TY - JOUR
T1 - Commercial wrist extensor orthoses
T2 - A descriptive study of use and preference in patients with rheumatoid arthritis
AU - Stern, Erica B.
AU - Ytterberg, Steven R.
AU - Larson, Lea M.
AU - Portoghese, Caroline Parke
AU - Kratz, William N.R.
AU - Mahowald, Maren L.
AU - Krug, Hollis E.
PY - 1997
Y1 - 1997
N2 - Objective. To describe patients' functional uses of 3 commercial wrist orthoses, to describe patients' preference patterns for the orthoses, and to clarify orthotic attributes that are viewed positively and negatively. Methods. Using a cross-overdesign, 42 patients with definite rheumatoid arthritis used each of 3 commercial orthoses for one week. There was a one-week washout between each week of use. At the end of the study, private semi-structured interviews were conducted with each participant. Data from close-ended questions were tabulated. Open-ended data were analyzed using qualitative methods. Results. Patients reported that the 3 commercial wrist orthoses reduced wrist pain similarly, but that comfort and a sense of security during functional tasks were only found if the orthoses were comfortable and well-fitting. Most subjects preferred the padded, short forearm orthosis, though a small number found it uncomfortably warm, and many complained that it was difficult to use when wearing long-sleeved garments. Common complaints about the two elastic orthoses included chafing at the thumb webspace and chafing at the proximal closures. Longer forearm length was often perceived as providing unnecessarily high levels of wrist support. Conclusions. No single orthosis suited all subjects. Satisfaction with an orthosis appears to be based not only on its therapeutic effect, but also the comfort and ease of its use. To maximize patient satisfaction and improve the likelihood of appropriate fit and comfort, several styles of commercial orthoses should be available. The current trend toward restricted clinic stocks appears contrary to both therapeutic goals and patient satisfaction.
AB - Objective. To describe patients' functional uses of 3 commercial wrist orthoses, to describe patients' preference patterns for the orthoses, and to clarify orthotic attributes that are viewed positively and negatively. Methods. Using a cross-overdesign, 42 patients with definite rheumatoid arthritis used each of 3 commercial orthoses for one week. There was a one-week washout between each week of use. At the end of the study, private semi-structured interviews were conducted with each participant. Data from close-ended questions were tabulated. Open-ended data were analyzed using qualitative methods. Results. Patients reported that the 3 commercial wrist orthoses reduced wrist pain similarly, but that comfort and a sense of security during functional tasks were only found if the orthoses were comfortable and well-fitting. Most subjects preferred the padded, short forearm orthosis, though a small number found it uncomfortably warm, and many complained that it was difficult to use when wearing long-sleeved garments. Common complaints about the two elastic orthoses included chafing at the thumb webspace and chafing at the proximal closures. Longer forearm length was often perceived as providing unnecessarily high levels of wrist support. Conclusions. No single orthosis suited all subjects. Satisfaction with an orthosis appears to be based not only on its therapeutic effect, but also the comfort and ease of its use. To maximize patient satisfaction and improve the likelihood of appropriate fit and comfort, several styles of commercial orthoses should be available. The current trend toward restricted clinic stocks appears contrary to both therapeutic goals and patient satisfaction.
KW - Adherence
KW - Occupational
KW - Rheumatoid arthritis
KW - Therapy
KW - Wrist splint
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U2 - 10.1002/art.1790100105
DO - 10.1002/art.1790100105
M3 - Article
AN - SCOPUS:84988288938
SN - 2151-464X
VL - 10
SP - 27
EP - 35
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 1
ER -