Compression gloves for patients with hand arthritis (C-GLOVES): A feasibility study

Introduction Compression gloves are frequently provided to patients with hand arthritis. Evidence for effectiveness is limited. The aim of this study was to determine feasibility of recruitment, assessment and treatment procedures, in preparation for a future compression glove trial. Methods A non-randomised feasibility study with out-patients with either undifferentiated inflammatory arthritis, rheumatoid arthritis or hand osteoarthritis, with moderate to severe hand pain. All received Isotoner™ compression gloves provided by rheumatology occupational therapists. The main outcomes were feasibility of recruitment, assessment and treatment procedures, trial outcome selection and sample size calculation. Participants were assessed at baseline and four weeks. Assessments included: numeric rating scales (0–10) of hand pain (on activity, at rest, at night) and stiffness; hand joint swelling; finger flexion; and hand function (Grip Ability Test). Results Of 318 patients screened, 86/204 (42%) of inflammatory and 68/114 (60%) of hand osteoarthritis patients were eligible. Of these, 41 (48%: age: 59.10 (SD 12.54) years) and 32 (47%: age: 60.75 (SD 8.64) years) respectively, consented. All completed four-week follow-up. Assessment and treatment protocols were feasible. Hand pain on activity and at night, stiffness, joint swelling, finger flexion and hand function improved: e.g. hand pain on activity: inflammatory arthritis change = −0.95 (SD 2.26; p = 0.01); osteoarthritis −1.57 (SD 1.78; p = 0.001). Participants reported improved hand pain, stiffness and hand function as main benefits. Conclusion Procedures tested were feasible. The most relevant primary outcome was hand pain on activity. Future trials would need 161 participants (Inflammatory arthritis) and 151 (hand osteoarthritis). Trial registration: Clinical Trials.Gov: NCT01874067

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Measures of hand function: Arthritis Hand Function Test (AHFT), Australian Canadian Osteoarthritis Hand Index (AUSCAN), Cochin Hand Function Scale, Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability Test (GAT), Jebsen Hand Function Test (JHFT)

Arthritis Care & Research ◽

10.1002/acr.20631 ◽

2011 ◽

Vol 63 (S11) ◽

pp. S189-S199 ◽

Cited By ~ 63

Author(s):

Janet L. Poole

Keyword(s):

Hand Function ◽

Hand Osteoarthritis ◽

Functional Index ◽

Ability Test ◽

Function Test

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Exercise for Hand Osteoarthritis: A Cochrane Systematic Review

The Journal of Rheumatology ◽

10.3899/jrheum.170424 ◽

2017 ◽

Vol 44 (12) ◽

pp. 1850-1858 ◽

Cited By ~ 7

Author(s):

Nina Østerås ◽

Ingvild Kjeken ◽

Geir Smedslund ◽

Rikke H. Moe ◽

Barbara Slatkowsky-Christensen ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Hand Function ◽

Joint Stiffness ◽

Risk Of Bias ◽

Finger Joint ◽

Hand Osteoarthritis ◽

Hand Pain ◽

Quality Evidence

Objective.To assess the benefits and harms of exercise compared with other interventions, including placebo or no intervention, in people with hand osteoarthritis (OA).Methods.Systematic review using Cochrane Collaboration methodology. Six electronic databases were searched up until September 2015. Inclusion criteria: randomized or controlled clinical trials comparing therapeutic exercise versus no exercise, or comparing different exercise programs. Main outcomes: hand pain, hand function, finger joint stiffness, quality of life, adverse events, and withdrawals because of adverse effects. Risk of bias and quality of the evidence were assessed.Results.Seven trials were included in the review, and up to 5 trials (n = 381) were included in the pooled analyses with data from postintervention. Compared to no exercise, low-quality evidence indicated that exercise may improve hand pain [5 trials, standardized mean difference (SMD) −0.27, 95% CI −0.47 to −0.07], hand function (4 trials, SMD −0.28, 95% CI −0.58 to 0.02), and finger joint stiffness (4 trials, SMD −0.36, 95% CI −0.58 to −0.15) in people with hand OA. Quality of life was evaluated by 1 study (113 participants) showing very low-quality evidence for no difference. Three studies reported on adverse events, which were very few and not severe.Conclusion.Pooled results from 5 studies with low risk of bias showed low-quality evidence for small to moderate beneficial effects of exercise on hand pain, function, and finger joint stiffness postintervention. Estimated effect sizes were small, and whether they represent a clinically important change may be debated.

