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Evidence summaries

Occupational Therapy for Rheumatoid Arthritis

Occupational therapy may have a positive effect on functional ability in patients with rheumatoid arthritis. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 38 studies. The studies were grouped to 'comprehensive occupational therapy' (all six intervention categories included; 4 studies); 'training of motor function' (6 studies); 'instruction on joint protection and energy conservation' (5 studies); 'advice/instruction in the use of assistive devices' (one study); and 'provision of splints' (16 studies). No studies were identified concerning the interventions 'training of skills' and 'counseling'. The results of the best evidence synthesis shows that there is strong evidence for the efficacy of instruction on joint protection (an absolute benefit of 17.5 to 22.5, relative benefit of 100%) and that limited evidence exists for comprehensive occupational therapy in improving functional ability (an absolute benefit of 8.7, relative benefit of 20%). Indicative findings for evidence that provision of splints decreases pain are found (absolute benefit of 1.0, relative benefit of 19%).

Comment: The quality of evidence is downgraded by limitations in study quality and by inconsistency (heterogeneity in interventions and outcomes).

    References

    • Steultjens EM, Dekker J, Bouter LM, van Schaardenburg D, van Kuyk MA, van den Ende CH. Occupational therapy for rheumatoid arthritis. Cochrane Database Syst Rev 2004;(1):CD003114. [PubMed]

Primary/Secondary Keywords