Effectiveness of a night-time hand positioning splint in rheumatoid arthritis: a randomized controlled trial.

Abstract

OBJECTIVE: To evaluate the effectiveness of a night-time hand positioning splint in patients with rheumatoid arthritis. DESIGN: Randomized controlled trial. METHODS: Fifty patients with rheumatoid arthritis were divided randomly into 2 groups. The study group used a night-time splint starting at baseline, while the control group used the splint only during evaluations. All patients attended evaluations wearing their splints, so that the assessor remained blinded to patient allocation. The splints used in the control group were stored in a cabinet between assessments. Participants were evaluated at baseline, 45 and 90 days, using the visual analogue scale for pain; the Jamar dynamometer for grip strength; a pinch gauge for pinch strength; a Health Assessment Questionnaire for function; the Disability of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb disability and symptoms; and a Likert scale for patient satisfaction with treatment. RESULTS: The groups were homogenous for all parameters at baseline. Pain, Health Assessment Questionnaire score, DASH score, grip strength and pinch strength were significantly different between groups over time and satisfaction with the splint was reported as "better" and "much better" by most participants. CONCLUSION: The use of a night-time hand positioning splint reduces pain, improves grip and pinch strength, upper limb function and functional status in patients with rheumatoid arthritis.