Wrist splints helpful for inflammatory arthritis

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Wrist splints helpful for inflammatory arthritis

Last Updated: 2004-11-15 14:38:34 -0400 (Reuters Health)

SOURCE: Arthritis & Rheumatism, October 15, 2004.

http://www.medicinenet.com/script/main/art.asp?articlekey=40609

For people with inflammatory arthritis affecting the wrist, using a

wrist splint can reduce pain and improve strength, Canadian researchers

have shown.

Previous reports suggested that wrist splints may improve symptoms but

at the risk of reducing dexterity and the performance of some functional

tasks, the authors explain in the medical journal Arthritis & Rheumatism.

Barbara Porter from Vancouver Coastal Health Authority in British

Columbia and colleagues compared several types of wrist splints -- a

custom-made leather device, an off-the-shelf model, and an elastic wrist

support -- in a study of 45 patients with inflammatory arthritis in

their wrists.

The participants used each type of splint for an average of 29 hours per

week, the authors report, with all but two participants using them for a

minimum of 10 hours per week.

All the splints significantly reduced pain, the team found. The leather

model proved more effective than the elastic support in reducing pain,

but other comparisons were not significantly different.

Rather than decreasing dexterity, the splints were associated with

improvements in an aggregate dexterity score, in the ability to pour

water, and other measures of hand function, the researchers note.

Differences between the splint types were minimal.

Patients ranked the leather splint as the best, and this was the most

expensive; the cheapest -- the elastic support -- ranked lowest, but all

splints were favored over not wearing a splint.

Improvements in hand function and pain were maintained at the 6-month

follow-up point, the report indicates.

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Conclusion: A wrist splint has been shown to help inflammatory arthritis

in a crossover trial (see below). The splint reduces pain and increases

hand strength and does not impair dexterity.

Crossover trial: Three different types of wrist splints were tested in a

crossover trial. The order in which a given patient wore the 3 splints

was decided by chance alone. A splint was worn for 4 weeks, followed by

a week " washout " period in which the patient wore no splint and the

effect of the prior splint was allowed to " wash out. " The patient then

" crossed over " and wore a different splint for 4 weeks, and so on. The

patients were tested at baseline (before the start of the trial), after

wearing each splint and after each washout period, and 6 months after

the trial ended.

Comment: The conclusion that a wrist splint can help inflammatory

arthritis of the wrist is based on an effectively designed and executed

trial. The following article provides more information about the three

different splints.

Barbara K. Hecht, Ph.D. , Frederick Hecht, M.D.

Medical Editors, MedicineNet.com