Bobos P1, Lalone E2, Ferreira L2, Grewal R3, MacDermid J1
1University of Western Ontario, Health and Rehabilitation Sciences, London, Canada, 2University of Western Ontario, Mechanical and Materials Engineering, London, Canada, 3University of Western Ontario, Schulich School of Medicine and Dentistry, London, Canada
Background: Joint protection (JP) has been developed as a self-management intervention to assist people with hand arthritis to improve occupational performance and minimize joint deterioration over time.
Purpose: We examined the effectiveness of JP and usual care/control on pain, hand function and grip strength levels for people with hand osteoarthritis (OA) and rheumatoid arthritis (RA).
Methods: A search was performed in 5 databases from January 1990 to February 2017. Two independent assessors applied Cochrane's risk of bias tool, and a GRADE approach was adopted.
Results: For pain levels at short-term, we found similar effects between JP and controlstandardized mean difference (SMD) -0.00, 95% CI: -0.42 to 0.42, I2=49%, at mid and long-term follow-up JP was favored over usual care SMD: -0.32, 95% CI: -0.53 to -0.11, I2=0and SMD -0.27, 95% CI: -0.41 to -0.12, I2=9% respectively. For function levels at mid and long-term follow-up JP was favored over usual care SMD -0.49, 95% CI: -0.75 to -0.22, I2=34% and SMD -0.31, 95% CI: -0.50 to -0.11, I2=56% respectively. For grip strength levels, at long term JP was inferior over usual care Mean Difference (MD) 0.93, 95% CI: -0.74 to 2.61, I2= 0%.
Conclusion(s): Evidence of very-low to low quality indicates that the effects of joint protection programs compared to usual care/control on pain and hand function are too small to be clinically important at short-, intermediate- and long-term follow-ups for people with hand arthritis.
Implications: Future research should aim to be more specific for all the components of joint protection programs for better head to head comparisons.
Keywords: Joint Protection, Hand Osteoarthritis, Rheumatoid Arthritis
Funding acknowledgements: This study is supported by the Canadian Institutes of Health Research (CIHR) with funding reference number (FRN: 201710GSD-402354-282879).
Purpose: We examined the effectiveness of JP and usual care/control on pain, hand function and grip strength levels for people with hand osteoarthritis (OA) and rheumatoid arthritis (RA).
Methods: A search was performed in 5 databases from January 1990 to February 2017. Two independent assessors applied Cochrane's risk of bias tool, and a GRADE approach was adopted.
Results: For pain levels at short-term, we found similar effects between JP and controlstandardized mean difference (SMD) -0.00, 95% CI: -0.42 to 0.42, I2=49%, at mid and long-term follow-up JP was favored over usual care SMD: -0.32, 95% CI: -0.53 to -0.11, I2=0and SMD -0.27, 95% CI: -0.41 to -0.12, I2=9% respectively. For function levels at mid and long-term follow-up JP was favored over usual care SMD -0.49, 95% CI: -0.75 to -0.22, I2=34% and SMD -0.31, 95% CI: -0.50 to -0.11, I2=56% respectively. For grip strength levels, at long term JP was inferior over usual care Mean Difference (MD) 0.93, 95% CI: -0.74 to 2.61, I2= 0%.
Conclusion(s): Evidence of very-low to low quality indicates that the effects of joint protection programs compared to usual care/control on pain and hand function are too small to be clinically important at short-, intermediate- and long-term follow-ups for people with hand arthritis.
Implications: Future research should aim to be more specific for all the components of joint protection programs for better head to head comparisons.
Keywords: Joint Protection, Hand Osteoarthritis, Rheumatoid Arthritis
Funding acknowledgements: This study is supported by the Canadian Institutes of Health Research (CIHR) with funding reference number (FRN: 201710GSD-402354-282879).
Topic: Musculoskeletal: upper limb
Ethics approval required: No
Institution: Western University
Ethics committee: Faculty of Health Sciences Ethics Committee of Western University. Setting
Reason not required: Not applicable for systematic reviews
All authors, affiliations and abstracts have been published as submitted.
