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Transcript of Effective Conservative Intervention Strategies for Arthritis of the Hand: Increasing Overall...
Effective Conservative Intervention Strategies for Arthritis of the
Hand: Increasing Overall Functional Ability
ASOT 2015 Vision in Action Conference
Jordan Towery, OTSJanuary 23, 2015
Research Question
Is joint protection demonstration/education the most effective treatment, to reduce
pain and increase hand function in patients with rheumatoid arthritis/osteoarthritis of
the hand?
Prevalence
Approximately 13.9% of adults <25 and 33.6% of adults <65 in the US have Osteoarthritis (CDC).
Approximately 1% of the US has been diagnosed with Rheumatoid Arthritis (CDC).
Patients typically are not seen in the clinic until in late stages of OA or RA presenting with severe deformities
Cause
Osteoarthritis◦Total joint breakdown including the cartilage, joint lining, ligaments, and contacting bone normally from overuse of specific joints.
◦Normally affects the body unilaterallyRheumatoid Arthritis
◦Auto-immune disease that affects the synovial fluid of a joint causing significant inflammation. This leads to erosion of the bone and cartilage making up the joint causing significant pain, swelling, and redness.
◦Normally affects the body bilaterally.
Joints Effected in the Hand
Osteoarthritis◦IPs◦DIPs◦CMC
Rheumatoid arthritis◦IPs◦MPs◦Inter-Carpal joints (wrist)
Treatments- Joint Protection
Educational-Behavioral Training
Psycho-educational training supporting behavior change
Occupational Based vs Cookie Cutter
Individualized and Client Centered
Treatments- Splinting
Custom vs Pre-fabricated
Functional day time splint
Night time splint
Patient education
Daily wearing journal
Treatments - Exercises
Simple easy to follow directions
Do not overwhelm the client with an hour a day
Begin with P/AROM exercises
Begin strengthening when max perceived AROM for that client has been reached
Again keep daily journal to hold client accountable
Functional Outcomes
Exercise
SplintingJoint
Protection
Decreased perceived pain, Decreased perceived stiffness, Increased grip strength, Increased
functional ability, Increased AROM
Questions
Email: [email protected]