STATIC WRIST SPLINT USE IN THE PERFORMANCE OF DAILY ACTIVITIES BY INDIVIDUALS WITH RHEUMATOID ARTHRITIS

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STATIC WRIST SPLINT USE IN THE PERFORMANCE OF DAILY ACTIVITIES BY

INDIVIDUALS WITH RHEUMATOID ARTHRITIS

http://www.jrheum.com/subscribers/06/02/21-40.html

Objective: The primary objective of this study was to identify, in

individuals with rheumatoid arthritis (RA), the impact of wrist splint wear

on pain, work performance, endurance, perceived task difficulty and

perceived splint benefit while performing various upper limb tasks as

simulated on a work simulator.

Methods: This crossover study included 30 individuals having RA with wrist

involvement. Participants were eligible if they were using a commercially

available, circumferential fabric-type wrist splint for at least one month.

Work performance (amount of work done over 30 seconds) was assessed on 10

Baltimore Therapeutic Equipment (BTE) work simulator activities, each

activity being performed under two conditions, with the splint on and with

the splint off. Four work performance tasks were chosen to assess endurance

(the amount of work done for a maximum of 7 minutes) Pain, perceived task

difficulty and perceived splint benefit were rated using a 10 cm horizontal

visual analog scale. Order of splint use was randomly assigned such that

half of individuals were assessed first with the splint, the other half

first without the splint.

Results Obtained and Conclusion: With the splint on, pain was significantly

lower in five tasks as was perceived difficulty in task performance. Work

performance did not differ significantly with the splint on versus off.

While mean endurance scores were always better with the splint on,

differences reached significance on only one. task. The task with greatest

overall perceived splint benefit was " chopping with a knife " . Results

demonstrated that for most tasks, there was generally a positive effect of

splint use on hand function, however, perceived splint benefit was marginal.

For most tasks, splint use improved or did not change pain levels, did not

interfere with work performance, increased or maintained endurance and did

not increase perceived task difficulty

Brief Conclusion: The findings suggest that the impact of wrist splint use

on hand function is highly task specific and does not make splint

prescription a simple process; clinicians and clients need to work together

to determine the daily wear pattern that maximizes benefit and minimizes

inconvenience according to the client's individual needs.

Ada Pagnotta 1,2,3, Nicol Korner-Bitensky 3,4,5, Babara Mazer 3,4 , Murray

Baron 2,5,6, Sharon Wood -Dauphinee 3,4,5 (1.Occupational Therapy Department

of the Jewish Rehabiliation Hospital, 2.Rheumatology of the Jewish

Rehabilitation Hospital, Chomedey., Laval, Quebec, Canada, 3.Centre de

recherche interdisciplinaire en réadaptation du Montréal métropolitain

(CRIR), 4.School of Physical and Occupational Therapy, 5.Faculty of

Medicine, McGill University, Montreal, Quebec, Canada, , 6.Jewish General

Hospital, Montreal, Quebec, Canada.)