Effectiveness of proprioceptive training in patients with thumb carpometacarpal osteoarthritis: A systematic review

BACKGROUND: Thumb carpometacarpal joint osteoarthritis is a prevalent degenerative condition causing pain, reduced strength, and impaired hand function, primarily in postmenopausal women. Proprioceptive deficits contribute to joint instability and functional decline, yet the effectiveness of proprioceptive training remains unclear. PURPOSE: To systematically review randomized controlled trials evaluating proprioceptive exercise interventions vs conventional rehabilitation alone (strengthening, orthotics, and activity modification) on pain, hand function, proprioceptive acuity, and strength in adults with thumb carpometacarpal joint osteoarthritis. STUDY DESIGN: Systematic review of randomized controlled trials. METHODS: Seven databases (PubMed, Embase, Cochrane CENTRAL, CINAHL, Scopus, Web of Science, and PEDro) were searched through December 2025 for randomized controlled trials of adults with clinical/radiographic thumb carpometacarpal joint osteoarthritis receiving proprioceptive training plus conventional therapy vs conventional therapy alone. Methodological quality was assessed using the PEDro scale. Due to clinical/methodological heterogeneity, narrative synthesis was performed. Outcomes included pain (NPRS/VAS), function (QuickDASH, COPM), joint position sense (JPS error), and grip/pinch strength. Total sample: n = 260 across five randomized controlled trials. RESULTS: Five randomized controlled trials (PEDro scores 6-8/10, moderate-high quality) met inclusion criteria. Proprioceptive training produced moderate-to-large effects vs controls: pain reduction SMD = -0.6 (3/5 trials, Minimal Clinically Important Difference (MCID) exceeded in 2), JPS error reduction SMD = -1.2 (all five trials), QuickDASH/COPM improvements SMD = -0.7 (three trials), and grip/pinch strength gains SMD = 0.8 (four trials). Greatest benefits occurred in early-stage (Eaton-Littler I-II) osteoarthritis. CONCLUSIONS: Moderate- to high-quality evidence supports adding proprioceptive training to conventional rehabilitation for superior pain relief, proprioceptive acuity, hand function, and strength in thumb carpometacarpal joint osteoarthritis. Larger randomized controlled trials are needed to standardize protocols and confirm durability beyond 3 months.