Static wrist splint use in the performance of daily activities by individuals with rheumatoid arthritis.
OBJECTIVE
In individuals with rheumatoid arthritis (RA), to identify the influence of wrist splint wear on pain, work performance, endurance, perceived task difficulty, and perceived splint benefit while performing various upper limb tasks.


METHODS
This crossover study included 30 individuals with wrist involvement. Pain, work performance, endurance, and perceived task difficulty were assessed with the splint on and off. Using a work simulator, participants performed 14 tasks, 10 assessing work performance and 4 assessing endurance. A visual analog scale (VAS) was used to rate pain, task difficulty, and perceived splint benefit.


RESULTS
With the splint on, pain was significantly lower in 5 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."


CONCLUSIONS
Results revealed 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. The findings suggest that wrist splint prescription is not 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.
Pagnotta
Ada
A
Department of Occupational Therapy, Jewish Rehabilitation Hospital, Chomedey, Laval, Québec, Canada. adapagnott_hjr@ssss.gouv.qc.ca
Korner-Bitensky
Nicol
N
Mazer
Barbara
B
Baron
Murray
M
Wood-Dauphinee
Sharon
S
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000628:therapy*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009788:Occupational Therapy / Q000295:instrumentation*; D010147:Pain Measurement; D017060:Patient Satisfaction; D013165:Splints; D014955:Wrist Joint