Evaluating hand surgery in patients with rheumatoid arthritis: Short-term effect on dexterity and pain and its relationship with patient satisfaction

Lankveld, Wim van; Bosch, P. Van't Pad; Schaaf, D. van der; Dapper, M. M. L.; Malefijt, Maarten De Waal; Putte, Leo van de

doi:10.1053/jhsu.2000.16361

Cited by 18 publications

(8 citation statements)

References 17 publications

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“…In 7 patients, SODA scores improved by 9 points or more, which is considered a relatively good change (11). After hand surgery in RA patients, a mean improvement of 4.4 points was found (12), with largest improvement after metacarpophalangeal implant arthroplasty (8.7 points) and arthrodesis of fingers or thumb (10.0 points). In a 1‐year observational study of 94 RA patients with a mean disease duration of 13 years, the SODA score decreased by a mean of 6 points (13).…”

Section: Discussionmentioning

confidence: 99%

Silver Ring Splints improve dexterity in patients with rheumatoid arthritis

Zijlstra¹,

Heijnsdijk-Rouwenhorst²,

Rasker³

2004

Arthritis & Rheumatism

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Objective. To study the effect of Silver Ring Splints (SRSs) on hand function in patients with rheumatoid arthritis (RA). Methods. RA patients with stable disease and finger deformities eligible for splinting received 1 or more SRSs. Primary outcome was dexterity, which was measured with the Sequential Occupational Dexterity Assessment (SODA). Secondary outcome measures were self-reported hand function (Dutch Arthritis Impact Measurement Scales 2), hand pain, grip and pinch strength, Disease Activity Score in 28 joints (DAS28), and patient satisfaction. Results. Seventeen patients (median age 65 years; median disease duration 21 years) received a total of 72 SRSs. After 1 year, 48 SRSs were regularly used. Two patients dropped out because of adverse events related to SRSs. In the remaining 15 patients, SODA dexterity scores increased significantly (median 71 at baseline, 81 at 3 months, and 85 at 12 months), Wilcoxon signed ranks test P ‫؍‬ 0.005 and P ‫؍‬ 0.026. DAS28 scores did not change at 3 months and improved slightly after 12 months (-0.5; P ‫؍‬ 0.019). Grip strength, self-reported hand function, and hand pain showed no significant changes. Eleven patients stated they would continue using their splints. Conclusion. SRSs can improve dexterity in selected patients with rheumatoid hand deformities. For a satisfactory result, careful patient preassessment and optimal adjustment of SRSs are essential.

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Section: Discussionmentioning

confidence: 99%

Silver Ring Splints improve dexterity in patients with rheumatoid arthritis

Zijlstra¹,

Heijnsdijk-Rouwenhorst²,

Rasker³

2004

Arthritis & Rheumatism

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“…Both tests were moderate to highly sensitive to change during the follow-up period. Pain is also one of the most commonly used outcome measures of hand surgery, and changes in hand pain has previously been shown to be related to patient satisfaction with the outcome of the surgical intervention [ 4 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Measures and time points relevant for post-surgical follow-up in patients with inflammatory arthritis: a pilot study

Sandqvist

Johnsson

Sturesson

et al. 2009

BMC Musculoskelet Disord

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BackgroundRheumatic diseases commonly affect joints and other structures in the hand. Surgery is a traditional way to treat hand problems in inflammatory rheumatic diseases with the purposes of pain relief, restore function and prevent progression. There are numerous measures to choose from, and a combination of outcome measures is recommended. This study evaluated if instruments commonly used in rheumatologic clinical practice are suitable to measure outcome of hand surgery and to identify time points relevant for follow-up.MethodsThirty-one patients (median age 56 years, median disease duration 15 years) with inflammatory rheumatic disease and need for post-surgical occupational therapy intervention formed this pilot study group.Hand function was assessed regarding grip strength (Grippit), pain (VAS), range of motion (ROM) (Signals of Functional Impairment (SOFI)) and grip ability (Grip Ability Test (GAT)). Activities of daily life (ADL) were assessed by means of Disabilities of the Arm, Shoulder and Hand Outcome (DASH) and Canadian Occupational Performance Measure (COPM). The instruments were evaluated by responsiveness and feasibility; follow-up points were 0, 3, 6 and 12 months.ResultsAll instruments showed significant change at one or more follow-up points. Satisfaction with activities (COPM) showed the best responsiveness (SMR>0.8), while ROM measured with SOFI had low responsiveness at most follow-up time points. The responsiveness of the instruments was stable between 6 and 12 month follow-up which imply that 6 month is an appropriate time for evaluating short-term effect of hand surgery in rheumatic diseases.ConclusionWe suggest a core set of instruments measuring pain, grip strength, grip ability, perceived symptoms and self-defined daily activities. This study has shown that VAS pain, the Grippit instrument, GAT, DASH symptom scale and COPM are suitable outcome instruments for hand surgery, while SOFI may be a more insensitive test. However, the feasibility of this protocol in clinical practice awaits prospective studies.

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“…The primary outcome measure was dexterity as measured by the Sequential Occupational Dexterity Assessment (SODA) (14–16). With the SODA, the patient performs 12 standardized tasks and an assessor scores the ability to perform every task (where 4 = able to perform in the requested way, 1 = able to perform in a different way, and 0 = unable to perform) and the level of difficulty in the performance (where 2 = not difficult, 1 = some difficulty, and 0 = very difficult).…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of two finger splints for swan neck deformity in patients with rheumatoid arthritis: A randomized, crossover trial

Giesen¹,

Lankveld²,

Kremers-Selten³

et al. 2009

Arthritis & Rheumatism

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Objective. To compare the effectiveness and acceptability of silver ring splints (SRS) and commercial prefabricated thermoplastic splints (PTS) in treating swan neck deformities in patients with rheumatoid arthritis (RA). Methods. Consecutive patients with RA and a mobile swan neck deformity were included in a randomized, crossover trial. In 2 different sequences, patients used both splints for 4 weeks, with a washout period of 2 weeks. Afterward, patients used the preferred splint for another 12 weeks. The primary outcome measure was dexterity measured with the Sequential Occupational Dexterity Assessment (SODA). Secondary outcome measures included other measures of hand function, satisfaction with the splints, and splint preference. Results. Fifty patients were included, and 47 (94%) of those completed the study. Eighteen patients (36%) had 1 swan neck deformity, whereas the other patients had 2 or more. The improvement of the total SODA score with the SRS (11.2; 95% confidence interval [95% CI] 8.1, 14.3) and PTS (10.8; 95% CI 7.5, 14.1) was similar (difference ؊0.5; 95% CI ؊2.2, 1.2). In addition, there were no significant differences in change scores regarding the other clinical outcome measures, or satisfaction. Twenty-four patients preferred the SRS, 21 preferred the PTS, and 2 patients chose neither. A comparison in the 12-week followup period yielded similar clinical outcomes, with the exception of a significantly higher score in 3 items of satisfaction in the SRS group. Conclusion. For patients with RA and a mobile swan neck deformity, SRS and PTS are equally effective and acceptable.

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Evaluating hand surgery in patients with rheumatoid arthritis: Short-term effect on dexterity and pain and its relationship with patient satisfaction

Cited by 18 publications

References 17 publications

Silver Ring Splints improve dexterity in patients with rheumatoid arthritis

Silver Ring Splints improve dexterity in patients with rheumatoid arthritis

Measures and time points relevant for post-surgical follow-up in patients with inflammatory arthritis: a pilot study

Effectiveness of two finger splints for swan neck deformity in patients with rheumatoid arthritis: A randomized, crossover trial

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