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Arthritis glove provision in rheumatoid arthritis and hand osteoarthritis: A survey of United Kingdom rheumatology occupational therapists

Hand Therapy ◽

10.1177/17589983211060620 ◽

2022 ◽

pp. 175899832110606

Author(s):

Alison Hammond ◽

Yeliz Prior

Keyword(s):

Rheumatoid Arthritis ◽

United Kingdom ◽

Hand Function ◽

Symptom Relief ◽

Occupational Therapists ◽

Hand Osteoarthritis ◽

North West ◽

Hand Pain ◽

And Function ◽

Hand Symptoms

Introduction Hand pain and function limitations are common in rheumatoid arthritis (RA) and hand osteoarthritis (HOA). Provision of arthritis (compression) gloves to relieve hand symptoms is increasing in occupational therapy. Research evaluating arthritis gloves dates to the 1990s, focussing on night-wear of full-length finger gloves in RA. This survey examined glove provision in contemporary clinical practice in the United Kingdom. Methods A survey of arthritis glove provision in RA was conducted with Royal College of Occupational Therapists Rheumatology Specialist Section members. A more detailed survey about glove provision in RA and HOA was conducted with rheumatology occupational therapists in North-West England. Results Response rates were good, with 60 (73%) therapists responding to the national and 24 (69%) to the regional surveys. Most therapists provided open-finger gloves (commonly IsotonerTM) to about a third of their RA and HOA patients, and to those with any arthritic condition causing significant hand pain and/or swelling. Day-wear was as common as night-wear, and patients were advised to wear these ‘as and when’ for hand symptom relief and support for hand function. They were advised not to wear gloves continually in the day, and regularly perform hand exercises and monitor for potential adverse effects, for example, skin discolouration. Therapists commonly provide replacement gloves as these are often used long-term. Conclusion Prescription of arthritis gloves has changed considerably in the last 30 years, with open-finger gloves provided to a wider range of people with arthritis, for a broader range of clinical reasons.

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The Need for a Broad-Based Model of Phonological Disorders

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.2303.261 ◽

1992 ◽

Vol 23 (3) ◽

pp. 261-268 ◽

Cited By ~ 24

Author(s):

Alan G. Kamhi

Keyword(s):

Speech Production ◽

Phonological Disorders ◽

Production Processes ◽

Assessment And Treatment ◽

Speech Delays ◽

Explanatory Adequacy ◽

State Of Affairs ◽

Assessment Procedures ◽

Treatment Procedures

My response to Fey’s article (1985; reprinted 1992, this issue) focuses on the confusion caused by the application of simplistic phonological definitions and models to the assessment and treatment of children with speech delays. In addition to having no explanatory adequacy, such definitions/models lead either to assessment and treatment procedures that are similarly focused or to procedures that have no clear logical ties to the models with which they supposedly are linked. Narrowly focused models and definitions also usually include no mention of speech production processes. Bemoaning this state of affairs, I attempt to show why it is important for clinicians to embrace broad-based models of phonological disorders that have some explanatory value. Such models are consistent with assessment procedures that are comprehensive in nature and treatment procedures that focus on linguistic, as well as motoric, aspects of speech.

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Author Correction: Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome

Scientific Reports ◽

10.1038/s41598-021-82090-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Young Hoon Kim ◽

Eun Young Han ◽

Jinseok Kim ◽

Kyu‑Bum Seo ◽

Young Tae Jeon ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Hand Function ◽

Hand Osteoarthritis ◽

Different Ages ◽

Electrophysiological Measurements ◽

Tunnel Syndrome

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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O26 Testing an intervention to reduce fatigue impact in inflammatory arthritis: design and outcomes of a single-arm feasibility study

Rheumatology ◽

10.1093/rheumatology/keab246.025 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Susan Bridgewater ◽

Joe Lomax ◽

Bryan Abbott ◽

Jo Adams ◽

Alice Berry ◽

...

