Use of commercially produced elastic wrist orthoses in chronic arthritis: a controlled study.

ABSTRACT To examine the efficacy of wrist orthoses on pain, motion, and function of the wrist.
Consecutive patients were randomized to a treatment group using wrist orthoses or to a control group using no wrist orthoses, in a prospective, controlled, 6-month study.
Changes in wrist joint variables and general disease activity variables were not statistically different between the orthosis group (n = 36) and the control group (n = 33). Patients in the orthosis group had 25% and 12% improvements in grip strength and pinch grip and 50% reduction in pain while using the wrist orthosis.
Use of wrist orthoses improves function and reduces pain, but has no effects after 6 months, compared to a control group, on measures of local or general disease activity.

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    ABSTRACT: Rheumatic diseases and their resultant musculoskeletal and cardiopulmonary impairments are primary conditions limiting activity and function in older adults. Certain rheumatologic conditions such as polymyalgia rheumatica, degenerative spinal stenosis, and osteoporosis occur later in life. Other conditions such as rheumatoid arthritis, osteoarthritis (OA), and ankylosing spondylitis manifest at younger ages but their clinical manifestations may exacerbate with advancing age and concomitant changes in the musculoskeletal and sensory–motor systems, and with the coexistence of multiple comorbidities and polypharmacy. In fact, studies (Dunlop et al., Arthritis Rheum 44:212–221, 2001; Covinsky et al., J Am Geriatr Soc 56:23–28, 2008) indicate that older adults with arthritis are more limited in mobility and activities of daily living. Physical therapy interventions focus on restoration, maintenance, and promotion of maximal physical function (American Physical Therapy Association, Guide to physical therapist practice, 2003). The physical therapy model of practice is based on the International Classification of Function (ICF) [World Health Organization, International Classification of Functioning, Disability, and Health (ICF): ICF full version, 2001] and addresses patients’ needs at multiple levels across a continuum of care (Fig. 12.1). Physical therapy interventions for older adults with rheumatologic conditions aim to reduce pain; increase and maximize joint mobility; muscle strength; flexibility; aerobic capacity and to prevent functional loss. Interventions consist of exercise, physical modalities (e.g. heat, cold), skilled techniques such as joint mobilization/manipulation, and use of orthotics and assistive devices, combined with patient education. This chapter discusses the physical therapy management of six rheumatic conditions: polymyalgia rheumatica, spinal stenosis, osteoporosis, rheumatoid arthritis, OA, and ankylosing spondylitis. KeywordsPhysical therapy-Older adults-Arthritis-Polymyalgia rheumatica-Spinal stenosis-Osteoporosis-Rheumatoid arthritis-Osteoarthritis-Ankylosing spondylitis
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    ABSTRACT: We describe the design of an active soft ankle- foot orthotic device powered by pneumatic artificial muscles for treating gait pathologies associated with neuromuscular disorders. The design is inspired by the biological musculoskele- tal system of a human foot and a lower leg, and mimics the muscle-tendon-ligament structure. A key feature of the device is that it is fabricated with flexible and soft materials that provide assistance without restricting degrees of freedom at the ankle joint. Three pneumatic artificial muscles assist dorsiflexion as well as inversion and eversion. The prototype is also equipped with various embedded sensors for gait training and gait pattern analysis. The prototype is capable of 12 dorsiflexion from a resting position of an ankle joint and a 20 dorsiflexion from plantarflexion. Results of early feedback control experiments show controllability of ankle joint angles. Ultimately, we envision a system that not only can provide physical support to improve mobility but also can increase safety and stability during walking, while enhancing muscle usage and encouraging rehabilitation. I. INTRODUCTION In patients with neuromuscular disorders, such as stroke, cerebral palsy (CP), amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS), pathologies of the ankle-foot can result in abnormal gaits over time. Drop foot is one example. Due to the damage of the long nerves or of the brain/spinal
    2011 IEEE/RSJ International Conference on Intelligent Robots and Systems, IROS 2011, San Francisco, CA, USA, September 25-30, 2011; 01/2011
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    ABSTRACT: To compare the effectiveness of a custom-made leather wrist splint (LS) with a commercially available fabric splint (FS) in adults with chronic wrist pain. Participants (N = 25, mean age = 54) were randomly assigned to treatment order in a 2-phase crossover trial. Splints were worn for 2 weeks, separated by a one-week washout period. Outcomes were assessed at baseline and after each splint phase using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Canadian Occupational Performance Measure (COPM) and Jamar dynamometer by an observer blinded to treatment allocation. Both styles of wrist splint significantly reduced pain (effect size LS 0.79, FS 0.43), improved hand function and increased grip strength compared to baseline (all p < 0.05) with no increase in wrist stiffness. There was a consistent trend for the LS to be superior to the FS but this was statistically significant only for patient perceived occupational performance (p = 0.008) and satisfaction (p = 0.015). Lastly, 72% of patients preferred the custom-made leather splint compared to the commercially available splint. Leather wrist splints were superior to a commercially available fabric splint for the short-term relief of pain and dysfunction.
    BMC Musculoskeletal Disorders 01/2009; 10:129. · 1.88 Impact Factor