapment neuropathies or cervical radiculopathy, neuromuscular diseases, systemic conditions including diabetes or hypothyroidism, history of cancer, rheumatoid arthritis, anticoagulation therapy, chemotherapy, exposure to neurotoxins, or recent upper limb trauma or surgery.

Surface electromyography (sEMG) is used to record muscle activity of the FDI and APL. Bipolar surface electrodes with a diameter of 20 millimeters and an inter-electrode distance of 20 millimeters are placed according to SENIAM guidelines. For the FDI, electrodes are positioned over the dorsal belly of the muscle aligned with fiber direction, with one electrode in the distal ulnar region between the first and second metacarpals. For the APL, electrodes are placed approximately five centimeters distal to the wrist, medial to the radius, longitudinally aligned and transversely away from adjacent muscles.

Participants perform six standardized exercises designed to selectively activate the FDI, including variations of index finger abduction with ulnar support, elastic resistance with ulnar support, elastic resistance with palmar support using a ball, palmar support without resistance, elastic resistance with palmar support, and elastic resistance with maximal palmar abduction of the thumb. Each exercise is performed in three consecutive three-second isometric repetitions with a thirty-second rest between repetitions to minimize fatigue.

Keywords
trapeziometacarpal osteoarthritis, first dorsal interosseous, surface electromyography, muscle activation, thumb stabilization

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07421089
Study groupRoleWhat they receive
OA GROUPAdults aged 18 years and older with a clinical diagnosis of thumb trapeziometacarpal (TMC) osteoarthritis. Participants will perform six standardized exercises designed to selectively activate the first dorsal interosseous (FDI) muscle, while surface electromyography (sEMG) of the FDI and abductor pollicis longus (APL) muscles is recorded. No pharmacological or physical intervention is administered beyond the exercises themselves; this is an observational measurement of muscle activation during standardized exercise performance.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Surface electromyographic amplitude of the First Dorsal Interosseous muscle.

    Mean surface electromyographic amplitude of the First Dorsal Interosseous muscle recorded during each of the 6 standardized exercises

    Measured: Day 1

  2. Surface electromyographic amplitude of the Abductor Pollicis Longus muscle

    Mean surface electromyographic amplitude of the Abductor Pollicis Longus muscle recorded during each of the 6 standardized exercises

    Measured: Day 1

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Feb 2026
  2. Study start28 Feb 2026
  3. Primary completion28 Jul 2026
  4. Study completion28 Aug 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Cross-sectional
Enrolment
30 participants (actual)
Target duration
1 Day
IDs, dates and publications
ClinicalTrials.gov ID
NCT07421089
Sponsor's protocol ID
UMA-AOTMC-2026-001
Status last verified
Oct 2026
First submitted
4 Feb 2026
Last updated
8 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • McGee C, O'Brien V, Van Nortwick S, Adams J, Van Heest A. First dorsal interosseous muscle contraction results in radiographic reduction of healthy thumb carpometacarpal joint. J Hand Ther. 2015 Oct-Dec;28(4):375-80; quiz 381. doi: 10.1016/j.jht.2015.06.002. Epub 2015 Jun 27.

    PubMed 26209165
  • Bertozzi L, Valdes K, Vanti C, Negrini S, Pillastrini P, Villafane JH. Investigation of the effect of conservative interventions in thumb carpometacarpal osteoarthritis: systematic review and meta-analysis. Disabil Rehabil. 2015;37(22):2025-43. doi: 10.3109/09638288.2014.996299. Epub 2015 Jan 5.

    PubMed 25559974
  • Ahern M, Skyllas J, Wajon A, Hush J. The effectiveness of physical therapies for patients with base of thumb osteoarthritis: Systematic review and meta-analysis. Musculoskelet Sci Pract. 2018 Jun;35:46-54. doi: 10.1016/j.msksp.2018.02.005. Epub 2018 Feb 21.

    PubMed 29510316
  • Tossini NB, Melo CS, Braz de Oliveira MP, Moreira RFC, Serrao PRMDS. Effect of physical therapy interventions in individuals with primary thumb carpometacarpal osteoarthritis: a systematic review and meta-analysis. Disabil Rehabil. 2024 Dec;46(26):6251-6265. doi: 10.1080/09638288.2024.2325652. Epub 2024 Mar 7.

    PubMed 38450686
  • Deveza LA, Hunter DJ, Wajon A, Bennell KL, Vicenzino B, Hodges P, Eyles JP, Jongs R, Riordan EA, Duong V, Min Oo W, O'Connell R, Meneses SR. Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO). BMJ Open. 2017 Jan 12;7(1):e014498. doi: 10.1136/bmjopen-2016-014498.

    PubMed 28082368
  • McVeigh KH, Kannas SN, Ivy CC, Garner HW, Barnes CS, Heckman MG, Brushaber DE, Murray PM. Dynamic stabilization home exercise program for treatment of thumb carpometacarpal osteoarthritis: A prospective randomized control trial. J Hand Ther. 2022 Jul-Sep;35(3):435-446. doi: 10.1016/j.jht.2021.06.002. Epub 2021 Jul 24.

    PubMed 34312043
  • Osteras N, Hagen KB, Grotle M, Sand-Svartrud AL, Mowinckel P, Kjeken I. Limited effects of exercises in people with hand osteoarthritis: results from a randomized controlled trial. Osteoarthritis Cartilage. 2014 Sep;22(9):1224-33. doi: 10.1016/j.joca.2014.06.036. Epub 2014 Jul 5.

    PubMed 25008206
  • Cantero-Tellez R, Algar LA, Valdes KA, Naughton N. Clinical effects of proprioceptive thumb exercise for individuals with carpometacarpal joint osteoarthritis: A randomized controlled trial. J Hand Ther. 2022 Jul-Sep;35(3):358-366. doi: 10.1016/j.jht.2022.06.009. Epub 2022 Aug 23.

    PubMed 36008246
  • Villafane JH, Valdes K. Combined thumb abduction and index finger extension strength: a comparison of older adults with and without thumb carpometacarpal osteoarthritis. J Manipulative Physiol Ther. 2013 May;36(4):238-44. doi: 10.1016/j.jmpt.2013.05.004. Epub 2013 May 27.

    PubMed 23719517
  • Sodha S, Ring D, Zurakowski D, Jupiter JB. Prevalence of osteoarthrosis of the trapeziometacarpal joint. J Bone Joint Surg Am. 2005 Dec;87(12):2614-2618. doi: 10.2106/JBJS.E.00104.

    PubMed 16322609
  • Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK, Felson DT. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Ann Rheum Dis. 2011 Sep;70(9):1581-6. doi: 10.1136/ard.2011.150078. Epub 2011 May 27.

    PubMed 21622766

Questions about this trial

What is this clinical trial studying?

An observational study of Trapeziometacarpal Osteoarthritis, run by University of Malaga at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Surface electromyographic amplitude of the First Dorsal Interosseous muscle. (time frame: Day 1). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07421089, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Oct 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in