Wrist splint can help rheumatoid arthritis patients

NEW YORK - Using a wrist splint can improve performance of some daily activities in patients with rheumatoid arthritis, according to Canadian researchers, but for some tasks splints can be a hindrance.

In a study published in The Journal of Rheumatology, the researchers examined the influence of wearing a wrist splint on performance of daily activities in 30 rheumatoid arthritis patients with wrist involvement. The subjects were an average of 57 years old and had rheumatoid arthritis for about 9 years.

Dr. Ada Pagnotta, of Jewish Rehabilitation Hospital, Quebec, and colleagues assessed pain, work performance, endurance and perceived task difficulty with the splint on and off.

Using a work simulator, the subjects performed 14 tasks -- 10 that assessed work performance and four that assessed endurance. The subjects rated pain, task difficulty and perceived splint benefit.

Pain was significantly lower in five tasks with the splint on, including three work performance tasks and two endurance tasks. There was no significant difference in work performance with the splint on versus off.

Endurance scores were always better with the splint on, according to the researchers. However, the differences were statistically significant on only one task - "pulling an electric cord."

On a 10-point scale, the average perceived splint benefit on the endurance and work performance tasks ranged from 3 to 5. The task with the highest perceived splint benefit was "chopping with a knife."

Overall, "17 percent reported less pain when using the splint, while 79 percent reported no difference," the team reports.

"When exploring the effects of the splint on work performance, 24 percent of participants had better work performance with the splint on, 62 percent had no difference in work performance, and 14 percent were worse," they note. "Forty-eight percent had improved endurance with the splint on and 20 percent had poorer endurance."

Pagnotta and colleagues conclude that "wrist splint prescription is not a simple process; clinicians and clients need to work together to determine the daily wear pattern that maximizes benefit and minimizes inconvenience."