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Research project: Effectiveness of silver ring splints in rheumatoid arthritis - Dormant - Dormant

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This project reviewed the immediate effectiveness of custom made small finger silver ring splints for people with hand rheumatoid arthritis in preventing hyperextension when conducting functional movement. This pilot research project applied a novel, three-dimensional measurement system to evaluate the effectiveness of silver ring splints during functional movement and explored individuals’ perceptions of using these splints on a daily basis.

Aim:

The research aimed to measure the immediate effectiveness of silver ring splints in controlling proximal interphalangeal joint (PIPJ) hyperextension during functional hand motion and to investigate individuals’ experiences and perceptions of wearing these splints.

Design:

A pilot, mixed methods observational study was conducted. Individuals were randomised into functional hand measurement with and without silver ring splints in place and interviewed using semi-structured interviews about their perceptions of these splints.

Setting and Participants:

Forty patients who had already received silver ring splints from the Rheumatology Department at the Royal Hampshire Hospital, Winchester were invited to take part.

Outcome measures:

The Vicon 3D motion analysis system was used to capture PIPJ motion whilst carrying out a standardised hand assessment task from the Southampton Hand Assessment Procedure. Semi-structured interviews were audio taped, transcribed and analysed using thematic analysis.

Results:

When silver ring splints were worn during a functional hand task there were statistically significantly lower levels of PIPJ extension and hyperextension (p = 0.00), PIPJ flexion was increased but not to significant levels (p = 0.43). Time taken to complete the functional task was significantly quicker when the splints were not worn (p = 0.02).

Three distinct categories emerged from the qualitative data with various themes identified within each. These categories related to importance of hand aesthetics, high levels of outcome expectancy of the splints and the importance of the impact of the splints in preventing further deterioration.

Conclusion:

Silver ring splints control PIPJ hyperextension whilst carrying out a functional power handgrip task but increased the time taken to carry out the functional task. Individuals rate the aesthetics of these splints very highly, they have high outcome expectations of the effectiveness of these splints and place more emphasis on the importance of these splints in preventing further joint deterioration than improving functional hand performance.

Project team

Prof Jane Burridge, Prof Cyrus Cooper, Dr Cheryl Metcalf
Ms Christina Macleod Senior Occupational Therapist Royal Hants County Hospital 

Project funder

Wessex Medical HOPE Charity

Associated research themes

Hand joint surgery
Health Technologies
Rheumatology
Musculoskeletal disorders

Related research groups

Active Living and Rehabilitation

Conferences and events associated with this project:

British Society of Rheumatology Annual Conference
European League against Rheumatism 2002-2010
National Association of Rheumatology Occupational Therapy National Conference

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