Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis a systematic review.docVIP

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Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis a systematic review.doc

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Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis a systematic review

Yeetal.ArthritisResearchTherapy2011,13:R28 /content/13/1/R28 RESEARCH ARTICLE OpenAccess Effectsofrehabilitativeinterventionsonpain, functionandphysicalimpairmentsinpeoplewith handosteoarthritis:asystematicreview LiuzhenYe1,2,LeonidKalichman3,AliciaSpittle2,4,5,FionaDobson6,7,KimBennell6* Abstract Introduction:Handosteoarthritis(OA)isassociatedwithpain,reducedgripstrength,lossofrangeofmotionand jointstiffnessleadingtoimpairedhandfunctionanddifficultywithdailyactivities.Theeffectivenessofdifferent rehabilitationinterventionsonspecifictreatmentgoalshasnotyetbeenfullyexplored.Theobjectiveofthis systematicreviewistoprovideevidencebasedknowledgeonthetreatmenteffectsofdifferentrehabilitation interventionsforspecifictreatmentgoalsforhandOA. Methods:AcomputerizedliteraturesearchofMedline,theCumulativeIndextoNursingandAlliedHealth Literature(CINAHL),ISIWebofScience,thePhysiotherapyEvidenceDatabase(PEDro)andSCOPUSwasperformed. Studiesthathadanevidencelevelof2borhigherandthatcomparedarehabilitationinterventionwithacontrol groupandassessedatleastoneofthefollowingoutcomemeasures-pain,physicalhandfunctionorother measuresofhandimpairment-wereincluded.Theeligibilityandmethodologicalqualityoftrialswere systematicallyassessedbytwoindependentreviewersusingthePEDroscale.Treatmenteffectswerecalculated usingstandardizedmeandifferenceand95%confidenceintervals. Results:Tenstudies,ofwhichsixwereofhigherquality(PEDroscore6),wereincluded.Therehabilitation techniquesreviewedincludedthreestudiesonexercise,twostudieseachonlaserandheat,andonestudyeach onsplints,massageandacupuncture.Onehigherqualitytrialshowedalargepositiveeffectof12-monthuseofa nightsplintonhandpain,function,strengthandrangeofmotion.Exercisehadnoeffectonhandpainorfunction althoughitmaybeabletoimprovehandstrength.Lowlevellasertherapymaybeusefulforimprovingrangeof motion.Norehabilitationinterventionswerefoundtoimprovestiffness. Conclusions:Thereisemerginghighqualityevidencetosupportthatrehabilitationinterventionscanoffer signif