1. Effective Conservative Intervention Strategies for Arthritis of the Hand: Increasing Overall Functional Ability ASOT 2015 Vision in Action Conference Jordan Towery, OTS January 23, 2015

2. Research Question Is joint protection demonstration/education the most effective treatment, to reduce pain and increase hand function in patients with rheumatoid arthritis/osteoarthritis of the hand?

3. Prevalence Approximately 13.9% of adults <25 and 33.6% of adults <65 in the US have Osteoarthritis (CDC). Approximately 1% of the US has been diagnosed with Rheumatoid Arthritis (CDC). Patients typically are not seen in the clinic until in late stages of OA or RA presenting with severe deformities

4. Cause Osteoarthritis ◦Total joint breakdown including the cartilage, joint lining, ligaments, and contacting bone normally from overuse of specific joints. ◦Normally affects the body unilaterally Rheumatoid Arthritis ◦Auto-immune disease that affects the synovial fluid of a joint causing significant inflammation. This leads to erosion of the bone and cartilage making up the joint causing significant pain, swelling, and redness. ◦Normally affects the body bilaterally.

5. Joints Effected in the Hand Osteoarthritis ◦IPs ◦DIPs ◦CMC Rheumatoid arthritis ◦IPs ◦MPs ◦Inter-Carpal joints (wrist)

6. Treatments- Joint Protection Educational-Behavioral Training Psycho-educational training supporting behavior change Occupational Based vs Cookie Cutter Individualized and Client Centered

7. Treatments- Splinting Custom vs Pre-fabricated Functional day time splint Night time splint Patient education Daily wearing journal

8. Treatments - Exercises Simple easy to follow directions Do not overwhelm the client with an hour a day Begin with P/AROM exercises Begin strengthening when max perceived AROM for that client has been reached Again keep daily journal to hold client accountable

9. Functional Outcomes Exercise Splinting Joint Protection Decreased perceived pain, Decreased perceived stiffness, Increased grip strength, Increased functional ability, Increased AROM

10. Questions Email: JTowery@spalding.edu