A crossover trial of custom-made and commercially available wrist splints in adults with inflammatory arthritis.
OBJECTIVE
To compare the effect of 3 wrist splints (2 prefabricated commercial splints and 1 custom made) on perceived wrist pain, hand function, and perceived upper extremity function in adults with inflammatory arthritis.


METHODS
Subjects (n = 45, mean age 49 years, mean disease duration 8.6 years) were randomly assigned to treatment order in a 3-phase crossover trial. Splints were worn for 4 weeks, separated by 1-week washouts. Outcomes were assessed at baseline, after each splint phase and washout period, and at 6 months' followup using a pain visual analog scale (VAS), the Arthritis Hand Function Test, and McMaster-Toronto Arthritis Patient Function Preference questionnaire. Data were analyzed with multivariate analyses of variance (MANOVAs), t-tests, and chi-square tests.


RESULTS
There did not appear to be order or carryover effects. MANOVA indicated that wrist splints significantly reduced pain (P = 0.007). The custom leather splint was most effective in reducing pain, from 4.1 cm to 2.8 cm on the VAS (P = 0.001). All splints improved hand strength, and the commercial Rolyan splint provided significantly stronger grip than the Anatech commercial splint (P = 0.04). In contrast to previous studies, splints did not compromise dexterity. There were several significant differences among splints, depending on the outcome measure. Improvements were maintained at 6 months.


CONCLUSIONS
After 4 weeks' use, wrist splints reduce pain, improve strength, and do not compromise dexterity. Similar improvements were achieved with the custom leather splint and Rolyan commercial splint, which were superior to the Anatech commercial splint.
Mary Pack Arthritis Program, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada.
Sandra
S
Haskett
Catherine
C
Backman
Barbara
B
Porter
Jill
J
Goyert
Gillian
G
Palejko
D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000628:therapy*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000628:therapy*; D018592:Cross-Over Studies; D005260:Female; D006225:Hand; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010147:Pain Measurement; D020127:Recovery of Function; D013165:Splints; D016896:Treatment Outcome; D034941:Upper Extremity; D014955:Wrist Joint