Keyword(s):

Feasibility Study ◽

Inflammatory Arthritis ◽

Primary Outcome ◽

Time Frame ◽

Secondary Outcome ◽

Control Group ◽

Regression To The Mean ◽

Intervention Delivery ◽

Cognitive Behavioural ◽

One To One

Abstract Background/Aims Patients with inflammatory arthritis report that fatigue can be a challenging symptom to manage, with little support available. In response, we developed a brief one-to-one cognitive-behavioural manualised intervention, delivered by rheumatology health professionals (RHPs), to help patients manage their fatigue. Methods We designed a single-arm feasibility study called FREE-IA (Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis). Patients were eligible if they were ≥18 years, had a clinician confirmed diagnosis of inflammatory arthritis, scored ≥6/10 on the BRAF NRS Fatigue Impact with fatigue that they considered recurrent, frequent, and/or persistent, and were not accessing support for their fatigue. Following training, RHPs delivered 2-4 one-to-one sessions to participants. The initial two core sessions were delivered face-to-face in clinic; participants then had the option of up to two further sessions, either in clinic, by telephone or online. We proposed delivering sessions 1 and 2 within two weeks of each other, and sessions 3 and 4 in the following two weeks. Baseline data were collected before the first session (T0), and outcomes at six weeks (T1) and six months (T2). The primary outcome was fatigue impact (BRAF NRS Fatigue Effect), collected by telephone. Secondary outcomes included fatigue severity, fatigue coping, multi-dimensional impact of fatigue, disease impact and disability and measures of therapeutic mechanism (self-efficacy, and perceived confidence and autonomy to manage health). These outcomes were collected by post. This study allowed us to test the feasibility and acceptability of RHP training, study design and materials, intervention delivery and outcome collection, ahead of a possible RCT to determine intervention effectiveness. Results Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Four sessions were delivered by phone and none online. Session 2 was only delivered within the two-week time frame for 37% of participants attending both core sessions. Out of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 missing primary outcome responses and 27 missing secondary outcome responses. Results indicated improvements in all measures except disability at either T1 or T2, or both, with confidence intervals supporting an interpretation of improvement. Conclusion We were able to design and deliver FREE-IA training to RHPs, deliver FREE-IA sessions to patients, and collect outcomes at three time points with low levels of attrition. Outcomes in all measures except disability were in a direction to suggest improvement at T1, T2, or both. Study numbers were small, there was no control group and regression to the mean was a possibility. However, outcomes were in the direction to cautiously suggest benefit, and there is evidence of promise of the intervention. A definitive RCT is the next step to test clinical and cost effectiveness of the intervention. Disclosure S. Bridgewater: None. J. Lomax: None. B. Abbott: None. J. Adams: None. A. Berry: None. S. Creanor: None. P. Ewings: None. S. Hewlett: None. L. McCracken: None. M. Ndosi: None. J. Thorn: None. M. Urban: None. E. Dures: None.

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Metabolic Syndrome and Osteoarthritis Distribution in the Hand Joints: A Propensity-Score Matched Analysis from Osteoarthritis Initiative

The Journal of Rheumatology ◽

10.3899/jrheum.210189 ◽

2021 ◽

pp. jrheum.210189

Author(s):

Bahram Mohajer ◽

Robert Kwee ◽

Ali Guermazi ◽

Francis Berenbaum ◽

Mei Wan ◽

...

