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夜间手部定位夹板对类风湿关节炎的疗效:一项随机对照试验。

Effectiveness of a night-time hand positioning splint in rheumatoid arthritis: a randomized controlled trial.

作者信息

Silva Ana Carolina, Jones Anamaria, Silva Paula Gabriel, Natour Jamil

机构信息

Rheumatology Division, Federal University of São Paulo, Brazil.

出版信息

J Rehabil Med. 2008 Oct;40(9):749-54. doi: 10.2340/16501977-0240.

Abstract

OBJECTIVE

To evaluate the effectiveness of a night-time hand positioning splint in patients with rheumatoid arthritis.

DESIGN

Randomized controlled trial.

METHODS

Fifty patients with rheumatoid arthritis were divided randomly into 2 groups. The study group used a night-time splint starting at baseline, while the control group used the splint only during evaluations. All patients attended evaluations wearing their splints, so that the assessor remained blinded to patient allocation. The splints used in the control group were stored in a cabinet between assessments. Participants were evaluated at baseline, 45 and 90 days, using the visual analogue scale for pain; the Jamar dynamometer for grip strength; a pinch gauge for pinch strength; a Health Assessment Questionnaire for function; the Disability of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb disability and symptoms; and a Likert scale for patient satisfaction with treatment.

RESULTS

The groups were homogenous for all parameters at baseline. Pain, Health Assessment Questionnaire score, DASH score, grip strength and pinch strength were significantly different between groups over time and satisfaction with the splint was reported as "better" and "much better" by most participants.

CONCLUSION

The use of a night-time hand positioning splint reduces pain, improves grip and pinch strength, upper limb function and functional status in patients with rheumatoid arthritis.

摘要

目的

评估夜间手部定位夹板对类风湿关节炎患者的疗效。

设计

随机对照试验。

方法

50例类风湿关节炎患者随机分为2组。研究组从基线开始使用夜间夹板,而对照组仅在评估期间使用夹板。所有患者在评估时均佩戴夹板,以使评估者对患者分组情况保持盲态。对照组使用的夹板在两次评估之间存放在柜子里。在基线、45天和90天时对参与者进行评估,使用视觉模拟疼痛量表;Jamar握力计测量握力;捏力计测量捏力;健康评估问卷评估功能;上肢残疾和症状的手臂、肩部和手部残疾(DASH)问卷;以及患者对治疗满意度的李克特量表。

结果

两组在基线时所有参数均具有同质性。随着时间推移,两组之间的疼痛、健康评估问卷得分、DASH得分、握力和捏力存在显著差异,大多数参与者对夹板的满意度报告为“更好”和“好得多”。

结论

使用夜间手部定位夹板可减轻类风湿关节炎患者的疼痛,改善握力和捏力、上肢功能及功能状态。

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