Occupational therapy (OT) can benefit patients in the early stages of rheumatoid arthritis (RA), a study of hand function has shown.
“Despite new, effective drugs, early OT programs may have their own importance in improving early RA,” write P Miossec (Hôpital Edouard-Hérriot, Lyon, France) and co-workers.
The randomized controlled trial compared a full information program versus no information in 60 patients with RA for less than 2 years and followed up the patients for grip strength and Health Assessment Questionnaire (HQA) score.
The multidisciplinary program included education on joint protection and twice daily wrist and hand exercises, OT training in motor function and skills, counseling, advice on use of assistive devices, and where helpful, splints to use during rest and overnight to prevent joint deformation.
After 3 months, patients who took part in the full information program experienced greater improvement in grip strength of both their dominant and non-dominant hands than controls. This was accompanied by a greater decrease in HQA score denoting a subjective improvement in function.
Controls then went onto complete the program and were re-assessed at the 6-month point. At this point, patients had achieved improvements in both grip strength and HQA similar to that recorded for the patients who had originally been assigned to receive the OT program.
“This study concluded that an OT program improved the function of both hands,” say Miossec et al in the Annals of the Rheumatic Diseases.
“Accordingly, rheumatology departments should provide early OT programs to everyone with early RA.”
Nevertheless, the team adds: “Long-term follow-up studies (5–10 years) are essential to evaluate whether these interventions can truly be preventive, in conjunction with the effects of drug treatment.”