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Systematic review of design and effects of splints and exercise programs in hand osteoarthritis
Author(s) -
Kjeken Ingvild,
Smedslund Geir,
Moe Rikke H.,
SlatkowskyChristensen Barbara,
Uhlig Till,
Hagen Kåre Birger
Publication year - 2011
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20427
Subject(s) - splints , medicine , physical therapy , osteoarthritis , randomized controlled trial , confidence interval , range of motion , meta analysis , physical medicine and rehabilitation , orthodontics , surgery , alternative medicine , pathology
Objective To describe and evaluate the design and effects of splints and exercise programs in hand osteoarthritis. Methods Controlled trials identified through systematic literature reviews were included. Design of splints and exercise programs were evaluated according to existing recommendations and classification systems. The risk of bias was assessed by 2 independent reviewers and effects were summarized descriptively or by meta‐analyses. Results Twelve trials were included in the review: 7 assessed the effect of splints, 3 the effect of exercises, and 2 a combination of splints and exercises. The results revealed a great variety in the design of splint and exercise programs. A meta‐analysis of the 2 randomized trials with low risk of bias demonstrated that splints significantly reduced hand pain at short‐term (<3 months) and long‐term (≥3 months) followup, with a standardized mean difference of 0.37 (95% confidence interval [95% CI] 0.03, 0.71) and 0.80 (95% CI 0.45, 1.15), respectively. Further, results from single trials indicated that hand exercises may reduce pain and increase range of motion and strength, while a combination of splints and daily exercises may reduce pain and stiffness and improve function. Conclusion There is consistent evidence that splints reduce hand pain, but limited evidence for the effects of hand exercises and a combination of hand exercises and splints in hand osteoarthritis.