National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Ann Rheum Dis. 2011 Aug;70(8):1447-52. doi: 10.1136/ard.2010.148668. Epub 2011 May 12.
Hand osteoarthritis (HOA) is a common joint disorder with an expected rise in prevalence due to the increasing ageing population, but with few available effective treatment options. The main aim of this study was to evaluate the effect of assistive technology (AT) in patients with HOA.
In this observer-blinded, randomised controlled trial, 35 patients with HOA (AT group) received provision of information and AT (assistive devices and splints), while 35 patients received information only (control group). Primary outcomes were activity performance and satisfaction with performance, measured by the Canadian occupational performance measure (COPM) on a 1-10 scale. Secondary outcomes included measures of disease activity, pain, fatigue and function. Outcome assessments were made at 3 months follow-up.
Of 70 participants randomised, 66 participants completed all assessments. Provision of AT was associated with improvement in the COPM performance score (mean difference (95% CI) in change scores 1.8 (1.1 to 2.6) and in the satisfaction score (1.7 (0.7 to 2.6)), indicating a moderate to large treatment effect (effect sizes 0.9). There was a significant improvement in the Australian/Canadian hand index function score in the AT group after 3 months (-0.4, p<0.001), and an adjusted mean difference between groups of -0.3 (p=0.06, effect size -0.5). No other differences were found in the secondary outcomes. Self-reported AT usage rate in the AT group was 92%, and participants rated their comfort with AT usage as high.
Use of AT is well tolerated and significantly improves activity performance and satisfaction with performance in patients with HOA. The trial is registered in the ISRCTN register (ISRCTN40357804).
手骨关节炎（HOA）是一种常见的关节疾病，由于人口老龄化的增加，预计其患病率将会上升，但目前有效的治疗方法却很少。本研究的主要目的是评估辅助技术（AT）在手骨关节炎患者中的疗效。
在这项观察者盲法、随机对照试验中，35 名手骨关节炎患者（AT 组）接受了信息和 AT（辅助设备和夹板）的提供，而 35 名患者仅接受了信息（对照组）。主要结局指标是加拿大职业表现量表（COPM）在 1-10 分范围内评估的活动表现和对表现的满意度。次要结局指标包括疾病活动度、疼痛、疲劳和功能的测量。在 3 个月的随访中进行了结果评估。
在随机分配的 70 名参与者中，有 66 名参与者完成了所有评估。提供 AT 与 COPM 表现评分的改善相关（变化评分的平均差异（95%CI）为 1.8（1.1 至 2.6）和满意度评分（1.7（0.7 至 2.6）），表明治疗效果为中度至较大（效应大小为 0.9）。在 AT 组中，澳大利亚/加拿大手部指数功能评分在 3 个月后显著改善（-0.4，p<0.001），且组间调整平均差异为-0.3（p=0.06，效应大小-0.5）。在次要结局方面没有发现其他差异。AT 组的自我报告 AT 使用率为 92%，参与者对 AT 使用的舒适度评价较高。
AT 的使用耐受性良好，显著改善了手骨关节炎患者的活动表现和对表现的满意度。该试验已在 ISRCTN 注册处（ISRCTN40357804）注册。