Keyword(s):

Metabolic Syndrome ◽

Propensity Score ◽

International Diabetes Federation ◽

Hand Osteoarthritis ◽

Cox Regression Analysis ◽

Hand Pain ◽

Hand Joints ◽

The Metabolic Syndrome ◽

Osteoarthritis Initiative

Objective To investigate the metabolic syndrome (MetS) association with radiographic and symptomatic hand osteoarthritis (OA). Methods Using 1:2 propensity-score-matching for relevant confounders, we included 2509 (MetS+896: MetS–1613) participants from the Osteoarthritis Initiative dataset. MetS and its components, according to the International Diabetes Federation criteria, were extracted from baseline data, including hypertension, abdominal obesity, dyslipidemia, and diabetes. We scored distinct hand joints based on modified Kellgren–Lawrence grade (mKL) of baseline radiographs, with OA defined as mKL≥2. In the cross-sectional analysis, we investigated the association between MetS and its components with radiographic hand OA and the presence of nodal and erosive OA phenotypes using regression models. In the longitudinal analysis, we performed Cox regression analysis for hand pain incidence in follow-up visits. Results MetS was associated with higher odds of radiographic hand OA, including the number of joints with OA (odds ratio, 95%confidence interval:1.32, 1.08–1.62), the sum of joints mKLs (2.42, 1.24–4.71), mainly in distal and proximal interphalangeal joints (DIPs:1.52, 1.08–2.14, PIPs:1.38, 1.09–1.75), but not metacarpophalangeal (MCP) and first carpometacarpal (CMC1) joints. Hand pain incidence during follow-up was higher with MetS presence (hazard ratio, 95%CI:1.25, 1.07–1.47). Erosive hand OA phenotype and joints' nodal involvement were more frequent with MetS (1.40, 1.01–1.97, and 1.28, 1.02–1.60). Conclusion MetS, a potentially modifiable risk factor, is associated with radiographic DIP and PIP OA and longitudinal hand pain incidence while sparing MCPs and CMC1. Nodal and erosive OA phenotypes are associated with MetS, suggestive of possible distinct pathophysiology.

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Effectiveness of Triamcinolone Hexacetonide Intraarticular Injection in Interphalangeal Joints: A 12-week Randomized Controlled Trial in Patients with Hand Osteoarthritis

The Journal of Rheumatology ◽

10.3899/jrheum.140736 ◽

2015 ◽

Vol 42 (10) ◽

pp. 1869-1877 ◽

Cited By ~ 14

Author(s):

Natalia de Oliva Spolidoro Paschoal ◽

Jamil Natour ◽

Flavia S. Machado ◽

Hilda Alcântara Veiga de Oliveira ◽

Rita Nely Vilar Furtado

Keyword(s):

Adverse Effects ◽

Repeated Measures ◽

Controlled Trial ◽

Hand Function ◽

Intraarticular Injection ◽

Pinch Strength ◽

Hand Osteoarthritis ◽

Triamcinolone Hexacetonide ◽

Link Type ◽

Pain At Rest

Objective.To evaluate the effectiveness and tolerance of intraarticular injection (IAI) of triamcinolone hexacetonide (TH) for the treatment of osteoarthritis (OA) of hand interphalangeal (IP) joints.Methods.Sixty patients who underwent IAI at the most symptomatic IP joint were randomly assigned to receive TH/lidocaine (LD; n = 30) with TH 20 mg/ml and LD 2%, or just LD (n = 30). The injected joint was immobilized with a splint for 48 h in both groups. Patients were assessed at baseline and at 1, 4, 8, and 12 weeks by a blinded observer. The following variables were assessed: pain at rest [visual analog scale (VAS)r], pain at movement (VASm), swelling (physician VASs), goniometry, grip and pinch strength, hand function, treatment improvement, daily requirement of paracetamol, and local adverse effects. The proposed treatment (IAI with TH/LD) was successful if statistical improvement (p < 0.05) was achieved in at least 2 of 3 VAS. Repeated-measures ANOVA test was used to analyze intervention response.Results.Fifty-eight patients (96.67%) were women, and the mean age was 60.7 years (± 8.2). The TH/LD group showed greater improvement than the LD group for VASm (p = 0.014) and physician VASs (p = 0.022) from the first week until the end of the study. In other variables, there was no statistical difference between groups. No significant adverse effects were observed.Conclusion.The IAI with TH/LD has been shown to be more effective than the IAI with LD for pain on movement and joint swelling in patients with OA of the IP joints. Regarding pain at rest, there was no difference between groups. Trial registration number: ClinicalTrials.gov (NCT02102620).

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