OTCATS: Occupational Therapy Critically Appraised Topics
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There is inconclusive data to either support or refute the efficacy of splints in decreasing joint pain due to the progression of rheumatoid arthritis

Prepared by:

Katrina Foo (kfoo6388@uni.sydney.edu.au) and
Andrew Hollis (ahol7606@uni.sydney.edu.au)

Date:

May 10, 2012

Review Date:

 

Clinical Question:

Among people with rheumatoid arthritis, does the use of hand and wrist splints reduce the intensity of pain in hands and wrists compared to not using splints?

Clinical Scenario:

Rheumatoid arthritis (RA) is an autoimmune disease that results in pain and loss of function (Lahita, 2001). It afflicts approximately 1% of the world population and is more common in women (Radomski & Trombly, 2008). Of these individuals, approximately, 75% have wrist arthritis (Flatt, 1968). These numbers are estimated to increase exponentially over the next years as a result of the aging population (Centers for Disease Control and Prevention, 2010). 
One of the most common treatments prescribed by Occupational therapists (OT) as an adjunct to other medical treatments is the use of splints (Spoorenberg, Boers, & Van der Linden, 1994; Melvin, 1989). Splints are often used to decrease the deformation of joints and pain experienced (Ouellette, 1991; Deshaies, 2002). Whilst this evidence supports the use of splints to reduce deformity there is little evidence to support the use of splints to reduce pain (Egan et al., 2003). For these reasons, we propose that researching the efficacy of splinting in the hand and wrist to reduce pain in cases of RA is of clinical importance.

Clinical Bottom Line:

There is inconclusive evidence to support the clinical effectiveness of splint use to reduce pain in the hand and wrist joints of individuals diagnosed with rheumatoid arthritis.

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