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The clinical effectiveness of static resting splints in early rheumatoid arthritis: a randomised controlled trial

Adams, J, Burridge, J, Mullee, M, Hammond, A and Cooper, C 2008, 'The clinical effectiveness of static resting splints in early rheumatoid arthritis: a randomised controlled trial' , Rheumatology, 47 (10) , pp. 1548-1553.

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Abstract

Objective. To evaluate the effectiveness of static resting splints in early RA. Methods. A multicentre, randomized, trial was conducted. Patients (n = 120) received either static resting splints [positioned with the wrist in neutral, MCP joint (MCPJ) and IP joint (IPJ) in a maximum of 60° and 30° of flexion, respectively] plus standardized occupational therapy or standardized occupational therapy alone. Change in grip strength (Ns), structural impairment (MCPJ ulnar deviation), applied dexterity (Button Board), self-report hand ability [Michigan Hand Outcomes Questionnaire (MHQ)], hand pain and morning hand stiffness were assessed at 0 and 12 months. Results. Data for 56 (97%) splinted and 60 (97%) control group patients were analysed. Splint wear adherence was moderate; 24.5% ‘never wore’ the splints. The adjusted mean difference between groups for handgrip was –14.2 Ns (P = 0.342; 95% CI –43.7, 5.4); MCPJ ulnar deviation –1.1° (P = 0.657; 95% CI = –6.2, 3.9); dexterity 0.1 s (P = 0.975; 95% CI = –6.6, 6.8) and self-report ability –3.0 on the MHQ score (P = 0.426; 95% CI –10.5, 4.5). Pain scores were unchanged in either group (P = 0.15). The occurrence of morning hand stiffness was reduced in a small group of splinted patients (P = 0.021), but the duration shortened in control patients (P = 0.010). Conclusions. There was no significant difference between the two interventions on grip strength, deformity, hand function and pain. The data favoured the control group and this study suggests that resting splints should not be used as a routine treatment of patients with early RA.

Item Type: Article
Uncontrolled Keywords: Static splint, Rheumatoid arthritis, Hand, Occupational therapy
Themes: Subjects / Themes > R Medicine > R Medicine (General)
Health and Wellbeing
Schools: Colleges and Schools > College of Health & Social Care > School of Health Sciences > Centre for Health Sciences Research
Colleges and Schools > College of Health & Social Care
Colleges and Schools > College of Health & Social Care > School of Health Sciences
Journal or Publication Title: Rheumatology
Publisher: Oxford University Press
Refereed: Yes
ISSN: 1462-0324
Depositing User: Users 29196 not found.
Date Deposited: 07 Jun 2010 15:37
Last Modified: 14 Jul 2014 11:11
URI: http://usir.salford.ac.uk/id/eprint/9344

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