Occupational therapy for rheumatoid arthritis: A systematic review

Steultjens, Esther; Dekker, Joost; Bouter, Lex M.; Schaardenburg, Dirkjan van; Kuyk, Marie-Antoinette H. Van; Ende, C.H.M. van den

doi:10.1002/art.10801

Cited by 83 publications

(70 citation statements)

References 60 publications

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“…The independence of the assessors could not be guaranteed, as we included five reviews from our own research group. However, eight of the 14 reviews included were Cochrane reviews or used the same methodology as Cochrane eviews7 11 12,14,16,[18][19][20] and others were included in DARE in the Cochrane Library. Since the Cochrane Collaboration sets the standards for high quality research synthesis, we believe we have included mainly valid systematic reviews.…”

Section: Discussionmentioning

confidence: 99%

Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews

Steultjens

Dekker

Bouter³

et al. 2005

Clin Rehabil

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Objective: To summarize the research evidence available from systematic reviews of the efficacy of occupational therapy (OT) for practitioners, researchers, purchasing organizations and policy-makers. Data source: The search for systematic reviews was conducted in PubMed and the Cochrane Library (October 2004). Methods: The reviews included were those that utilized a systematic search for evidence with regard to OT for specific patient groups. Data were summarized for patient group, interventions, outcome domains, type of study designs included, method of data synthesis and conclusions. Results: Fourteen systematic reviews were included. Three reviews related to rheumatoid arthritis, four reviewed stroke and four focused on elderly people. Reviews of Parkinson's disease, multiple sclerosis, Huntington's disease, cerebral palsy and mental illnesses were also identified. The reviews of rheumatoid arthritis, stroke and elderly people showed evidence of the efficacy of OT in increasing functional abilities. Positive results were presented for quality of life and social participation in elderly people and stroke respectively. The efficacy of OT in all other patient groups is unknown due to insufficient evidence. Conclusion: This summary shows that elderly people and people with stroke or rheumatoid arthritis can expect to benefit from comprehensive OT. Evidence of the efficacy of specific interventions is sparse and should be addressed in future research. The evidence that does exist should be incorporated into OT practice.

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Section: Discussionmentioning

confidence: 99%

Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews

Steultjens

Dekker

Bouter³

et al. 2005

Clin Rehabil

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“…Splinting: Hand and wrist splints reduce pain and improve grip and functional ability while being worn, and resting splints reduce pain at night (Steultjens et al, 2002). There is no evidence as yet that splinting maintains function long-term or prevents deformity.…”

Section: Occupational Therapy (Ot) -Evidencementioning

confidence: 98%

Rehabilitation in rheumatoid arthritis: a critical review

Hammond

2004

Musculoskeletal Care

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This article considers the evidence for effectiveness and timing of rehabilitation for people with rheumatoid arthritis (RA). The Cochrane Library, DARE, Medline, Embase, CINAHL and AMED were searched to identify systematic reviews and randomized controlled trials evaluating rehabilitation interventions for people with rheumatoid arthritis. Many trials identified had methodological limitations (e.g. short follow-up periods, small sample sizes). Evidence to date is that symptomatic relief results from thermotherapy, laser therapy, acupuncture and assistive devices. In the short-term, comprehensive occupational therapy (in established rheumatoid arthritis), orthoses, and mind-body approaches can help maintain function. Over at least a one-year period, the following are effective in reducing pain and maintaining function: patient education and joint protection training using behavioural approaches; dynamic exercise therapy, hand exercises and hydrotherapy; and cognitive-behavioural therapy (in people with poorer psychological status). Many trials have recruited people with moderate to severe, established RA and relatively little is known about the long-term effectiveness of early rehabilitation, although this is becoming much more common in practice. Despite the increased availability of guidelines and systematic reviews, most conclude there is insufficient evidence for many areas of rheumatology rehabilitation. Further well-designed clinical trials are needed recruiting people with early disease using patient-centred outcomes.

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“…Checklists for evaluation of other designs including cohort and casecontrol designs have also been developed. 19 25 and other sources. 26 However, at the time of starting this development, no simple practical tools were immediately to hand.…”

Section: Pre-existing Research Appraisal Techniquesmentioning

confidence: 99%

Generating the evidence base for the National Service Framework for Long Term Conditions: a new research typology

Turner-Stokes

Harding

Sergeant³

et al. 2006

Clinical Medicine

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. This article describes the challenges and some proffered solutions towards development of the evidence base to support best practice in the management of life-long neurological conditions, which are the principal focus of the NSF. The inherent limits in current systems for appraisal of evidence and their lack of applicability to these conditions are discussed. A new typology of evidence is proposed, which acknowledges the importance of expert opinion from users, carers and professionals as well as encompassing a broad range of research designs. To apply the typology, a brief evaluation tool is presented, which provides simple assessment of both qualitative and quantitative research evidence in terms of design, quality and applicability, and is practical for use by clinicians. Preliminary testing and application in development of the evidence base for the NSF are described.

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Occupational therapy for rheumatoid arthritis: A systematic review

Cited by 83 publications

References 60 publications

Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews

Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews

Rehabilitation in rheumatoid arthritis: a critical review

Generating the evidence base for the National Service Framework for Long Term Conditions: a new research typology

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